Wednesday, March 18, 2020

Coronavirus: Punjab thrown at mercy of mismanagement

Umar Cheema
Punjab that has woken up late to the grave challenge of coronavirus has set up isolation wards in hospitals right in the heart of Lahore city instead of setting them up outside of the populated area as done in Sindh.
This decision was made ignoring the advice of doctors that isolation wards in the city may lead to disproportionate spread of virus as hundreds of thousands of patients and their attendants visit big hospitals each day.
Likewise, screening point at provincial border of Punjab in Dera Ghazi Khan has started working just now, almost two weeks after Sindh, which has outsmarted all provinces in timely detection of suspected patients at Sindh-Balochistan border. Meanwhile, doctors prone to contracting virus from patients due to lack of protective gears are concerned about their own safety and fear the health professionals will be the biggest source of its spread if they are kept ill-equipped.
Same goes with arrangement at airport. A person working at Lahore airport facing respiratory problem was Tuesday admitted to Mayo Hospital’s isolation ward as a suspect case exposed to virus while screening. As for the screening arrangement is concerned, a UK-Pakistani, Salman, went undetected from airport. He later got himself checked from private laboratory in Lahore and was tested positive. While UK’s National Health Service advised him to quarantine himself at home, he was taken by police and admitted in protest to Mayo Hospital where senior doctor visited him only a day later. Young doctors posted there are uploading videos to expose lack of protective equipment they need to keep themselves safe.
At a couple of hospitals, senior doctors are said to have displayed precautionary measures signboard for visitors from their own pockets as this has not been done at government level. Lack of information regarding who should visit hospitals for testing trigger resentments among visitors. An attempt to give them proper information at Services Hospital led to the removal of its medical superintendent whereas a doctor in Okara who suspected a patient is carrying the virus was transferred and sent on bed rest in order to contain unnecessary “panic”. Another doctor in Bahawalnagar met the same fate.
Background interviews with senior and young doctors found lack of preparedness. “I had been demanding high ups in bureaucracy since outbreak in China that we must take measures. Sooner the better. Later we get loser we become,” said a Lahore-based professor doctor posted at a key position. As we were looking towards the provincial government, he explained, it was waiting to get direction from federal government.
Suspected and confirmed patients of epidemic virus are kept at isolated places away from populated areas, another doctor said. We raised this point, he goes on, at many a meeting. “Unfortunately, we are administered by bureaucrats who knows nothing and also keep political leadership in the dark,” he said requesting anonymity as the government is taking action against doctors who speak to media.
Discussion with officials at Dera Ghazi Khan who are quarantining Iran-returned pilgrims further reveals how slowly government is responding to the impending disaster. “We are two weeks behind Sindh in starting screening,” said a doctor. “Today (Tuesday) is third day,” he said talking to The News. Initially, we were in receipt of 850 pilgrims; 100 of them were later moved to another screening facility set up near Sargodha/Faisalabad, he explained. Remaining will be quarantined in DG Khan.Tests collected in DG Khan are sent to Nishtar Hospital, Multan. In case of confirmation, patients are shifted to Tayyip Erdogan Hospital in Muzaffargarh. How many have turned out positive? From those tested on first day, the doctor said, one has been found contracting virus. Asked how come Iran-returned pilgrims from Punjab have not contracted (taking first day test as guide) virus whereas those from Sindh are multiplying, the doctor said the latter had spent a month more than the former in Iran therefore pilgrims from Sindh were more exposed. About arrangements at Taftan border, the doctor said the quarantine facility is not up to the mark therefore it has to be repeated.Meanwhile, doctor community is in a state of panic as they lack personal protective equipment. Although provincial health minister Dr Yasmin Rashid insisted while talking to The News that protective equipment have been provided, doctors insist they are only for those assigned duties at isolation ward. “We deal with hundreds of patients in emergency. Who knows who is suspect? Doctors can’t make a choice among patients on the basis of their suspicion,” said a young doctor who shared a video where chief executive officer of Mayo was caught urging doctors to arrange mask for themselves and he would reimburse them.
The helpline set up by Punjab was also not providing necessary information to concerned callers until recently. More than 100 people visited Services Hospital, Lahore on late Saturday; only six of them were those who had returned from Iran, the key source of Coronavirus in Pakistan. The helpline didn’t inform that the hospital will only be dealing with Iran-returned pilgrims as right now there is no epidemic; there are only the carriers of virus coming back from Iran, heavily infected neighbour of Pakistan. Nor were they apprised that none of the five teaching hospitals in Lahore has any testing facility for corona. Doing that required bio-safety labs of level 3 situated at Post Graduate Medical Institute (PGMI) and Directorate General of Health.
When the visitors were informed about this at Service Hospital, they started protesting on keeping them in the dark. Included among them were Iran-returned pilgrims who were advised to get admitted and their tests would be collected either by DG Health representative. In order to disperse unnecessary visitors and for public awareness at large, doctors at Services Hospital posted a message to let visitors know what kind of test should they expect. Further, it was noted in the message that corona tests are not carried out at Service Hospital and named above-mentioned two testing facilities. Instead of taking corrective measures, the medical superintendent was removed for letting doctors post this message for visitors.
https://www.thenews.com.pk/print/630811-coronavirus-punjab-thrown-at-mercy-of-mismanagement

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