COVID-19: Overwhelmed Chembur labs stop new RT-PCR tests, say residents

With rising cases of SARSCoV2 in Mumbai and rest of Maharashtra nonavailability of hospital beds and delay in getting RTPCR test results from laboratory and getting chest scan results from scan centers to ascertain COVID19score has become a matter of concern for health experts as they say lsquoThe golden hourrsquo in the emergency medical care is forgotten for COVID19rsquo thereby increasing the risk of patients slipping into severe conditions which otherwise could be dealt easily if they patients are brought for treatment with the Golden window hoursA long queue of people waiting to get tested for Coronavirus outside Topiwala Municipal Maternity Home Goregaon on Monday PicSatej ShindeOn Sunday family doctor of Chembur resident Anthony Gonsalves name changed who had initial flu symptoms since Thursday advised him to get the RTPCR test done But to his surprise almost all the laboratories that he contacted including the local private labs refused to collect samples citing a huge backlog of pending tests He is now compelled to stay in home quarantine anxious about his symptomsBelinda Dokras a family friend tried to help Gonsalves but in vain ldquoToday Sunday morning was a kind of a nightmare for me when I was calling labs in Chembur to enquire about the RTPCR test A private laboratory said they were not taking any new tests for the past two days due to a backlog of 40000 pending tests A wellknown laboratory also said it had a pending backlog and hence stopped conducting testsldquoWhile the public did not follow the COVID19 protocols when the city relaxed the restrictions the government was lax as well and not prepared for the second wave Entire healthcare system is overwhelmed The government needs to invest in healthcare infrastructure rather than focussing on Coastal Roads or Metrosrdquo she saidMost of the citys wellknown hospitals including Breach Candy Jaslok Hinduja Wockhardt Mumbai Central Leelavati are running short of COVID19 beds and the waitlist in most private hospitals is running at over 100 Admission to private hospitals or nearest civic COVID centres or hospitals is routed through the BMC war room at each ward Even if people are able to connect to their local war room for admission to a private hospital the employees are helpless due to nonavailability of bedsA health worker collects a swab sample of a woman for an antigen test at CSMT station on Monday PicSuresh KarkeraAt M West war room on an enquiry for bed availability at any private hospital in and around Chembur an employee said ldquoWe can only register your patients details with us at present as hospitals are running short of bed If you can arrange a bed at your end let us know we will facilitate the patient transfer from home or COVID19 centre or smaller nursing home to bigger set ups If your patient has got a bed we would suggest you let him continue treatment thererdquoDr Subhash Hira professor of Global Health at the University of Washington said ldquoSince June last year several national and global epidemiologists had been anticipating and predicting a second wave of COVID19 in India around midFebruary in 2021 Moreover the speed with which the virus is transmitting in several states during the second wave is much higher than the first A person infected with SARSCoV2 virus that causes COVID19 is spreading the virus to 16 others in the community During the first wave the spread was limited to two to five people This is one of the reasons why the second wave is expected to stay for a longer duration causing a large number of infections and deathsAs of now the epidemiologic predictions are seen to be correct in over 60 cities across six severely affected states including Maharashtra and Punjab Many of the fast spreaders are infected with South African and Brazilian mutants and the role of indigenous Indian mutants is still unclearrdquo Dr Hira addedDr Hira said ldquoThe roots of Indiarsquos COVID19 crisis lie in the first wave The SARSCOV2 hit the country hard and India took a determined decision of national shutdowns based on scientific fundamentals The economic blow of the resulting lockdowns was severe but at the cost of saving thousands of lives The sheer speed of new infections leading to the second wave has surprised health officials who now wonder whether variants might be a factor Yes the new variant viruses that are fast transmissible complacency of the public and pandemic controllers who were overconfident of success after the first wave and unplanned dismantling of COVID19 hospitalsquarantine centres and trained staff etc are responsible for the resultant chaos The mutant variant screening during JanuaryMarch 2021 was done on 10787 samples although the ten governmental sequencing centres have a monthly capacity of 30000 tests The critical number of sequenced samples helps to determine the proportion of mutants circulating in these cities The second wave that is likely to peak and stabilise in the next couple of months and will cause more damage Simultaneously some European countries and Australia that are ahead of the Indian epidemic are already going through the third and the fourth waves of the COVID19 outbreakrdquoldquoEven as we go through night curfew micro containment zones and massive scaleup of vaccine delivery measures like wearing masks social distancing and hand washing or sanitisation have to be strictly implemented In addition letrsquos not forget that patients require lsquothe golden hourrsquo emergency care by standardising PCR or rapid antigen test report within 12 hours provision for rapid hospital admission if required and postCOVID19 followup after treatment Contact tracing sexual and hygiene counselling to reduce transmission at home and COVIDappropriate behaviour requires strict implementation There canrsquot be startandshut systems of pandemic control in any country for the next several years till the WHO gives pandemic clearancerdquoldquoIndia has 47 million healthcare and frontline workers and an additional 50 million emergency service workers These cadres need to be gelled under a single lsquoCommanderrsquo to ensure a smooth national operationrdquo said Dr HiraDr Prashant Borade senior consultant and head of department Critical Care at Gleneagles Global Hospitals said It takes between five and seven days for a patient to recover unless the patient has severe disease Before advising a patient to get admitted at a hospital the severity of the disease should be assessed And for those patients who are on the waitlist it depends on severity if the condition is critical the waiting period can be about 24 hours to get a bed and if the condition is less severe the process could take three days at our hospitalrdquoDr Borade added ldquoA good solution is to have a good screening done of the patient along with some baseline tests in the emergency room and measure the severity of infection If the condition is severe then bed is allotted depending on availability and keeping in sync with the BMC ward war room If the patient does not have symptoms indicating severe infection then they should be recommended home quarantine The clinical team keeps in touch with the patient periodically to keep a track of their symptoms and severity of the infection This reduces the burden on the bedsDr Wiqar Shaikh professor of Medicine Grant Medical College and JJ hospital said he is not at all surprised at the second wave in India This is a pandemic and the history of Medicine teaches us that all pandemics in the past be it plague cholera measles Spanish flu etc had several waves before going into a plateau or abating he explainedDr Shaikh also clarified that human beings have coexisted with microorganisms such as bacteria and viruses for centuries and he would expect that COVID19 will remain in the world albeit at a low virulent level He added that indeed North America and Iran are in the middle of a fourth COVID19 wave and Europe is in the grip of a third waveDr Shaikh expressed alarm and serious concern with overburdened healthcare facilities in the country particularly in Mumbai He said most hospitals in the city have a waiting list of more than 100 patients He added that this was the scenario in several countries across the globe He quoted a BMJ report of January 22 2021 which studied the health systems in China Thailand and the USA and found that they were overwhelmed by COVID19 Scientific American on January 27 2021 said that these are the worst days for healthcare facilities and workers and that hospitals in the USA are looking like war zones Scientific American also said that COVID19 has shifted focus and attention away from all routine health care including surgeries which could prove disastrous The Journal of the American Medical Association reported on March 17 2021 that we are witnessing an advanced health system stretched beyond its capacity On March 28 2021 680 News reported that hospitals around the world are reporting being so overwhelmed by COVID19 doctors fear they may be forced to choose ldquowho lives and who diesrdquo Indeed doctors in some overburdened countries are already making that heartwrenching decisionBetween October 2020 when the first wave subsided and February 2021 when the second wave of COVID19 outbreak hit the nation the government had over four months to ramp up healthcare facilities including hospital beds critical care units ventilators oxygen medications etc India particularly Mumbai is suffering from an overwhelmed healthcare system due to a lack of homework and poor planning concluded Dr Shaikh