The demand for hospitalisation has suddenly gone up in the State following an exponential increase in COVID-19 cases and this time, the private sector hospitals rather than the Government hospitals, seem to be taking on the burden.
During the Delta wave, the public sector hospitals, especially, the Government Medical Colleges had taken the brunt of the entire COVID burden and its fall-out on the treatment of other non-COVID illnesses had been devastating. This time, a conscious decision has been taken by the administration to shift the focus of treatment to homes and periphery hospitals so that Government medical colleges need take in only severe COVID cases.
Many private hospitals are thus beginning to feel the pressure due to the demand for admissions. Major tertiary care private hospitals are now encouraging patients to opt for tele consultations first rather than rush in panic to hospitals as soon as they test positive for COVID.
In fact, many clinicians said that most of the elderly getting admitted to the hospitals following COVID are doing so out of sheer panic and not because they are seriously ill.
“Our in-patient admissions have doubled now, in comparison to the past two week but most of it is due to panic. A huge number of senior citizens who were vaccinated early and who have now contracted COVID (while they were anxiously waiting for the precaution dose) are now rushing to get admitted because they are extremely worried. This kind of panic is not warranted .We are also getting a lot of incidental COVID cases, which has added to the IP admissions,” says Dr. Rajalekshmi Arjun, senior consultant, Infectious Diseases, KIMSHEALTH.
“We believe Omicron is in wide circulation, going by the sheer number of cases and what we have seen of the disease so far has been mild. Other than those with serious co-morbidities -- uncontrolled diabetes, renal diseases, malignancies -- people should stay home and rest, take a tele consult and follow the advice of doctors, “ she added.
“Almost everyone in the community now seems to be having fever and respiratory symptoms, most likely COVID. Most of them have mild symptoms, which resolve in three days, even amongst the elderly. Even the ICU admissions are mostly mild or moderate cases, but who have co-morbidities. Panic admissions should not be allowed to threaten the limited surge capacity of hospitals, “ a senior clinician in the Government sector said.
Meanwhile, the sudden increase in the number of people testing for COVID has resulted in a huge demand for the monoclonal antibodies (mAbs) treatment, even though doctors are unsure about the efficacy of the current cocktail of casirivimab and imdevimab against Omicron virus variant..
“mAbs is a potentially life-saving drug, strictly indicated for those with multiple comorbidities, who may go on to develop severe COVID disease. It has saved many elderly and the comorbid from severe disease during the Delta wave but it has also turned out to be one of the most misused drugs. The drug is expensive at ₹60,000 for the single dose and while the State Government has put in place a strict protocol for the use of mAbs, many private hospitals are now forced to dispense it on demand,” says senior doctor at a hospital in the capital.
People with borderline obesity or asthma are queuing up in private hospitals demanding the drug and because of the admission rush, many hospitals are now administering it as an outpatient procedure and sending people home.
Doctors point out that since this was a drug widely advertised on television by pharma companies, when the demand is huge, it would be difficult for the private sector to refuse it for those who demand it. Because even if the current mAbs cocktail is not effective against Omicron, the patient will not come to any harm.
“Use of point-of-care tests (like Omisure test approved by the ICMR or S-gene Target Failure test) can determine the virus variant involved and may be, optimise the use of mAbs. But most private hospitals are yet to start doing this,” the senior doctor said.
