30 Aug 2020  |   04:30am IST

HOW TO REDUCE THE DEATH RATE IN COVID HOSPITAL

HOW TO REDUCE THE DEATH RATE  IN COVID HOSPITAL

M D Phal

SI Covid Hospital in Margao was the only Hospital in Goa till recently equipped to treat coronavirus patients. Very few know the functioning of this hospital as nobody is allowed inside the hospital since it is occupied by Covid-19 positive patients. My close relation was admitted in this hospital for 12 days for treatment and died on the 12th day. His wife who was also Covid-19 positive was accompanying him throughout. Some of the observations made by her are given below:

When the patient is admitted in the hospital, he’s taken to the fourth floor & based on his severity he is shifted to 3rd floor & 2nd floor of the hospital. The 2nd floor is equipped with ICUs & ITUs. This is as per their protocol/SOP.

Irrespective of severity in the patient, everybody is accommodated on the 4th floor & administered the normal treatment of COVID-19. In the process the condition of those patients having severe infection worsens. By the time he is taken to the 2nd floor 5 to 6 days lapse and he needs high–force oxygen support or ventilator.

Whatever effective treatment is administered to him at this stage, including injection Remdesivir or plasma, in a majority cases the patient doesn’t respond positively and he/she dies.

All cases that come to ESI Hospital, are directed from the quarantine centers operated by government.

After the Covid test is administered & the cases with severe infection if they’re directed to ESI hospital & if Covid hospital at the initial stage puts them on 2nd floor with Remdevisir or plasma then there are bright chances of survival of the patient. Unfortunately the government testing centres are sending all the patients to quarantine centers irrespective of their severity & when the condition of the patient starts deteriorating he is shifted to ESI Hospital. After reaching ESI Hospital another delay of 5-6 days takes place for the patient’s movement from 4th floor to 3rd floor to 2nd floor. And it is too late - the net result is death.

My relative who tested positive in ID Hospital Ponda on July 19, 2020 was placed in quarantine centre, Farmagudi on the same day. He was there for 3 days. Thereafter on the 4th day (i.e July 23, 2020) he was shifted to ESI hospital at 9.30am. He was allotted a bed at 6pm & was sitting on a bench for the full day & was almost exhausted. In the meanwhile his chest X-Ray was taken & infection was found in his lungs. Thereafter he was on the 4th floor for 2 days & shifted to 3rd floor on July 25, 2020 & remained there for 3 days till July 27, 2020. On July 28, 2020 he was shifted on 2nd floor in the ITU and administered central high flow oxygen. He was administered Remdivisir injection from July 30 to August 3 - a course of 5 injections. During this period, outwardly his condition was improving considerably. Last injection was given to him on August 3 & on August 4 at 6.30pm he breathed his last. It appears that there was medical complication.

We have a strong feeling that if my relative could have been taken to ESI hospital immediately after testing positive (without 3 days quarantine at Ponda) and he was admitted on the 2nd floor in ITU in ESI hospital with administration of Remdevisir immediately (which was given to

him on 7th day of admission), then probably there were all chances of his survival. This feeling is supporting particularly after reading the statement of Dean GMC as mentioned above.

Another observation is about the management of ESI Covid hospital, is the food served to the patients – the quality of food is very bad in all respect. The patients having high diabetic conditions & those on insulin are given breakfast/food after 1 hour or so which is against medical norms. Besides they are supplied prohibitory foods containing starch & carbohydrate & bakery product like pao/poi etc.

Another observation is the medical staff/health workers are less than required. At times one nurse is available on an entire floor. The number of doctors/nurses and other staff are always short in number in each shift.

Once the patient is admitted in the hospital, his family members have no source of information about his progress/regress. Floor-wise telephone numbers displayed by the hospital are of absolutely no use. The family will come to know after his return fully cured or death.

Generally the serious Covid patients who are brought to ESI hospital are from slums or belonging to poor families. Therefore there is no possibility of finding fault with the treatment/management of Covid hospital. The information/version given by GMC in this respect is considered as authentic & final.

If the authorities can look into above observations with open mind & initiate to do some corrections then hopefully the daily death rate could be brought down drastically.


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