NEW DELHI/MUMBAI/LUCKNOW/PATNA/JAIPUR/KOLKATA: Laxmi Devi, 70, was detected with breast cancer on March 21, just days before the lockdown. A few days later when her family took her to the Bhagwan Mahveer Cancer Hospital in Jaipur, the largest specialised cancer hospital in the city, she was turned away as the hospital was facing staff shortage.
Saroj Nigam, 49, found herself in the same boat. Diagnosed with breast cancer on March 18, doctors at the Sanjay Gandhi Institute of Medical Sciences in Lucknow advised her immediate surgery. But with the lockdown kicking in days later, a surgery has not been possible so far.
From Guwahati to Jaipur and Mumbai to Kolkata, the coronavirus contagion and the resultant lockdown have caused major disruptions in non-Covid healthcare services. A study of hospital data by this newspaper in some major cities shows patients of other diseases have been the silent victims of the pandemic.
A nationwide official data of the disruption is not available because health authorities are preoccupied in battling Covid-19, but experts said the figures from select hospitals were representative of the reality all over.The findings also complement a new report by the University of Birmingham, which says the lockdown is set to derail nearly six lakh surgeries, many of them life saving.
The report estimated that 28 million surgeries are set to be impacted during 12 weeks of lockdown globally. India will see a postponement of 5,05,800 benign surgeries, 51,100 cancer surgeries and 27,700 obstetric surgeries, the researchers found.
The extent of misery faced by lakhs of patients is evident in the fall in OPD and IPD admissions in hospitals. Take for example the Tata Memorial Centre in Mumbai, considered the top cancer hospital in India. There were just 350 OPD patients in April this year as compared to 3,500 during the same month last year, a drop of 90 per cent.
Major surgeries performed at the hospital in April 2019 were 800. This fell to 350 this year. The drop in minor surgeries was similar, 400 in April 2019 and only 100 last month.
At Jaipur’s Bhagwan Mahveer Cancer Hospital, there were 12,597 OPD patients, 3,055 IPD patients and 197 surgeries in January 2020. In April, these numbers were 1,935, 711 and 3 respectively.
The Institute of Respiratory Disease, also in Jaipur, which caters to TB, asthma and lung cancer patients, reported 10,669 OPD and 1,175 IPD patients in January this year. These numbers fell to 8,548 and 870 respectively in March.
At the Dr Bhubaneswar Barooah Cancer Institute in Guwahati, a unit of the Tata Memorial Centre, the footfall of patients between February 18 and March 24 was 5,961. This fell to 3,081 between March 25 and May 1, or after the lockdown. New cancer patients undergoing chemotherapy during the same period fell from 330 to 147.
“Before the lockdown, 60 patients used to turn up at the hospital every day. The figure has come down to 20. Many patients who are in critical stage and need regular radiotherapy are not coming to the OPD fearing infection,” said Arnab Gupta, a director at the Saroj Gupta Cancer Centre and Research Institute, a premier hospital at South Kolkata’s Thakurpukur.
After initial instructions to postpone elective surgeries and procedures, the Centre has been asking state governments to ensure that non-Covid essential medical care are not affected but experts feel the issues are complicated.
S P Kalantri, medical superintendent at the Mahatma Gandhi Institute of Medical Sciences, said the lockdown, panic, lack of PPEs and lack of implementation of evidence-based guidelines for treatment of non-Covid likenesses have taken a huge toll. “At risk are pregnant women, children requiring vaccinations, patients dependent on maintenance dialysis, those with cancer and diseases of heart, lung and liver,” he said.
The shutting down of most small private hospitals, including TB hospitals, has worsened things. Lalit Anande of the Sewri TB Hospital in Mumbai said a patient from Panvel had to travel 50 kms just to get the medicine. “The government should ensure that all hospitals function during this time,” he said.
Some experts felt the situation was avoidable. “What should have happened is that primary health centres and other hospitals providing essential care should not have been closed down,” said Nafis Faizi, who teaches community medicine at Aligarh Muslim University.
“In UP, Bihar and other states with a broken primary healthcare system, health services are highly dependent on private providers. So, what happens in the absence of an efficient primary care is that even hypertension treatment is done by hospitals and specialists. This kind of hospitalized approach creates innumerable problems during epidemics and disasters,” Faizi added.
Reported by Sumi Sukanya Dutta, Sudhir Suryawanshi, Namita Bajpai, Rajesh Kumar Thakur, Rajesh Asnani & Pronab Mondal