Mumbai, 28th April, 2020: The COVID-19 pandemic has put our healthcare system to the test, even as our doctors, nurses and other health workers rush to meet the surge of patients. The pandemic has also made things tougher for patients with pre-existing medical conditions, especially if they happen to contract the disease. In India, there are around 13-15 Lac dialysis patients and around 25% of the 60,000 dialysis patients in Mumbai suburban region are affected because of the closure of their dialysis provider due to several reasons. These include running out of supplies, to a COVID-19 positive patient or staff found at the hospital or dialysis center. As a significant step to address the difficulties faced by the kidney patients for, The Renal Project has started operations at its new Dombivli (Mumbai outskirts) site for ONLY COVID-19 POSITIVE kidney patients.
Whereas COVID-19 negative patients scramble for finding other dialysis centers who may charge them anywhere between Rs. 6-7000, which is 5 times the cost of regular dialysis, if the patient is COVID-19+, the patient really is left counting his/her days.
Mr. Kulkarni, for instance, is one such patient. Now COVID-19 positive, he had to be rushed to the hospital on April 15 when he complained of chest pains and difficulty in breathing. Knowing he was a kidney patient, the doctor ordered an urgent blood report, which showed high creatinine levels and excessive fluids.
“A COVID-19 patient has nowhere to go for life-saving dialysis treatments”, said Shashank Moddhia, founder of The Renal Project. His venture runs a chain of dialysis micro centers alongside a newly constructed dialysis ward in the Neon hospital in Dombivli. This hospital is one of the few places allocated for COVID-19 positive patients by the local municipal corporation.
The Renal Project has decided to serve such patients, by opening their doors to such cases. They’ve also drafted specific SOPs and protocols to deal with such cases.
“Till a month ago, we would’ve never imagined that we would perform the first dialysis in our new center located in Dombivli in these times, especially on a COVID-19 positive patient. Since then, we’ve decided to serve COVID-19 positive cases exclusively and ensure that they don’t end up stranded in the current situation,” said Moddhia.
While the SOP is extremely essential to protect technicians and doctors and ensure that the center is available for patients who need it the most, there is a definite strategy Mr. Moddhia suggests for facilities to re-start quickly and effectively back up when they have to shut down, so that they can start serving their kidney patients without them having to risk loss of therapy.
If a dialysis facility had to shut down due to COIVD-19 positive case found, here are the steps to re-start service in 3 days –
- Inform your regular dialysis patients about the shutdown; though ensure that it’s closed for three days only.
- Test all patients and staff, even those who were not working on the day when COVID-19+ case was provided therapy. Identify staff that needs to be self-quarantined.
- Disinfect and fumigate the facility with chemicals for COVID-19 control.
- Prepare a revised schedule to accommodate patients scheduled for the shutdown period. Prioritize it according to the criticality of their condition.
- Inform the patients’ respective nephrologists to handle their cases for the shut-in period through medicine and dietetics.
- Advise patients to refrain from visiting other dialysis centers unless critically required, as they can risk infection from other places.
- Arrange for PPE gowns kits for dialysis technicians for at least 20 days.
- Inform repair technicians for dialysis machines to be available on an urgent basis in the coming days, especially in a critical situation.
- Counsel patients and their family that you’d be available to take care of them.
- Motivate and thank your staff for their continued support and availability.
India’s COVID positive crisis remains, unfortunately, on the rise. It requires rethinking in terms of facilities for such patients. We hope that more health centers start addressing patients with existing problems or those who require routine, OPD treatment.