Elective surgeries take a beating in COVID-19 chaos

Updated: May 20, 2020, 07:21 IST | Vinod Kumar Menon | Mumbai

While some non-COVID hospitals have resumed elective procedures, the costs for patients have gone up considerably owing to PPEs and other measures

Chandra Wilson's surgery has been indefinitely postponed; (right) her MRI scan showing the lump
Chandra Wilson's surgery has been indefinitely postponed; (right) her MRI scan showing the lump

With a third extension to the nationwide lockdown, and most hospitals running out of ICU beds, pre-planned and elective surgeries have been put on hold for a long time now. This has left thousands of patients across the country in a lurch, with the ones undergoing non-COVID treatment/surgery, coughing up an additional cost. This is for the PPE gears and other measures that private hospitals take.

Dombivli resident Chandra Wilson is one such patient. The 63-year-old was to get operated for a lump in her left back below the shoulder blade at Jupiter hospital on March 26 but it was indefinitely postponed amid the crisis even as Wilson continues to live in pain.

"I never sensed the presence of a lump until recently when I started experiencing pain. After visiting a number of doctors and undergoing some medical examinations, it turned out to be a non-cancerous lump. However, the surgery is a must as the size of the lump is growing," said Wilson, adding, "I will now have to repeat the tests before the next surgery date. Until then, I will have to bear with the pain."

The situation is also grim for Vile Parle's Rajeshwari Sagar who underwent surgery for her uterine cancer on March 19 at Tata hospital in Parel. The 74-year-old was advised radiotherapy post-operation, but the lack of transport facility has put that on hold. Her 81-year-old husband Mukund said, "My wife is doing much better post the surgery. But we were supposed to start her therapy before she got discharged but it has been postponed now."

Low turnout for elective procedures
Dr Ketan Vagolkar, professor of surgery at DY Patil medical college in Navi Mumbai, said, "Usually I perform three to four elective surgeries every week, which have been put on a complete hold due to COVID. Also, those undergoing surgery in this scenario, have to undergo a mandatory COVID test and bear the expenses of PPE used by the doctors and hospital staff. However, it will not affect patients with an insurance cover."

While emergency surgeries are taking place, elective surgeries were suspended in the initial three lockdowns to provide beds for COVID patients. With lockdown 4.0, however, "most non-COVID hospitals are open for elective surgical procedures," Dr Vagolkar said. "The patient turnout, however, is poor for elective surgeries. One reason is the fear of contracting COVID during their stay in the hospital and another reason being the lack of transport facilities. One more issue is that of delays in the processing of insurance approval due to shortage of staff," he added.

Dr Vagolkar, however, said that stringent testing procedures were in place to ensure the safety of patients as well as hospital staff.

25 to 30 per cent hike in bills
Dr Ajay Chaughule, a senior cardiothoracic surgeon, said, "We used to get patients with a history of chest pain, uneasiness, breathing etc based on which we could advise some planned interventions like a bypass surgery etc. But owing to the extended lockdown, we have to suggest angioplasty as an immediate remedial measure instead of a bypass for the patients' benefit."

The availability of ICU beds, he said, is also a challenge. "Those who have emergencies, end up shelling out almost 25 to 30 per cent extra towards hospital bills," explained Dr Chaughule.

Overhaul in hospital ACs must
Professor Pradeep Bhosale, director, Arthritis and Joint replacement surgeon at Nanavati super specialty hospital, too had to postpone many of his planned hip and joint replacement surgeries in the last two months.

"The medical association and the government have specified that only emergency cases like fractures, trauma and accidents will be dealt with across hospitals as Mumbai is a COVID hotspot," said Dr Bhosale who conducts 40 to 50 hip and knee replacements surgeries in a month. He now mostly attends to patients over phone calls and suggests them medication for pain relief.

The biggest challenge for surgeons, he said, is to ensure no infection to their patients post-surgery. "A major overhaul of the centralised air conditioning system within the operation theatres, ICUs and wards will have to be considered. Hospitals need to ensure that central air conditioning units are no longer used to keep all forms of virus and infections from spreading."

25-30%
Average hike in hospital bills amid COVID pandemic

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