Patient contact without PPE sends more doctors, nurses to quarantine

Risks for healthcare personnel getting infected by the novel coronavirus are increasing in the country, thanks to a scant supply of Personal Protective Equipment (PPE) against the demand.

Already, three doctors and two nurses, according to government data, have been infected by the virus.

Besides, over 90 health workers across Bangladesh, as per a doctors' platform - FDRS, have isolated themselves in home quarantine, suspecting they have contracted the virus.

However, no government data are available, though, about the number of doctors and nurses in home quarantine.

In such a situation, healthcare personnel are suspenseful about their safety while attending patients amid an inadequate supply of protective gears for them.

According to the health directorate, hospitals in the country need 10 lakh PPE in the next three months while the monthly supply of masks required is 10 lakh.

But, the central medical stores have collected 3.57 lakh PPE so far, of which some three lakh have been supplied to different hospitals. Now the reserve is merely 54,000.

Doctors complained that not all hospitals have received enough supply of PPE to meet their demand, forcing many to attend patients without the protective gears.

Already, intern doctors of some medical college hospitals in Rajshahi, Sylhet and Khulna have gone for work stoppage to stress their demand for the supply of PPE.

In the meantime, many doctors are also in home quarantine after attending patients in their private chambers.

Dr Abdul Wadud Chowdhury, the chief of cardiology department at DMCH, placed himself in home quarantine after he had seen a Covid-19 patient in his private practice on March 16. The patient died of coronavirus soon after.

Meanwhile, Cox's Bazar Sadar Hospital sent 21 health workers, including doctors, nurses and cleaners, to home quarantine as they came in contact with a patient who died of coronavirus on March 24.

Besides, 10 doctors and nurses from Dhaka Medical College Hospital (DMCH) as well as 15 from Delta Medical College Hospital, 10 from Apollo Hospital, 15 from Anwer Khan Modern Medical College Hospital, three from Syed Mansur Ali Medical College Hospital and 15 from Khulna Medical College are in home quarantine.

Dr Abdur Nur Tushar, consultant at the Foundation for Doctors' Safety and Responsibility (FDRS), said patients with cold, cough and other respiratory issues should be separated at the hospital gate according to the World Health Organisation guidelines.

Otherwise, coronavirus cases among doctors will rise and with that the number of doctors in home quarantine will go up too, he opined.

"But many hospitals have no such facility to isolate patients, nor do they have separate Covid-19 corners for coronavirus patients," he added.

Usually it takes some time to develop Covid-19 symptoms in a patient and the patient might see a doctor in the meantime, increasing the risk of silent infection among doctors, he said.

Dr Tushar also said many doctors have no training on safety measures or PPE, causing doctors to be more vulnerable to infection. Besides, the increase of coronavirus patients will raise the infection rate among nurses as well. The situation then may become serious as much needed healthcare professionals would be out of action.

Doctors said if they come in contact with coronavirus patients, they have to keep themselves in a 14-day home quarantine even if they are not infected. It ultimately deprives the patients of proper healthcare.

Professor Khan Abul Kalam Azad, principal of the medicine department at DMCH, said the patient-to-doctor transmission of the virus is increasing because patients do not go to the selected hospitals. Besides, doctors see patients without wearing PPE.

"For that reason, doctors should treat patients carefully. They should not see the patients in a group; rather one or two should go to collect information about the patient," he said.

Professor Dr Benzir Ahmed, former director of health directorate (disease control), said doctors have to get very close to patients when they examine them. So enough PPE should be ensured for doctors for their safety, he opined.

Meanwhile, Dr Abdur Nur Tushar said the process of separating patients should be followed strictly. "Every incoming patient should go through the coronavirus testing before seeing any doctor in the hospital."

"If patients cannot be separated at the entry points, they will pose risks for other patients. Besides, different hospital units will become quarantine units," he said.