DIMAPUR, JUNE 9: After questions over infrastructure and healthcare facilities in the State, now concerns have been raised over the preparedness of some healthcare workers, and their delivery of services while treating COVID-19 patients.
Recent incidents at Dimapur in particular has brought into sharp focus the need for some doctors to keep pace with latest medical updates concerning COVID-19, as much as their behaviour towards patients.
A young man in his early 30s was advised home isolation by a doctor at a private Hospital here after testing positive for COVID-19.
“His oxygen levels kept fluctuating 5 days after testing positive and symptoms became prevalent. Oximeters at home helped monitor the oxygen levels”, the wife told Nagaland Page on Wednesday.
Then he started showing signs of chest contrition, shortness of breath, and unbreakable high grade fever for many days.
When consulted, the doctor told the wife these were “normal symptoms of COVID”.
“Being a Public Policy Analyst, I was aware of medical journals published by Johns Hopkins University, Oxford University, and Op Eds on the virus progression by international doctors on New York Times, Independent, Economic Times, etc., as well as guidelines on Public Health by ICMR, IMA, AIIMS, on the national-level”, she said.
Unconvinced by the doctor’s response, the wife consulted another doctor working outside Nagaland, who advised her to conduct a 6-Minute Walk Test (6MWT) at home using an odometer, and arrange an X-Ray.
According to her, the X-Ray results showed early signs of COVID pneumonia.
“Had I not insisted on opinions from doctors elsewhere, my husband would’ve ended up on a ventilator by end of the week as the disease progressed”, she shared.
Pointing out that the virus has mutated at an alarming rate, she suggested that Hospitals need to monitor patients and immediately conduct X-Rays and important blood work such as complete blood count and CR protein (CRP tests) to determine the progress of attack on the lungs by the virus.
“To my knowledge, the Dimapur District Hospital is vigilant of these tests. I cannot say about private Hospitals. The public must be aware of how aggressive the new strain has become. Public must conduct 6-Minute Walk Test with Oximeter at home and proning exercises, if tested positive to maintain oxygen saturation at home.
“I can’t say if hospitals are following guidelines to the extent laid out by the ICMR, IMA or WHO. But they must update themselves on medical journals and articles by experts all over the world. New articles/medical journals were out as latest as May (last month)”, she said.
According to her, Health Authorities must be more vigilant with home isolation cases and private Hospitals too need to follow guidelines set up by experts such as pulmonologists, epidemiologist, virologists, etc.
“I understand that the health system and frontline workers have been spread thin because of the failing system. I hope the Government wakes up to this situation and step up the fiscal responsibility it owes to the public with its health and welfare policies”, she stated.
In another case, a woman was admitted to a private Hospital at Dimapur on June 5.
“She had difficulty breathing and symptoms were similar to that of COVID-19. We took her to the hospital where they gave her a Rapid Antigen Test which came out negative (which is inconclusive). They did a CT scan and, according to them, it confirmed she had COVID-19 and was diagnosed with COVID pneumonia. She was immediately admitted to the general COVID ward following COVID protocols. We requested for a cabin but were denied”, said the woman’s nephew to Nagaland Page.
Three days later, her oxygen levels stabilised and haemoglobin blood count was also neutralised (she has a prior health issue i.e. anaemia).
So the doctor, who had consulted her in the morning, declared she could be discharged either that day or the next.
“Even though our family was thrilled by the news of her speedy recovery, we grew a bit wary and suspicious about the whole situation”, he said, adding that he decided to visit the hospital and speak with the COVID Duty Doctor.
“This is when I found out that no following confirmatory test was done to back up the diagnostic made from the CT scan, which is also protocol. I was explained that they usually just administer a Rapid Antigen Test because the results were quicker. I addressed my concerns with the doctor on duty who was already very defensive, dismissive and rude from the get go. I stated that if by any chance she wasn’t COVID-19 positive at the time of admission, then that would mean she was possibly exposed to the virus for 3 days in the COVID ward.
“He said that wasn’t a possibility and questioned me if I was challenging their professional capability. I disagreed with him on that and asked him if there might be room for error in this situation. It was assured to me that if she took the TrueNat test that day, it would turn up positive. We ended the conversation there. Then I took it upon myself to get a TrueNat test for the patient, but before I had the chance to do so, he (the doctor) had already administered one without mentioning it to me. And the result of that test turned out to be negative”, he shared.
According to him, when he took the results to the doctor seeking an explanation, he continued to be “unprofessional and condescending” and told him that they’d arranged a cabin for the patient (after he had denied the request for a cabin earlier that day).
“After a point, he just snatched the test result from my hand and walked away deliberately choosing to ignore me when I prompted him”, he said.
Later that night, he reportedly received calls from the dayshift Doctor and the Supervisor, assuring him that there couldn’t have been any error “and making excuse for the fact they didn’t administer a confirmatory test, and only did it 3 days later, that too only after I questioned them”.
“The Supervisor mentioned how their hospital was still new to opening its doors to COVID patients and how they were still ‘learning the ropes’, and made excuses for the unprofessionalism of the Doctor telling me that he is very new to COVID duty; and as for his behaviour, it is just ‘how he is’”, he said.
For now, the family is waiting for the right time to get another antibody test done to “completely confirm our suspicions because even her husband got the COVID test and his results are negative”, he informed.
This allegation of rude behaviour is not limited to the doctors but extends to the nurses as well.
On June 4, a 62-year-old woman with cancer was admitted to another private Hospital here.
Her daughter told Nagaland Page that post-radiation, her mother had bladder infection and was told to admit to the Hospital.
Per protocol, she was required to undergo COVID test, which returned positive.
She was put in the COVID ward. “And she was told to follow the dos and don’ts chart they had put on the wall”, the daughter said.
Other than that, she said, there were no instructions from any of the hospital workers. “When we asked the nurses, they said they don’t know. They would say that they’ll ask the doctor and inform us, but never did. They were not very attentive and were very rude”, the daughter shared.
Citing the timetable provided by the Hospital, she said the doctors were supposed to conduct two rounds in a day, one each in the morning and evening. “But they never came in the morning”, she informed.
“My mother was asked to do an Ultrasound by her Doctor. But later, the nurses said they cannot do it as my mother is a COVID patient”, she said.
According to the daughter, they have experienced similar behaviour from the nurses at another private Hospital at Dimapur previously.
She said that it was too risky to take a serious patient to a private Hospital at Dimapur because “the Management there is too slow at taking decisions”.