Heart, stroke, cancer patients avoiding treatment

Labaid Cardiac Hospital in Dhaka is a strangely quiet place these days. Not a single outpatient has shown up there in the last two days. Before Covid-19 made inroads in the country, on an average, 25 heart attack patients would come to the hospital for treatment each day.

The number of patients has declined steeply at the National Institute of Cardiovascular Diseases too, where all types of surgery is on hold.  

The National Heart Foundation is also witnessing a low number of patients with only 20-25 percent seeking treatment at present. Only patients needing bypass surgery and those for routine check-ups are coming to the hospital.

Even people with life-threatening emergencies like heart attacks, stroke and other chronic diseases are reluctant to go to the hospital for fear of catching coronavirus, and also because of the countrywide transportation shutdown. 

Moreover, all activities except for emergency services are suspended in most hospitals. Doctors have also stopped treating patients at private chambers considering their health safety. So, the number of patients has fallen drastically both in government and private hospitals.

In fact, most patients suffering from chronic diseases are not coming for treatment.

Shahjadi Dolly, Deputy Director (PR) at the National Heart Foundation, said, "75 percent of our patients are from outside Dhaka. Only emergency heart patients are coming now amid the ongoing transportation shutdown."

"We have kept all our services open, but very few of the patients who need heart surgery, heart-stenting and angiograms are coming," she said.

Before the coronavirus hit, stroke patients or those with neurological problems thronged the National Institute of Neuroscience in large numbers every day. But in the weeks since the coronavirus began its spread in the country, the number has plummeted to a great extent. No patients other than emergency ones are seen there now.

Professor Badrul Alam, joint director at the hospital, said, "The number of our outpatients has declined significantly. When a person has a stroke, he/she cannot stay at home, so we have stroke patients. But very few patients are coming to the hospital because of the transportation shutdown."

Cancer patients need to stay under the supervision of doctors regularly. However, the number of patients coming to cancer hospitals for chemotherapy and radiotherapy has decreased, said sources at the National Cancer Institute and the Ahsania Mission Cancer Hospital. 

Dr Rafiqul Islam, assistant professor at the Medical Oncology Department of the National Cancer Institute, said, "We used to treat more than 300 patients per day in our department.  At present, not more than 100 patients are seeking treatment. They are not coming unless it is an emergency."

Diseases continue onslaught

It is not that other diseases are at bay in this time of coronavirus pandemic. People are being affected, and are dying without treatment on many occasions.

There are allegations that many patients died without treatment after moving from one hospital to another.

Zulfikar Ali, a resident of Keraniganj in Dhaka, has been suffering from heart disease for the last three months and is being treated at the National Institute of Cardiovascular Diseases. On April 2, a myocardial perfusion imaging (MPI) test was supposed to be performed on him. His treatment – whether he will undergo heart surgery or heart stenting – will be determined based on the test.

But a day before his testing date, he learnt that his MPI test would not be possible for non-availability of a "tracer" – that comes from Europe – owing to the suspension of all international flights amid the coronavirus pandemic.  

Now, Zulfikar's treatment depends on when the situation becomes normal.

Dr AM Shamim, managing director of Labaid Hospital, told The Business Standard that heart, stroke and other patients cannot come to Dhaka because of the shutdown of public transportation. Fear of coronavirus is also causing patients and their families to stay at home unless it is an emergency.

Without prompt treatment, many patients have suffered permanent damage or have died from untreated heart attacks and strokes, he said, adding that non-Covid health problems are more concerning than Covid-19 as more people are dying from other serious conditions by staying home for fear of catching Covid-19.

Professor Rashid-e-Mahbub, president of the Bangladesh Medical Association, said, "People are avoiding treatment or failing to receive treatment which may have a long-term negative effect on them. If surgery cannot be performed on those requiring immediate surgery, they might suffer serious damage."

"Everyone is suffering from the coronavirus pandemic – some physically and some economically. Telemedicine has helped to some extent in this situation. But surgery cannot be performed through telemedicine."