Mumbai doctors, activists seek plan to help with post-Covid-19 health expenses
The Sars-Cov-2 virus that causes Covid-19 is causing long-term impacts on the health of patients after recovery. This is not only affecting their lifestyle but also burning large holes in their pockets. Patients and social workers have now raised the need for an affordable post-Covid-19 rehabilitation program.
Jyotsna Maru, a resident of Mahalaxmi, was diagnosed with Covid-19 in August and received treatment at a private hospital. In a rare incident, she developed Covid-19-triggered paralysis named as Guillain-Barré syndrome (GBS) – an autoimmune disorder in which the body’s immune system that is supposed to protect the person, starts destroying them. It mistakenly starts attacking the nerves of the hands and legs, leading to sudden paralysis.
The 38-year-old dancer spent around ₹7 lakh on treatment at the hospital but her expenditure has not stopped there. Even after getting cured of the virus, in the last two months, she has spent ₹1 lakh more on post-Covid-19 related expenditures.
“When I was discharged from the hospital, I had to hire a caretaker to look after me around the clock as I couldn’t stand due to the numbness in my legs. Though I have improved a lot, I am still on medication and physiotherapy for my GBS. This costs me around ₹30,000 per month, excluding other expenses,” said Maru.
Just like Maru, thousands of patients across the state are forced to bear the burden of additional expenses, most of which are not covered under medical insurance. According to city doctors, many recovered patients are developing Covid-19 instigated illnesses like lung fibrosis, neurological disorders, chronic fatigue, muscle weakness and blood clot formation.
Poor patients are the most affected as they cannot afford months-long post-recovery treatment at private hospitals. The same has been echoed in the study — Planning for the Post-COVID Syndrome: How Payers Can Mitigate Long-Term Complications of the Pandemic published in the Journal of General Internal Medicine. “These [post-recovery] complications are likely to place additional medical, psychological, and economic burdens on all patients, with lower-income individuals, the uninsured and underinsured, and individuals experiencing homelessness being most vulnerable,” the study mentioned.
For instance, 45-year-old Gopi Shelar, a slum dweller from Dharavi who suffered from a Covid-19 instigated stroke, is struggling to arrange money for his weekly physiotherapy at a private clinic.
“I used to work as a daily wager at construction sites but lost my job due to the lockdown. After four months, finally, my wife has started working as a domestic help. But her income isn’t enough to afford my father’s treatment. The stroke has left my father paralysed on the right side of his body. To pay for his physiotherapy, I need ₹12,000 per month,” said Ramesh, Shelar’s son.
Shelar was diagnosed with Covid-19 in October and underwent treatment at Lokmanya Tilak General Hospital (Sion hospital).
Though the state health department does not have any cumulative data about post-recovery complications, as per city doctors, such cases are increasing. “Post-recovery health complications are more among older people with comorbid health issues. However, we have also received patients with health issues who were mildly symptomatic,” said Dr Gautam Bhansali, consultant general physician at Bombay Hospital.
Dr Hemant Deshmukh, dean of King Edward Memorial (KEM) Hospital, Parel, said that they receive some of the most seriously-ill patients. “We are getting Covid-19 recovered patients with complaints of numbness in their legs or breathlessness. Some have been diagnosed with lung fibrosis, and many have developed neurological issues. We refer them to specialists in the hospital as per their symptoms,” he said.
Covid-19 is not only leading to physical complications but also adding to the mental health issues, which leads to further medical expenditures. Many city psychiatrists are currently treating recovered Covid-19 patients for depression and anxiety. “Spending days in isolation wards among medical staffers wearing personal protective equipment (PPE) is leaving people with a history of mental illness, traumatised. I am getting many of my recovered patients who have redeveloped anxiety or depression,” said Harish Shetty, a psychiatrist from Khar.
Taking note of these issues, doctors have raised the need to focus on post-recovery health infrastructure, especially pulmonary rehabilitation which focuses on monitored exercise to increase the functions of the lungs, along with physiotherapy.
“Even though there are hundreds of hospitals providing treatment for Covid-19, there are hardly any hospitals that focus on overall rehabilitation. They should include chest rehab programmes, breathing exercises, lung ventilation, among others,” said Dr Sundeep Salvi, director of Chest Research Foundation. “Many people who can’t afford it in private setups may report delayed recovery, which can have long-term implications,” he said.
Health activists want the state government to put a cap on prices for the treatment of ailments related to Covid-19 infections, to make them affordable. “Considering the need of the hour, the health department should create some regulations to make the treatment of post-Covid-19 infections affordable for all,” said Dr Abhijit More, co-convenor of the NGO Jan Arogya Abhiyaan.