'Labs giving patients results directly was causing bed-hogging', says civic chief Iqbal Singh Chahal
As Supreme Court asks state to review guideline, BMC Chief Iqbal Singh Chahal explains to mid-day the reasoning behind move, and how behaviour of pvt hospitals is undermining COVID-19 battle
Two of BMC Commissioner Iqbal Singh Chahal's recent circulars on the COVID-19 situation in the city, have drawn criticism from doctors, who believe they are vague. Speaking to mid-day hours before the SC ruling, Chahal said the circulars were issued after studying the situation and taking expert opinion. He also assured that the BMC took the decisions strictly to safeguard the interests of symptomatic patients, who are in need of urgent medical care. "We shall implement the SC order fully," Chahal said later.
The first circular that was issued earlier this month had asked private laboratories to not share COVID-19 reports with patients or private hospitals and send them to the BMC instead. The civic body would then share them with the patients or hospitals concerned through their teams. In the second circular issued on June 13, the corporation asked private hospitals to not admit walk-in COVID-19 suspected or positive patients without permission from the local ward war rooms.
Meanwhile, on Friday the Supreme Court asked the Maharashtra government to review its order to prevent private labs from sharing reports with patients.
The civic chief has been visiting several areas and hospitals to review the COVID-19 situation in the city
Amidst all the confusion, civic chief Iqbal Singh Chahal cleared the air in an interview with mid-day earlier in the day.
People are worried about not getting reports on time
Earlier private labs were collecting samples beyond their capacities and taking about three to four days to give the reports. We warned them to clear all reports within 24 hours or face action. Now all the reports arrive by the same night and the health department prepares a list by the next morning. So, there will be no delay and patients will get to know about their reports from civic health officials, who will also answer all their queries.
Private labs have been asked to not share reports with hospitals as well
Because we fear hospitals will continue the same practice. People will go to hospitals and they will then send samples for tests. It will start another cycle wherein these hospitals will admit asymptomatic patients and no beds will be available for needy symptomatic patients. The patients will be kept under supervision at the hospitals and doctors can stabilise them if there are any emergencies. There is no need to worry if they get their reports the next morning.
BMC teams take at least two days to reach positive patients
It might happen sometimes, but now we have decentralised the system and there are war rooms at ward level. We get on an average 50 positive patients from each ward every day. As per our experience, about 35 of them don't have symptoms and they are ready to quarantine at home and take medicines. Our health team will visit the homes of the remaining 15 people with pulse oximeters, temperature guns and other equipment and examine them. The teams will then assess the symptoms and inform the patients about which type of bed — normal, oxygen or ICU — they require. Mildly symptomatic patients won't get ICU or oxygen beds, for sure.
How can any hospital deny admission to patients?
Asymptomatic patients are occupying private hospital beds, which is against the Indian Council of Medical Research (ICMR) guidelines. Such patients don't need hospitalisation. We have warned hospitals to not entertain them. They have to inform us if such patients approach them. Meanwhile, if an asymptomatic patient develops symptoms after a few days, then he/she can call the ward war room for assistance. Our team will then allot them beds in the nearest hospitals.
If all the patients get their positive test reports directly from the laboratories, then more than 80 per cent of the COVID beds in the private hospitals will be occupied by a non-eligible category of patients. This will stem from fear and anxiety and happen through the use of money and direct collusion with authorities of private hospitals.
Iqbal Singh Chahal
What about patients with false-negative tests?
Whenever these patients develop symptoms, they can call the ward war room for help or directly walk into any of the jumbo facilities (with oxygen beds) created by the BMC. There are many centres like Mahalaxmi Racecourse, Worli NSCI dome, NESCO Goregaon, BKC, Dahisar Toll centre, Dahisar Best Depot, Richardson Cruddas, Mulund etc. The civic body has already given instructions to admit such patients.
There isn't any clarity about senior citizens
Our health teams are regularly calling patients and assessing their situations. Senior citizens will get help in time.
How will BMC keep a check on hospitals?
We have already warned the hospitals. I know they are running on an economical model, but it's not a good practice to earn money by just providing quarantine facilities and no treatment to asymptomatic patients. Instead, they can treat needy symptomatic patients. Our health team will visit the hospitals to review the situation and those not following rules will face action under the provisions of Epidemic Act, 1897.
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