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Testing asymptomatic patients key to protecting other hospitalised patients

It is important for hospitals to test asymptomatic patients so that they can protect other hospitalised patients and healthcare workers from COVID19 infection

Testing asymptomatic patients admitted for non COVID illness for COVID- need of the day to protect other patients in a hospital from the novel corona virus infection (COVID19).

Mr Ray had to get his 65 yr aged brother admitted for a heart attack in the middle of the raging pandemic. He was not tested for COVID as he did not fulfil any of ICMR’s testing criteria and the admitting hospital was reluctant to test fearing reprisal from the government for not adhering to criteria. Mr Ray was put up in a twin sharing room where the other patient was a young man. The young man was due to undergo an orthopaedic surgery the next day. He too did not fulfil any of ICMR’s testing criteria, but the treating physician insisted on getting a COVID test before surgery.

Hospitals are wary of testing fearing government wrath . This situation is fraught with danger as COVID positives admitted to hospitals unknowingly for other illnesses are potential disease spreaders in these hospitals

The test came to be positive as most patients with COVID infection are asymptomatic positive. Mr Ray was worried sick, the nurses and other health care workers attending to both the patients in a single room were isolated.

This situation is becoming all too common across nursing homes and hospitals across India. ICMR testing criteria does not recommend testing of asymptomatic individuals unless they are contacts of a positive patient or health care workers – something that presumes lack of community transmission. Patients without any COVID symptoms admitted for non covid illnesses can be asymptomatic positives.

It means that they do not have any symptoms of corona virus illness, yet they harbour the virus and spread them. Identifying such individuals is crucial in the closed confines of a hospital set up. They not only expose health care workers, they are also potential source of infection for other patients and their attendants. Surgeries performed on such patients risk the spread of virus via aerosols and if such patients develop symptoms of COVID, they tend to do poorly.

In a bid to show declining COVID numbers to the media and give false reassurances to the public, governments are restricting testing. Each COVID test has to be accounted for and can be traced to source. Hospitals are increasingly wary of testing fearing government wrath and harassment. This situation is fraught with danger as COVID positives admitted to hospitals unknowingly for other illnesses are potential disease spreaders in these hospitals.

The solution for this dilemma lies in liberating testing policy from outdated guidelines. Or, changing guidelines to include patients admitted to hospitals for non COVID illnesses for a COVID test even if they show no signs and symptoms of COVID infection.

 

Dr. Rajesh Dey
Dr. Rajesh Dey
Dr Rajesh Dey is a consultant, liver transplant and a hepatobilliary surgeon. He can be reached at: drrajeshdey@gmail.com
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