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May 9, 2020

Experts call for providing COVID-19 patients at home with tele-consultation


May 9, 2020

Expressing serious concern over dozens of unexplained deaths of asymptomatic COVID-19 patients in home isolation in Sindh, local and foreign health experts have advised the government to provide tele-consultation to the patients in home isolation on a regular basis.

The experts also asked the patients and their family members to closely monitor their condition, and in case their health deteriorated, they should immediately rush to a tertiary-care hospital.

According to the experts, every unexplained death should ideally be investigated by the authorities, and in case of COVID-19 patients who had died in home isolation, post-mortem examinations on their bodies should be carried out to ascertain the actual cause of death. They said such patients died after suffering from strokes, lung collapse and heart attacks, which could be averted in other patients by providing them appropriate treatment.

Sindh Health Minister Dr Azra Pechuho also urged the COVID-19 patients with underlying conditions and classic symptoms of the viral disease to approach isolation centres and tertiary-care hospitals in case of health deterioration. She lamented that most of the COVID-19 patients tried to conceal their symptoms and health condition.

As many as 60 COVID-19 patients, including 52 in Karachi alone, who had isolated themselves at their homes on medical advice, have died at their residences during the last 50 days in Sindh, officials said, adding that most of these patients had either no or mild classic symptoms of COVID-19 but many of them could be patients of diabetes, hypertension, cardiovascular disease and other underlying health conditions.

“It is has been observed that COVID-19 patients are hesitating to seek medical help, fearing problems for their family members and due to that they are collapsing at their homes.

“Patients should not be afraid of this disease and also not be worried about their family members. In case of shortness of breath or any other health condition, they should seek medical help and rush to any of the health facilities treating coronavirus patients,” said Prof Javaid Khan from the pulmonary and critical care section of the Aga Khan University Hospital Karachi while talking to The News on Friday.

Prof Khan maintained that there was fear in many people about hospitals and they felt that they would not get appropriate care at the health facilities.

“Another reason behind people delaying seeking medical help is the fear that what would their neighbours think of them if they go to hospital and what would happen when everyone would come to know that they had coronavirus infection,” Prof Khan added.

He said any person quarantined at home should follow one simple advice. “Buy a pulse oximeter which costs just Rs1,000 to 1,500 and check oxygen saturation at home after every few hours. Any COVID-19 patient with saturation below 90 per cent must rush to a hospital. Otherwise, if saturation is fine, they need not worry.”

Another health specialist Dr Usman Ghani, who is a consultant stroke physician at University Hospital of Coventry & Warwickshire, United Kingdom, said the unexplained sudden deaths of COVID-19 patients in home isolation were a serious issue and people should be aware of the fact that COVID-19 is not a normal flu or cold.

“Cardiac conditions (heart attacks, heart failure, arrhythmias) and large stroke are serious complications along with PE (pulmonary embolism/blood clot in lungs) of COVID-19 which can lead to a sudden death. In several countries of the world, young and healthy people having coronavirus infection collapsed suddenly and died,” Dr Ghani said.

To a query as to what should be done by the COVID-19 patients in home isolation, he said they should closely monitor their temperature and oxygen saturation. “You can buy a pulse oximeter online. If persistent cough or temperature keeps on spiking after three to four days, the patient needs to be checked at a hospital for chest x-ray and oxygen levels along with complete blood picture,” he added.

Dr Ghani maintained that if oxygen levels of a COVID-19 patient are low, he or she requires oxygen and a CT scan of chest to rule out any blood clot. “Oxygen at that stage can prevent admission to the intensive care unit (ICU) or a ventilator,” he said.

Commenting on the deaths of people in home isolation, the Sindh health minister said COVID-19 patients were not being forced to live at their homes in isolation, adding that only those with no or mild symptoms were being advised to isolate themselves at their residences.

“Only those COVID-19 patients are suddenly collapsing who have other underlying conditions including diabetes, hypertension, asthma, cardiovascular disease and other co-morbidities. These are high risk patients and they should be under supervision of doctors either at the field isolation centre at the Expo Centre Karachi or at any other tertiary-care health facility,” Dr Pechuho said.