As India has increased testing for the novel coronavirus, the number of positive cases too are rising steadily in the country. With state-run hospitals being roped in to act as isolation facilities for patients testing positive, the government-run super speciality hospitals that cater to cancer care are also gearing up to treat COVID-19 patients.
With patients suffering from various forms of cancer being immunocompromised due to chemotherapy and radiation, several public health experts argue that having wards for COVID-19 patients in cancer care hospitals is dangerous. What’s worrying is that families of cancer patients say that they have been turned away from treatment at government-run cancer care hospitals.
At 9.12 am on April 6, 4-year-old Sayan Lashkar died at Kidwai Memorial Institute of Oncology. Sayan’s father Najmul Hossain Lashkar says that doctors at Kidwai turned his son away and did not provide radiation as prescribed.
“My son had stomach cancer. We are from Kolkata and came to Bengaluru 11 months ago for his treatment. For the last six months, he underwent radiation. In March end, the doctors at Kidwai prescribed radiation therapy to reduce the size of the tumour and then remove it via surgery,” Najmul recounts.
However, he claims that on April 2, when he took his son to Kidwai for the radiation therapy, the doctors allegedly turned them away stating that the isolation wards were being allocated for COVID-19 patients.
“Dr Pragati, who was treating my son, said that it won’t matter if my son dies today or in the next four months. She thought I could not understand English. My son was in immense pain. He would keep crying out for help. When we took him to the hospital, the doctors said radiation can be done only after two weeks. I was next to him when he died. He raised his arms, then he looked at me and said ‘hold me’. He closed his eyes after that and did not wake up. I cried and kept trying to wake him up but I think I knew he was no more,” he adds.
A report released by Naavu Bharatiyaru documented nine cancer patients who were asked by Kidwai to come back for treatment after a month as they were using isolation facilities for COVID-19 patients.
“There was a patient, an old lady from Bengaluru. She has no one but her grandson. She has ovarian cancer and she too was turned away and asked to come back after a month for radiation,” says Latifa, a volunteer for Kidwai Memorial Institute of Oncology.
Speaking to TNM, Gowramma, a 70-year-old Bengaluru resident, alleges that she was asked to stay at home and come back for treatment after a month. “I have been going to Kidwai for treatment since the last 2.5 years. This is the first time they have turned me away. The doctors said that COVID-19 patients are being housed and asked me to come back in a month when this lockdown ends,” she says.
However, doctors at Kidwai denied allegations saying that only 25 beds were designated for COVID-19 patients. “We have separate wards for cancer patients. The COVID-19 patients will be housed in the Dharamshala building. For those patients who live in other districts or states, we have asked them to stay at home. We are following up with them via phone. We have not been turning away any patients,” says Dr Prabha, who works in Kidwai’s palliative care department.
In Kerala’s Thiruvananthapuram, the Regional Cancer Centre’s (RCC) sixth floor has been converted into an isolation facility for COVID-19 patients.
“Cancer patients can also get coronavirus. Patients who get chemo-radiation will have lesser immunity. High-risk cancer patients are already isolated in a unit and they have no interaction with other patients. Now, for coronavirus, we have arranged the sixth level of the pay ward as an exclusive isolation ward for cancer patients suspected of having coronavirus. These can be clinical findings or patients who show symptoms like cough and cold. So far we have had no such cases,” says Dr Madhu Murali, RCC’s Deputy Superintendent.
However, the RCC has not been mandated to treat coronavirus. “We only move the cancer patients suspected of having coronavirus to the isolation ward. If any of them test positive, then they would be taken either to the Medical College or other coronavirus treating centres mandated by the government,” he adds.
He further says that the RCC has ensured that anyone suspected of having the disease would be taken to the isolation ward through a separate lift.
The Stanley Medical College in Chennai too has allotted 30 beds to treat COVID-19 patients.
“Patients suspected to have COVID-19 are accommodated in a separate block. We started with 30 beds and have now increased it to 150. We have taken over a separate block. Other patients don’t come in contact with this block. The other wards where normal patients are getting treated are at least 500 metres away. This ward (COVID-19) is opposite to the medical college. We shifted the OP wing that was there earlier. Minimum in patient reach is at least 500 metres away. Cancer patients are in no way affected,” Dr P Balaji, Dean of Stanley Medical College, says.
Speaking to TNM, public health expert Dr Sylvia Karpagam says that treating COVID-19 patients and those suffering from cancer in the same hospital is extremely dangerous.
“Cancer patients have very low immunity, especially those who undergo chemotherapy and radiation. They are generally susceptible to catching infections. If COVID-19 patients are housed in the same building, it is very risky and dangerous. Government-run super specialty hospitals can be used only for their ICU facilities while the other government hospitals can be converted into isolation facilities. Risking the lives of other patients is not correct,” she says.
She further states that private hospitals must also be taken over by the respective state governments on a temporary basis to provide critical care and also to house COVID-19 patients.
“If you see the expert committee suggestions to the state government in terms of extending the lockdown, in many states several private hospitals that could have been converted into isolation facilities have not been converted. If government-run super specialty hospitals are not left alone, where will the poor people, who are not positive, go for treatment?” she asks.
According to Dr T Sundaraman, former Dean of School of Health System Studies, displacing cancer patients to tackle COVID-19 cases is unwise. He says that respective state governments must ensure that cancer care hospitals do not earmark existing beds in their facilities for COVID-19 patients.
“Displacing cancer patients is just wrong. Certain private hospitals or certain wings of private hospitals can be taken over by the government and converted into treatment facilities for cancer patients. A lot of poor people go to government-run cancer hospitals because the price is highly subsidised. Most of these hospitals have earmarked existing beds for COVID-19 and have not created additional beds. In fact, housing them in the same space is highly risky and problematic,” he adds.
With inputs from Cris and Anjana Shekar