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SARI what! Telangana docs are gobsmacked by fiat to restrict Covid-19 tests

One practitioner wonders if that is why the state's new case numbers are so low

Hyderabad: The de facto decision of the government of Telangana to test only Severe Acute Respiratory Infections (SARI) patients for the nover coronavirus that causes Covid-19 is worrying doctors.

Within the fraternity, the questions being debated is why extensive testing is not being carried out during this pandemic.

In fact, according to sources in the TRS government, to test anyone other than SARI patients, you will require the permission of the director of health and medical education.

A senior doctor, speaking on the condition of anonymity, said Gandhi Hospital will have to be informed about all SARI cases in the state and details of the patients will have to be shared with them.

The patient is be shifted to Gandhi Hospital if the test turns out to be positive.

Random testing, contact tracing and identifying secondary contacts has been completely stopped. Government officials are not passing on any numbers or suspected cases list to district medical and health officials.

A senior district medical and health official, speaking on the condition of anonymity, said, “We are not able to understand what the government is doing. We have been told that secondary contacts will have to henceforth approach hospitals only if they have Covid-19 symptoms. If they are mild, home quarantine is advocated. If they develop breathlessness or pneumonia, only then will tests be done. Not otherwise.”

Both government and private doctors are very worried. They are expressing their displeasure privately that this is not the right way to go ahead. Tracing and testing has to be carried out as cases in lower numbers can be managed better than if and when the spread is high, doctors say.

A senior government doctor said, “Oral instructions have been given to department heads in the Covid designated hospitals. These are creating a lot of confusion. We are not able to understand what must be instructed to a patient at the clinical level. There is a lot of fear already but stopping tracing and testing is going to only add to the problem.”

In the past few days, Telangana's daily medical bulletin has been reporting new coronavirus cases in the single digits. This, according to the doctor, is clear evidence that there is no testing being done.

“It is not evidence of reduced incidence of disease. Compare the situation of Hyderabad to Mumbai, Delhi, Ahmedabad, Indore and other cities where tests are bringing in numbers and giving an idea of the spread. Here too, the same must be followed but it is not happening,” the doctor said.

Non-Covid hospitals are anxious as not testing patients may lead to spread of the undetected infection. Healthcare workers would have to take extra care and they are not sure how can they plan a post-lockdown work strategy in such a scenario.

With the cost of personal protection equipment (PPE) high and safety guidelines entailing a lot of costs, they are not sure about the future for those who are in medical practice.

A senior government official said, “Herd immunity is needed. The Telangana government is now looking at that option only. For this reason, we have reduced the testing process. We find the exercise costly. There has also been tremendous social and economic disruption due to the lockdown. By bringing the number to zero, the next move is to show 14 days without any new cases and end the lockdown in the state.”

This, medical experts say, is a classic ‘iceberg theory’. Without testing kits at their disposal even though they are the frontline, they are unable to decide whether to stand by the strategy, or otherwise.

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