Covid-19: Without a safety net, smaller Kerala hospitals were the worst-hit

THIRUVANANTHAPURAM: When a 45-year-old man came with symptoms of cold and cough on June 19, the doctor and staff at Sree Krishna Hospital in Thirumala, Thiruvananthapuram had no idea that he was a Covid-19 carrier. The man who works at VSSC had no travel history and no one in his family had toured recently. The doctor administered medicines after a primary diagnosis.
On June 24, he tested positive and a message was conveyed to the doctor and his staff to go on quarantine.
“He was asymptomatic and did not belong to high-risk groups. We were not sure whether he covered up details. We are fighting against such odds without a protective mechanism,” says Dr V Sukumaran (74), who is now in quarantine. This was not the case at Sarada Hospital, situated in the suburbs of Kochi at Nayarambalam in Vypeen.
On June 15, a 42-year-old man did not reveal his travel history; but Dr KR Ramachandran Menon (65), whom he consulted, knew something was not right. “I had intuition… I checked all basic parameters and he had symptoms. I told him to go to a bigger hospital and referred him to Kalamassery medical college. He tested positive on June 22; he came from another state and hid the fact from me. The result; I had to shut my hospital and am now in quarantine with my staff,’’ said Menon. This is the situation faced by smaller hospitals and clinics run by single doctors in state.
“They are considered as the lifeline for the poor. We have close to 3,000 such hospitals in Kerala and 75% are situated in villages. Many of them in Thrissur, Malappuram, Palakkad and Kasaragod are the worst-hit. People approach these hospitals for primary care and there are clinics that get 500-600 patients each day. They cannot afford thermal screening or protective gears before consulting patients. Due to fear, many went into temporarily closure,” said chairman of Kerala Association of Small Hospitals and Clinics Dr Suresh Kumar.
No one is aware that such hospitals were the primary target as many poor people approached them first. The impact of Covid-19 was huge for these hospitals. Only 50% of them are functioning now and people in rural areas are affected because of this. For routine checkup and periodic follow ups, they approach such smaller hospitals, he said. Now, an I-SAFE network protocol has been launched by IMA’s Dr Sreejith N Kumar, ensuring protection kits for small hospitals and clinics.
“We are procuring protective gears and giving it to smaller hospitals free of cost as most cannot afford to buy them at regular intervals. It has benefitted many small hospitals in Idukki, Wayanad and Kasaragod. We have 40 hospitals who utilized this protocol in Kasaragod, which was the worst-hit area earlier. We have supplied kits to 600 hospitals,” said Dr Sreejith. “I-SAFE protocol saved me or else I would have turned positive now. I was wearing PPE kit and face shields when the patient came. I tested negative as I had the right kit,” said Menon.