The treatment that the former Prime Minister Navin Ramgoolam has received at the Isolation Ward of Wellkin Hospital and all the means put in place for his transfer to New Delhi for his treatment in an Air Ambulance is making some think and others react… What about the Covid treatment in a Clinic for all those who can afford it? Why not the Covid treatment in another country of his choice for treatment of this virus related to a comorbidity or other condition? Or the democratisation of clinics in any case?
A case was identified of a patient suffering from acute bronchitis and positive for Covid but has been refused admission to ENT due to saturation. Through his own efforts and contacts, the elderly gentleman has been able to get admission to the Isolation Ward at Wellkin Hospital, where Navin Ramgoolam is resting before his transfer to the All India Institute Medical Services.
No Saturation at ENT Hospital
Dr Zouberr Joomye is clear on the subject that there is no saturation at the ENT Hospital. “There was a wait before admission. It was a personal and fundamental choice of the patient. Most patients are there as a precautionary measure and not for urgent admission to be placed on artificial respiration or reanimation. He confirms that in the ENT, there are 90 symptomatic patients and less than ten of them have severe signs. There are 700 cases placed in hotels and around 3,000 in self-isolation monitored by the Domiciliary Monitoring Unit,” he said. The PMO Advisor continues on the High Level Committee’s Preparedness Plan which has focused on the ENT hospital, “according to their Escalation Plan, it is possible to transform hospitals such as Souillac and Mahébourg, which have already operated as Isolation Wards in the past to accommodate more than 400 people“.
No request for funding from clinics for transformation
“Since the beginning of the pandemic, the Wellkin Clinic was already doing quarantines for mostly passengers, but had to stop for reasons specific linked to Wellkin Management,” he says. But Wellkin Hospital is an exception. Clinics like Wellkin are allowed to perform PCR tests and even allowed to keep Covid-positive patients. But are they equipped? The reason for the funding was mentioned as well as the lack of equipment, but Dr Joomye reveals that he is not aware of any request for funding for a transformation into a Covid Ward from the private clinics to the government. “The clinics are already raising funds from the PCR tests they are doing,” he said. He believes the reason for this is mainly due to organisation and management. “To create a pool of staff operational, it would require applying the same measures as for nurses of all grades in hospitals which include rotation over 7 days or more, isolation and quarantine, PCR testing among others. Are the clinics ready for such management?”
To be treated in a facility or country of one’s choice is fundamental and cannot be refused, discussed or even avoided. For the person who has the necessary means, it should be highlighted that receiving the same openings as Dr Navin Ramgoolam would require special authorisations from the governments and institutions involved.
Health evacuation, a series of authorisations
“Dr Navin Ramgoolam’s case is not isolated. There have been many before him, both Mauritians and foreign nationals, who have sought treatment abroad or repatriation. The formalities for transferring a patient are specific. The request is made to the Ministry of Health, which initiates the procedures with the relevant authorities. The PMO will then give clearance once the Ministry of Health deems the patient to be transportable, the Fitness for Flight, with approval at three levels including the medical teams of both countries for this transfer and the establishment that receives the patient in accordance with the health conditions of the countries. The organisation of a private flight is the responsibility of the patient’s family and will depend on the availability of the aircraft and medical crew. These authorisations are only subject to the health regulations of the destination country and the country of call for refuelling. A medical evacuation takes time from 24 to 48 hours and more, as in the case of Dr. Ramgoolam because of the need for authorization and approval from the medical authorities. Our evacuations to Reunion Island were more flexible in terms of proximity and availability,” he said. Anyone, who can incur the costs and be patient enough, can benefit from this treatment.
What is important to know is that the patient remains at risk during the entire process of preparation and medical evacuation by air as well as landing and transfer to the ground until treatment begins. Along the way, the patient’s illness may worsen or, worse, they may develop other forms of health problems related to the drop in oxygen levels in the blood due to the pressure. A Covid patient should never be subjected to a drop in oxygen!
