Wrong to withhold Covid-19 test result

IN PERSPECTIVE

Karnataka has done well thus far in managing the Covid-19 crisis - even Prime Minister Narendra Modi lauded the efforts of the state government machinery in fighting the deadly disease.

We see the same level of foresight when, with the continuing spike of Covid-19 cases in the state, the Karnataka government decided to reimpose Sunday curfews and extend the timing of night curfew (from 9 pm to 5 am) to 8 pm to 5 am with effect from June 29. Besides, all government offices shall remain closed on all Saturdays from July 10.

However, the recent notification by the Directorate of Health and Family Welfare is a little disconcerting. This office issued a notification on June 27 which mandates the government and private laboratories to withhold the result of the Covid-19 test from the patient, though the details will be shared with the surveillance officers, surveillance units and the Indian Council of Medical Research (ICMR).

This order has been passed under the Epidemic Diseases Act, 1897. The said Act mentions that the government may make temporary regulations to prevent the spread of any dangerous epidemic disease. On a closer look at the order of the Director, we see that this order does quite the contrary.

If the patient or his/her family do not know the test result and neither do the doctors, there will be a delay in seeking treatment. There is no mention in the order as to how the doctors will be informed of the test result.

It could also lead to a situation where the patient may access care at a non-Covid facility and the doctors at that facility will end up treating the patient without knowing the test result. These doctors at the facility and other healthcare workers may end up getting infected.

This is a situation where the people providing relief are themselves vulnerable to the disease. This is very different from most other cases in a hospital where, say, for example, a case of road traffic accident or a patient of liver failure doesn’t really infect the healthcare providers and the latter can continue their work of saving lives without risk to their own.

There is also a significant risk of transmission of infection to other patients who may be admitted to such healthcare centres for unrelated problems, and if they were to undergo surgery, the risk of death is greatly amplified.

Further, the patient not knowing his or her own status can also lead to a delay in self quarantine and a wider spread to the contacts. A delay in seeking care may lead to the patient seeking care at a much later stage when the symptoms may have aggravated, and it may be too late for the patient.

As we see from the points mentioned above, this will only does the opposite of what the Epidemic Disease Act wishes to achieve. It may not be farfetched to say that such an order may even impinge on the Right to Life of that patient which is guaranteed under Article 21 of the Constitution of India.

Disconcerting part

Sadly, the course of action notified here is only going to worsen the disease. The more disconcerting part here is that a similar order was passed on June 13, 2020 by the BMC (Brihanmumbai Municipal Corporation) which said that the test report will not be shared directly with the patient but instead, the laboratory will share the report with the MCGM (Municipal Corporation of Greater Mumbai) and the latter will in turn share it with the patients.

But the judiciary acted on this. The Supreme Court of India took suo motu note of this as part of the monitoring by the top court of the facilities provided to Covid-19 patients, and directed the Maharashtra government on June 19 to provide the reports of test for Covid-19 to the patients directly.

Despite the court’s clear directive to a neighbouring state against such an order, we saw a similar order in Karnataka, just eight days later.

The global pandemic we are facing today needs a continued prudent approach so that we all come out of it with the minimum damage.

Just like the doctors are tweaking their treatment regimens basis new data and experience as it emerges, the administrative machinery too would do well to keep updating its orders and decisions basis the evolving situation on the ground, including keeping track of what is happening in the other states.

As eminent historian Arnold J Toynbee said, `those living in an age of crisis must become pioneers of a better age, striving to find positive solutions, and thereby turning the age into one of achievement’.

(Dr Sumana Arora has worked in senior management positions in some of the leading hospitals including Apollo Group, Medanta Group and Parkway Pantai India Operations; Dr Subramaniam Swaminathan is Senior Consultant, Infectious Diseases, Gleneagles Global)