An overload of samples to be tested for COVID-19 and the consequent delay in obtaining results is wreaking havoc at Thiruvananthapuram Medical College Hospital, (MCH) where over 150 persons, including doctors and patients, have tested positive for SARS-CoV-2.
The hospital administration has so far not come out with the exact figures but every day, with more people testing positive, doctors are demanding that immediate steps be taken to do mass testing of 4,000-odd hospital employees on a war footing, lest the hospital shuts down.
The microbiology department at the MCH is testing over 1,100 samples a day from the district now and uses all molecular diagnostic modalities, including RT-PCR, TruNat and Genexpert for COVID testing. Now that the lab has acquired an automated RNA extraction machine, the time taken for results will be reduced, it is believed.
However, unless point-of-care tests such as the rapid antigen tests are used widely amongst health-care workers (HCWs) as well as patients, the turnaround time for testing is likely to result in more patients and doctors getting exposed to the virus.
“Doctors handling road traffic accident emergencies in the casualty and surgeons operating on such cases are at highest risk because they often have to intervene to do procedures to keep the patient alive even before they can don any protective gear. Last week, after a patient who underwent emergency surgery tested positive — the test results were delayed by five days — scores of doctors and nurses who had unwittingly come into contact with the patient in the ICU were forced into quarantine in panic,” senior residents told The Hindu.
The Kerala Medical PG Association and the House Surgeons’ Association have now written to the Health Secretary and the Chief Minister that all HCWs in the MCH be tested immediately. They have also demanded cyclical re-testing at 10-day intervals since every patient and visitor to the hospital are potential COVID carriers.
They have also demanded that the HCWs be provided adequate protective gear in non-COVID areas too as unlike those working in COVID wards, those in non-COVID areas have scant protection and are at greater risk.
“The mixing of COVID and non-COVID facilities and intermingling of staff is accelerating COVID spread inside the MCH. There are no effective means of separating these two now. In the present situation, only emergency admission, casualty, emergency theatre and ICUs in non-COVID section can be managed in the MCH. All other services like OP services, major and minor theatres, routine and cancer care have to close down now itself for two weeks,” a KMPGA representative said.
With more hospital staff and patients testing positive, doctors are being asked to go into quarantine based on risk assessment (nature of exposure and the degree of contact) or else entire medical departments will have to be shut down.
“It will take at least two weeks for the current state of affairs to stabilise. Most doctors are donning protective masks and gloves while at work but this protection matters after duty hours also. Quarantine has only a limited role to play as the risk of infection from the hospital now is the same as that from the community. Every patient has more than two companions and they all intermingle in the hospital amplifying the risk of transmission,” a senior doctor said.
Attempts to enforce physical distancing or reducing crowding within the hospital have never been successful inside the Medical College Hospital.
