Covid-19: Keeping clinics open is unsafe, caution Pune doctors

A number of doctors from Pune have cautioned that the Maharashtra government’s directive that clinics should be kept open during the on-going 21-day lockdown period could be unsafe as it could lead to the dispersal of the Sars-Cov-2 infection in the community

PUNE: A number of doctors from Pune have cautioned that the Maharashtra government’s directive that clinics should be kept open during the on-going 21-day lockdown period could be unsafe as it could lead to the dispersal of the Sars-Cov-2 infection in the community.

On March 24, Maharashtra health minister Rajesh Tope asked doctors in the state to keep their clinics open for patients, after receiving complaints that many clinics were shut (HT PHOTO)

“We are compelled to keep the clinics open but some doctors feel it is not justified,” said Dr Sanjay Patil, president, Indian Medical Association (IMA, Pune chapter).

Dr Shirish Gupta, general physician at Wanawdi said, “We have kept our clinics closed as there is a high possibility of community transmission of the virus as opening a clinic means calling the support staff too. We have been instructed by our fraternity to shut our clinics and if any patient comes or calls, then advise them to visit a hospital OPD (outpatient department). There are high chances of contracting the virus in clinics, so we all are shut,” he said, adding that most clinics were shut barring a few which dealt with critical heart problems.

One doctor who declined to be identified said: “It’s a retrograde step as it could lead to multiple points of contact and new routes of transmission in the community. Instead, suspected Covid-19 patients should go to big multi-speciality hospitals so that points of interaction with Covid patients are few.”

He pointed out that a doctor needs a staff of at least 5 people to keep a clinic open. This would mean intermingling with people while facing practical difficulties such as the ban on public transport and sale of petrol, he said.

On March 24, Maharashtra health minister Rajesh Tope asked doctors in the state to keep their clinics open for patients, after receiving complaints that many clinics were shut.

Speaking on Facebook Live, Tope had said, “The state government has exempted private practitioners from the curfew as people do need medical assistance. Call your staff and start examining patients at your clinics.”

Dr Patil said that while 70-80% clinics were open in Pune, doctors were facing numerous difficulties. “Some housing societies where clinics are located have served notices to doctors to keep their clinics closed,” he said. Besides, the staff at the clinic was finding it difficult to commute. “It is also difficult to maintain physical distance in small clinics,” he said, adding that some doctors had complained about shortage of protective gear

He said that IMA has appealed to people not to overcrowd at clinics to prevent transmission of the virus.

On March 27, he wrote to Pune divisional commissioner Deepak Mhaisekar that it had urged its members to “continue their valuable services in OPDs for emergency situations,” undertake clinical examination of patient if felt necessary and as far as possible, give telephonic advice.

“ A draft of clinically relevant conditions which require highest priority for consultation is being made by collective efforts of IMA Pune,” Dr Patil said, adding that emergency services will not be affected in any way during the lockdown.

He said, doctors and paramedics were sometimes being harassed by housing societies with the fear of developing infection and not allowed to enter, run their clinics or asked to vacate the residence. This should be dealt with firmly and efficiently on priority, he said in his letter.

The letter which was jointly signed by other IMA office bearers such as Dr Padma Iyer, Dr Raju Varyani and Dr Rajan Sancheti, also requested for insurance cover for private doctors working in OPDs and hospitals for suspected Covid-19 patients, similar to government medical and paramedical personnel.

There should be no compulsion: Dr. Kagal

Dr Shyam Kagal: “I cannot disagree with the Government; we should keep our clinics open. But my concern is, are we really equipped to deal with Covid-19? Is the IMA going to provide us with N95 masks? They should not impose upon us to keep the clinic open, If we do not have anything to protect ourselves. We are supposed to fend for ourselves, and I would prefer that people who feel they have these symptoms should head to those OPDs where doctors are better equipped.”

Dr Shivram Bhonagiri: “As a doctor it is my moral responsibility; but to keep the clinic open is not a feasible idea as most clinics are in crowded areas or in residential areas. Besides, if any of the patients show the symptoms, they should go straight to the dedicated OPDs in the hospitals. We need to keep the private hospitals open for patients who need to go for small illnesses.”

Dr Arun Gadre: “It is the moral duty of a doctor to be ready for such a clarion call but there are some practical issues. Most of the clinics are small and in crowded areas which makes it difficult to manage social distancing. No PPEs (personal protection equipment) have been provided to practising doctors to prevent them from becoming agents of transmission. The government should have a multi-pronged approach before announcing such decisions. Or, they should be ready to provide the clinics with equipment to serve all patients and not just blood pressure and other illness.”