OPD visits at AIIMS down to a fraction in post-Covid reality
At the waiting areas outside consultation rooms at the new Raj Kumari Amrit Kaur OPD block at Masjid Moth, yellow squares are marked on the floor, and every alternate chair is blocked in bids to ensure social distancing — but there are no patients.
It’s been two weeks since the All India Institute of Medical Sciences (AIIMS) reopened its outpatient clinics, after three months of keeping them closed due to the lockdown, but the eight-storey building is nearly empty on Friday. The 30 patients who had appointments were done with their consultations by 11.30 am.
At the waiting areas outside consultation rooms at the new Raj Kumari Amrit Kaur OPD block at Masjid Moth, yellow squares are marked on the floor, and every alternate chair is blocked in bids to ensure social distancing — but there are no patients.
Before it shut on March 23, around 13,000 patients would queue up for appointments at outpatient clinics every day. However, hospital officials said patients now stay away for fear of infection. Additionally, fewer patients are allowed to visit the campus, with most given tele-consultations.
The 60-year-old hospital had, in February, moved its clinics to the sprawling new building with modern amenities, as part of a redevelopment plan.
Outside the new building, a screening room has been set up to check every patient for symptoms of the coronavirus disease (Covid-19). Guards and volunteers at the gate check off the names of the patients against a list.
“Patients have to first register for tele-consultation. They are given an appointment for the OPD if doctors ask to see the patient in person. We receive such a list every day, since no walk-in patients are allowed. Since the reopening, we’ve mostly been getting patients from the orthopaedics department,” said a volunteer on duty who asked not to be named.
The hospital has been providing pre-registered patients with tele-consultations since April after the OPD was closed. The service has now been extended to new patients as well. At least 1,000 patients receive tele-consultations a day, hospital officials said.
“With OPD services reopening, five or six departments have started registering new patients. Patients are called in only if the doctor thinks they need to see the patient in person to treat them. We have restricted our OPD services to about 15 patients a day for each department. However, we are receiving fewer patients than that. People are scared they will get the infection if they come to the hospital,” said Dr DK Sharma, medical superintendent of the hospital.
With almost half the patients at the hospital coming from other states, travel restrictions have played their part in keeping the visitor-count low.
“Almost half our patients — about 48%, according to our data — travel in from outside Delhi, and they’re not able to travel because of the lack of inter-state trains and buses. This could be another reason for the low attendance,” said Dr Sharma.
On Friday, the only busy area in the hospital was outside the cancer wing, where patients submitted medical files to a guard outside. Before the lockdown, the cancer centre used to receive around 600 patients in its outpatient clinics daily, which had gone down to about 250 during the lockdown.
“With restrictions being lifted and travel allowed, the numbers are going up again now. Cancer patients cannot wait, they were coming to us throughout the lockdown,” said Dr Sharma.
Another person called patients inside, one at a time. A microphone has been fixed to the railing outside the building with bandages to ensure that everyone can hear the call, including those sitting across the road.
Fifty-four-year-old Mohd Ilias, a bladder cancer patient had travelled to the department for a quarterly screening. “I have already had surgery and chemotherapy, but I have to come here every three months to show the doctor my scans, to check if the cancer has returned. I have been waiting here for three hours now, but I have noticed that once their names are called, patients are immediately taken to the doctor’s cabin and come out within 10 minutes. There is no queue inside,” he said.
“We kept the cancer centre open even during the lockdown because cancer is almost an emergency. It is potentially life-threatening if not treated in time,” Dr Sharma said.
The palliative care centre — which provides morphine to cancer patients in pain — also remained open. “Opioids (strong and addictive pain medicines) cannot be prescribed after telephonic or vide consultations — the guidelines released by the health ministry are clear. So we kept the clinics running for patients in pain, asking new patients to come in for one consultation and providing adequate medicines to family members of our old patients. For those who travel from outside the state, we connected them to local hospitals where we have trained doctors from our centre,” said Dr Sushma Bhatnagar, head of the department of onco-anaesthesia and palliative care at AIIMS.
The only queue was outside the hospital’s emergency department, where patients waited for their turn to be screened for Covid-19 before receiving care. A separate set of trolleys have been placed for patients coming in with Covid-19 like symptoms. They are taken into the hospital emergency through a separate screening area where the entire staff is in full personal protective gear.
“The attendance at the emergency wing is also lower than we used to see. Most people are just not coming in. It’s the Covid ward that remains busy,” said a guard posted outside the hospital emergency wing.
