KOLKATA: Several private hospitals in the city have recorded a spurt in the number of non-Covid-19 patients — admitted for surgery or treatment for some other ailment — testing positive for Covid-19 during routine testing. This indicates wider transmission, something we should prepare for by having more Covid-19 beds across hospitals, feel experts.
Such patients are typically asymptomatic, and the discovery of the virus is often delaying treatment of their primary complaints.
A seemingly healthy 35-year-old, who got admitted at Fortis Hospital last week for surgery to remove pus that had formed around his spine, tested positive hours before he was to be wheeled into the operating theatre. He was completely asymptomatic, and the Covid report left even his doctors surprised. The surgery has now been deferred till he tests negative. At Medica Superspecialty Hospital, a patient who sought admission for gall bladder surgery tested positive. He, too, had no symptoms and his surgery was deferred by two weeks.
At Fortis, a 64-year-old tested Covid-19-positive after being admitted for surgery over a fractured femur. He has been shifted to the isolation unit, awaiting recovery.
Hospitals are deferring surgeries on Covid-19 patients, waiting for them to test negative, as the ailment increases mortality rate.
“Apart from the fact that Covid-19 patients have impaired immunity, the virus often triggers vascular anomalies, which may lead to myocardial infarction or a brain stroke. So, unless there is an emergency, it’s advisable to wait till the patient tests negative,” said Fortis pulmonologist Raja Dhar.
Since private hospitals resumed elective surgeries in early May after a month-and-half Covid-induced break, a Covid test has been made mandatory. Around 10%-15% of patients without symptoms seeking admission have tested positive across hospitals, leading the latter to alter their treatment plan. AMRI, for instance, now asks patents to get the test done a day before admission so that they can stay in home quarantine and recover if they test positive. “If the symptoms are mild or absent, which is often happening in the case of surgery patients, they can stay at home without wasting time at the hospital. It also helps to free up beds for symptomatic Covid patients,” said AMRI CEO Rupak Barua.
Medica Superspecialty Hospital, too, has been testing patients before taking them in. Around 10%-12% seeking admission at the hospital have tested positive over the last one month, said chairperson Alok Roy. “We have had patients seeking cardiac, gall bladder, appendectomy and hernia surgeries testing positive. Even a snake-bite patient was found to have the virus. We are advising home quarantine, unless the symptoms are severe,” said Roy.
Even though Covid patients with mild or no symptoms can recover at home, those with co-morbidities that require treatment should be admitted, felt Dhar. “While managing such patients at home could be difficult, we are asking the rest to opt for home quarantine. In case of co-morbid patients, we are offering an option to return to home quarantine in case their condition turns manageable after three days,” added Dhar.
All surgical and procedural patients are being tested for Covid before admission at RN Tagore International Institute of Cardiac Sciences (RTIICS). “We are seeing several patients who are being worked up for surgery showing Covid-positive results. The majority of them are asymptomatic, and hence they are placed on home isolation under remote supervision of our physicians for 14 days, as prescribed by government guidelines for asymptomatic/mildly symptomatic patients. They need not unnecessarily stay in the hospital, awaiting Covid results,” said RTIICS zonal director R Venkatesh.
He added that emergency patients were admitted in a holding area, which is in a separate building from the other non-Covid patients, and tested for Covid. “Emergency surgery, if required, is done without waiting for Covid results, with full PPE assuming that the patient may be positive. Once the results arrive, a decision is made regarding further management,” said Venkatesh.