Delhi's private hospitals violating COVID-19 guidelines, say inspection teams
What's the story
An inspection conducted by government-constituted teams has flagged several violations of COVID-19 management guidelines by private hospitals and nursing homes in Delhi. After surveying 114 private facilities in the national capital on November 17 and 18, the teams suggested tighter restrictions at these facilities, Hindustan Times reported. The report pointed out that facilities were needlessly testing patients with mild/moderate infections and using therapies improperly.
Testing
Mild, moderate cases tested before discharge
The report noted that as per guidelines, only severe cases of COVID-19 are required to be tested using RT-PCR prior to discharge, while moderate or mild cases can be discharged after three consecutive days of no fever without testing. However, it was noted in the report that all private hospitals inspected were testing every COVID-19 patient before discharge.
Treatment
Use of drugs, treatments not as per guidelines
A majority of hospitals were using drugs and treatments based on the clinical judgment of respiratory physicians, general physicians working in these hospitals, the report said. It said hospitals were found using favipiravir, doxycycline, azithromycin, ivermectin to treat COVID-19 when they are not prescribed in the government protocol. It also noted that investigational therapies such as remdesivir and convalescent plasma therapy were used "routinely."
Information
Inspectors satisfied with facilities' reservation of ICU beds
However, the inspectors said that they were satisfied with the facilities' compliance with the government's direction to reserve a certain percentage of ICU beds for COVID-19 patients. Last month, 42 private hospitals were asked to reserve 80% of ICU beds for COVID-19 patients.
Report
Report included in affidavit by Centre to Supreme Court
The findings were presented to the Director-General of Health Services and the report is now included in an affidavit by the Centre to the Supreme Court. The top court is hearing a matter over the steps taken by the central and state governments to tackle the COVID-19 outbreak. The DGHS has recommended a special vigil on private facilities to ensure compliance with guidelines.
Information
Report suggests restrictive order to avoid misuse of drugs
The report suggested a special restrictive order to avoid misuse of drugs not recommended by the Health Ministry. It also urged the Delhi government to consider appointing nodal officers for monitoring the performance of all these hospitals regularly.
Experts
Doctors should have 'some leeway' in treating patients, experts argue
However, treatments for COVID-19 are still evolving and most therapies are experimental, experts argued. Nathealth Senior Vice President Dr. Harsh Mahajan said several studies say opposite things about many therapies and doctors are relying on their clinical experience. "Even the national protocol is dynamic." Delhi Medical Council President Dr. Arun Gupta said there should be "some leeway" to decide what works for patients.
Quote
'Plasma therapy of not much use'
Dr. Samiran Panda—the head of epidemiology and communicable diseases at ICMR and a member of the National Task Force on COVID-19 management—said, "(Plasma therapy) isn't of much use based on the evidence that we have, and our revised guidelines were drastically modified for reference of those wanting to administer it." "It hasn't been banned but there are clear-cut dos and don'ts..."