Garth Rattray | Indirect COVID-19-related deaths likely

WE ALL wonder if Jodian Fearon’s passing might have been avoided were it not for the delays caused when the possibility of COVID-19 reared its ugly head and further complicated her very difficult case. We expect that the upcoming inquiries will illuminate this sad and painful matter. Then again, perhaps we’ll never know. However, there may be many more circumstances like hers, because I saw hospital rejects that were sent away or sent home because of the COVID-19 pandemic.

Whereas I fully understand and wholeheartedly agree with the need to reduce the risk of transmitting the virus in hospital patients, we have to be very careful not to compromise the care given to patients suffering from everything except COVID-19. After all, other diseases remain unabated. Additionally, fear of possible exposure to the virus is causing many people to compromise their screening, investigations and management of non-communicable diseases. This will, no doubt, lead to hospital admissions and cause indirect COVID-19-related deaths.

Hospitals are breeding grounds for all sorts of extremely dangerous bugs. It is known that the sooner patients get well and get out of hospital, the better. Sometimes patients are admitted for simple and/or straightforward reasons and fall victim to dangerous nosocomial infections. Some have even died from such infections. Therefore, it’s always a balancing act to decide on the need to be in a hospital versus the risk of hospitalisation. Another reason for keeping admissions low at this time is the essentiality of social distancing on the wards and reserving space for possible COVID-19 admissions. Judging from the number of cases seen in other countries, freeing up hospital space is very important.

TIPPED THE SCALES

Obviously, the current viral plague has tipped the scales in favour of keeping patients out of hospitals for their own safety and for the safety of other, more seriously ill patients. However, we must be careful not to react in such a way as to endanger the health and lives of patients in genuine need of hospitalisation by turning them away and denying them the care necessary for their proper treatment.

I became very concerned when I saw an elderly patient who suddenly fell ill, was constantly confused, combative, helpless and incontinent, taken to a major hospital twice, and twice sent home after only a few hours. The relatives were told that he was not admitted because of protocols in place due to COVID-19. And, when another patient turned up in my office with a swollen knee, oozing pus, hopping on a single crutch and grimacing in pain, reported that another major hospital did not even look at his knee but gave him a clinic appointment for about three months away, all because of COVID-19 protocols, I was mortified. He reported witnessing the same happening to other patients.

The relatives of the very ill, elderly gentleman are unable to care for him in his current state. He remains undiagnosed until pending results can guide his treatment. In the interim, he and his family are suffering, and his life is in real danger. It would not only be sad, it would also be unethical to deny such a patient appropriate, badly needed care based on the possibility of COVID-19-related problems popping up at a healthcare facility.

The sending home of ill patients and issuing of appointments being practised in some hospitals seem to be an effort to delay treatment for some patients in order to be ready for a possible flood of COVID-19 cases. Because our healthcare system is already oversubscribed, underequipped and understaffed, this shift towards lightening patient load can be dangerous.

Efforts have been made to accommodate a possible influx of COVID-19 patients in satellite healthcare facilities. Obviously, more needs to be done in that regard.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.