Despite ICMR guidelines, hospitals liberalize testing
“Asymptomatic patients undergoing invasive surgical/non-surgical procedures, including pregnant women in labor/near labor who are hospitalized for childbirth, should not be tested unless warranted or symptoms develop. develop,” the new guidelines state.
The number of Covid-19 tests in the capital has fallen sharply since new guidelines scrapped on-demand testing for asymptomatic patients, low-risk contacts of a positive patient and asymptomatic people hospitalized for other procedures .
A senior Delhi government official told The Indian Express government sample collection dropped by two-thirds after the guidelines came into force.
At the All India Institute of Medical Sciences (AIIMS), a senior administrator said, “The guidelines have been issued by the ministry and we need to implement them.”
Doctors at the hospital, however, said tests were carried out regularly before admitting patients, transferring patients to other departments, as well as before procedures.
“Unless it is a life-threatening emergency, we test patients before any intervention. Patients are also tested before being moved from one ward to another. There is no bypass. Even an asymptomatic person can spread the infection to other sick patients on a ward and we don’t know who will get serious illness. Not to mention the healthcare workers exposed,” said a doctor at the hospital, speaking on condition of anonymity.
At Safdarjung Hospital, patients are tested using a rapid antigen kit upon admission. They are transferred to the Super Specialty Block’s isolation ward if they test positive; if they are symptomatic but the test is negative, they are sent to the suspect block in the same building; if they are asymptomatic and the test is negative, they are admitted to other services.
“Patients go through so many tests when they have to have a procedure in hospital. Adding a Covid-19 test doesn’t add too much time and effort. Failure to do so would mean exposing countless other people to infection. We ask for the test when patients are due for surgery or tests such as a CT scan or MRI,” a doctor at the hospital said.
Given the transmissibility of the new variant, dozens of healthcare workers have tested positive in recent weeks, leading to a labor shortage.
“Seventy-one of our 380 nurses tested positive within three days of the start of the increase in cases. It was becoming very difficult to run the hospital. But that’s not the only reason we get our patients tested before planned surgery,” said Dr. Sumit Ray, Medical Superintendent of Holy Family Hospital.
He said: “There is no evidence so far to suggest that the surgical outcome will not be worse in people with active infection. Outcomes for patients with Covid-19 were poor in the previous two waves. If it is a life-saving emergency surgery, of course it has to take place and is happening without a test. But why try your luck with elective surgery? they can just come back in about 10 days and get it.
Another senior doctor from a major private hospital in the city said, “We are also accountable to the families. What happens if other people in a ward are infected or the outcome of surgery is not good? We will be prosecuted. We have to do the test.