Doctors dilemma starts to start or not to start services.

Doctors dilemma starts to start or not to start services since corona virus pandemic has brought out problems unforeseen.How can we see a patient as a non covid19 patient?

Corona virus pandemic has brought out problems unforeseen. There were many pandemics in the past, and there will be many in future. Plague, Spanish flu of 1918, flu of 1957, 1968 and the latest was 2009 H1N1 flu. These pandemics spanned across many continents killing many million. But the problems are for today, for the current generation and for the existing technology at this point.Though medical field had a set of problems to deal, now the spectrum of problems have diversified. More advanced the system is, more problems we would encounter.

Today we see a lot of doctors working in the corona virus duties where they directly come in contact with the patients like, fever clinics, Inpatients ward, quarantine facilities, isolation wards, ICU’s and rarely emergency surgeries. But there are lot more procedures and OPD consultations done which are considered non-essential at this point. To name a few we have vaccines, troublesome nonmalignant tumors, K-wire removals, dilatation and curettage’s, back pain, neck pain and what not. This is just the tip of the iceberg.

Endless calls and messages keep pouring to doctors and hospitals everyday by patients regarding the functioning of these services. But what is to be highlighted here is there is no clear cut distinction between those essential visits/procedures to non-essential ones. A simple swelling may turn out to be a tumor and a severe abdominal pain may be just a lymphadenitis. This is where our dilemma starts to start or not to start those services.

There has been many reports of deaths due to non-coronavirus illness, where neither nursing staff nor the treating doctors are ready to take chances on that. Many smaller facilities like private clinics and small nursing homes may not be prepared to handle the situation, though the intent is there to help it has put the healthcare workers in a very sticky spot. Lawmakers want these facilities to be opened with some restrictions, and here is where the dilemma mounts.
How can we see a patient as a non covid19 patient?
How can we see a patient as a non covid19 patient? That is simply not possible at this point. To quote an example whenever a surgery or procedure happens screening happens for hepatitis B and HIV and we get results in few minutes to hours. But in this case it takes around 2 days for the diagnosis in RT-PCR technique and rapid antibody test in few hours. Second issue is the cost prohibition, we cannot keep doing this to every person who walks in to the facility. Here it is just not the patient, even the attender may be carrying the disease.

As the days go by we see a lot of doctors and the medical staff being quarantined and many of them turning positive. We recently saw death of a doctor in Indore. Though the source was traced it was late and the doctor succumbed. Was it foolish to go to work, brave or desperation or the concern for the patient? All this is post hoc analysis, but death did happen and infections continue to spread among the healthcare professionals. We recently saw a covid 19 patient suing the doctor for treating patient for another disease and at the same time spreading the disease.

As such summer is pretty healthy season, we happen to see less number of patients, on top of that national lockdown has nosedived common infections. But the non-infectious diseases still happen. All said and done the dilemma to run a small facility continues and there seems to be no logical end for this at this point. All we can do is work towards corona virus cases to come under control with efforts from both people and from the governments end.