With India recording over 14000 fresh cases of Covid 19 yesterday, it is little wonder that we are completely immersed in Covid 19. The social media is agog with covid figures, positivity rates, fatality rates, the increased risks to people with co-morbid conditions and the elderly. The government policy making on Covid can best be described as bizarre, with new and often contradictory guidelines emanating from different mandarins. Essentially, we are drowning in Covid.
Yet, it is important we shift our attention to more mundane but equally pressing matters such as the care we need to provide to other patients who have serious medical conditions and cannot wait for Covid 19 to go away. These patients have been postponing their surgeries and treatment in the hope of going to a hospital, which is Corona free. Unfortunately, with the pandemic still running its course, hospitals are seeing only more and more covid patients. No one knows, when the situation will return to normal. Thus, waiting for covid 19 to subside does not seem to be a good idea anymore.
Patients requiring heart interventions, cancer treatments, tumour surgeries and even transplants should plan their surgeries because for them getting timely medical attention may be far more important than waiting for corona virus to go away. While, the fears of these patients are understandable, they must realize that a far greater danger lies in not seeking appropriate medical care when needed.
With the battle with Corona virus now over three months old, many hospitals have learnt their lessons and have built expertise in tackling Covid 19. They have created stand-alone facilities, developed isolation areas completely segregated from the covid areas and put in place stringent infection control measures to ensure not only the safety of the patients but also of their clinical and other staff. In the initial days of Covid 19, the hospitals were still figuring out ways of managing Covid patients, while ensuring safety of everyone else. Many healthcare workers (HCWs) caught the disease, were quarantined and even hospitalized and the media went to town highlighting such cases and painting hospitals as truly dangerous places. A lot of that was the usual media exaggeration and hype. Now, three months in the covid battle, the HCW infections have significantly come down, patient infections are almost nil and the media has gone quiet.
While, it cannot be disputed that patients in times of a pandemic will always face higher chances of infection, they must evaluate this risk against the risk of postponing a treatment, which can potentially be more harmful. This is clearly not an easy decision, as patients will hardly have sufficient knowledge to evaluate their options and make the right choice. Even if they had, the ability to grasp the nuances of the risk involved, many a times their doctors and the hospitals do not share the full details.
This should not be the case.
It is the responsibility of the clinicians to advise their patients about the urgency of a procedure required and the risks associated with a covid infection or the chances of an adverse outcome in the covid times. This is most crucial as the patient and her caregivers must have a clear understanding of the pros and cons of what they might be getting into. The clinicians must explain in sufficient details all the aspects of either catching a Corona infection or (as the case may be) of a greater probability of an unexpected outcome. They must share data supporting their views and enable the patients and their caregivers to make an informed and intelligent choice. Pushing the patient into a hurried surgery or delaying an urgent medical procedure are both equally dangerous. The patient deserves an honest opinion more than anything else.
The hospitals on their part must ensure that they help the doctors walk the talk. The clinicians can advise a patient only if they themselves are confident that the hospitals will be able to support them. The hospitals must demonstrate to their surgical teams that they are really equipped to handle these procedures with minimal risk to either the patient or the hospital teams including the surgeons. Their is no room for any slippages here and empty talk can prove hugely detrimental to the patients as well as the surgical team. They must realize that a surgeon operating a patient in covid times is doing so only because his patient needs the surgery and does not have the choice to wait out the pandemic. Unlike, other times, the medical team too is risking a potentially serious infection while operating the case. They know they have to be doubly careful for the patient’s sake as well as their own.
These decisions are not easy, either for the patients or for their doctors. They must be taken with great care after evaluating various options and understanding the risks to everyone. The medical teams and the patients are in this together, far more than in normal times.
The views expressed are personal