How Covid war is hurting India's non-Covid patients

With the country’s entire healthcare set-up working towards fighting Covid-19, patients of diseases like HIV, cancer and renal disease who need to access hospitals regularly to continue their treatment, and are immuno-compromised, are facing quite a bit of hardship with most OPDs and operation theatres closed.Cancer treatment on pauseTake Maitri, who was in the middle of treatment for oral cancer at AIIMS, Delhi, when the lockdown happened. On March 13, she was told she needed an urgent surgery. Now, all OPD services are shut in AIIMS and doctors are not doing any surgeries. She is in severe pain and ulcers on her tongue have started bleeding. “We have to go to the AIIMS emergency almost every day because nothing else is open. They give us some painkillers and try to control the bleeding but say they can’t do anything further as the government has ordered a shutdown of all other services," said Maitri's husband. medium74950805Rajvinder of Cansupport, a Delhi-based organisation which helps cancer patients, said their teams were not even being able to visit patients on palliative care due to lack of transport during the lockdown. “Almost all outpatient chemotherapy services have shut down. Safdarjung hospital’s medical oncology department is working but most people who need chemotherapy are unable to get there,” said Rajvinder, expressing frustration at the way health services for patients of anything except Covid-19 were being denied.Asha Mehta, who is undergoing an expensive immunotherapy treatment for stage-3 colon cancer in Bengaluru, says as a cancer patient in lockdown, she feels like she is stuck between a rock and a hard place. “My treatment is running late by a week and a half, but with the current lockdown, we are not sure what is worse…staying indoors and delaying treatment or going out and exposing yourself to infection. My doctor has to take a call on this soon,” said Mehta, who has turned to online cancer support networks to deal with all this stress. In private hospitals, oncologists are trying to figure out what’s immediate and what can wait. “For example, in some breast cancer patients there’s robust evidence to show that giving a tablet a day can take care of the disease for next few months and surgery can be done later on a smaller tumour. But if cancer has hit lymph nodes, then the patient needs immediate surgery,” said Dr Nitesh Rohtagi, medical oncologist, Max hospital, Delhi.HIV patients more vulnerable In Mumbai, Ganesh Acharya, an HIV patient and activist with Humsafar Trust, says HIV patients are not able to reach their local ART centres for medicines. “Those who are on second and third line drugs are facing even more problems as these medicines are available only in bigger hospitals. They are missing their daily doses which will definitely bring down their immunity and make them more susceptible to getting co-morbidities like TB,” said Acharya, who gets close to 100 SOS calls daily. He adds that unavailability of food is also compromising patients’ immunity. “Someone called to say that he has been surviving on pav for the past four days,” added Acharya. Treatments for diabetes, kidney ailments, thalassemia affectedDialysis patients have been sending SOS on their social media groups for medicines and the difficulty in reaching dialysis centres. While in some cities like Hyderabad the police have been issuing passes for dialysis patients and arranging ambulances for their transport, in many others patients have complained about police stopping them despite showing them their doctor’s letter.Most government hospitals are dedicated to treating coronavirus cases and private hospitals, which provide free dialysis under government healthcare schemes, have been unable to do so, citing lack of staff. medium74950893“I have been turned away by four different hospitals citing the same reason. Two hospitals I went to had unending queues. Even at 10 pm I was told that I might get a slot only after the regular Aarogyasri and Employee Health Scheme (EHS) patients. It is difficult to get service as a first-time patient in any hospital,” said Shaikh Khaiser, who ended up paying Rs 4,000 for a dialysis session at the empanelled private hospital where he is a regular.Costs of empanelled private hospitals offering paid service are unaffordable for many. Worse, even for paid dialysis, hospitals are cutting down on time, which means symptoms start showing within two days. Says Dr B Nagender, superintendent, Osmania General Hospital, “We are trying to accommodate maximum number of patients but are completely overloaded.” OGH, one of Hyderabad's two hospitals providing other treatments, is running full house.“It is extremely important for dialysis patients to continue their regular treatment and take extra precaution...Skipping dialysis leads to serious adverse effects and increases risk of hospitalisation,” adds Dr JL Ranganath, a Hyderabad-based senior consultant nephrologist.Senior citizens die unattended at homeOn April 1, officers of Kolkata’s Bidhannagar North police station received a call from a resident about a stench coming from a house. “On reaching, we found a 40-year-old man, Sourav Mukherjee, lying dead on a sofa on the first floor and his sister crying beside him,” said an officer. Mukherjee, a diabetic who had suffered a cerebral attack, was ill and needed medical attention. “His relatives tried to admit him to three hospitals but had to take him back home,” said local councillor Anindya Chatterjee.A 70-year-old former Reserve Bank of India official who lived alone was found dead in his bathroom. His domestic help had stopped coming to work since the lockdown. medium74951213Said Bidhannagar Municipal Corporation mayor Krishna Chakraborty, “It’s a scary situation with domestic helps and neighbours not being able to pay visits during the lockdown. Elderly and ailing are completely helpless.”On his part Chakraborty has asked all his councillors to make a list of elderly persons living alone in their wards and go and check on them.Inputs by Amrita Didyala in Hyderabad and Tamaghna Banerjee in Kolkata Untitled Carousel 74958205