Deaths surge as doctors feud over COVID-19 pre-admission status

Many private hospitals now insist on a coronavirus disease (COVID-19) certificate before attending to sick patients, a situation that has inadvertently led to many non-COVID-19 deaths.

The Guardian investigation revealed that some patients, as a result, can no longer visit the hospital, while some hospitals are even turning back persons with medical conditions they had already been managing.

Since one of the largest private hospitals in Lagos was shut down on account of exposure to COVID-19 in April, many private hospitals have closed their doors to the admission of patients.

Unfortunately, patients with congestive heart failure, renal impairment, asthmatic attacks and other medical emergencies must have immediate care or give up the ghost.

A prominent Nigerian with a history of hypertensive heart failure died recently because all the hospitals he was taken to during a crisis rejected him. At the morgue, the corpse was described as a COVI-19 case. The authorities forced the family to hurriedly bury the corpse while his kin was quarantined.

Also, hospitals that admit or treat patients that later test positive to COVID-19 may be shut down and stigmatised as ‘COVID-19 hospitals’.

It was found that Nigerians are losing confidence in the health care system as more people resort to alternative care, especially herbal medicine and traditional birth attendants, often with grave complications and fatalities.

The situation has, consequently, generated debates within the medical community, with experts noting that misdiagnosis from improper care because of COVID-19 stigma or phobia is causing lots of avoidable deaths.

They blamed the Federal Government, the Nigeria Centre for Disease Control (NCDC) and state governments for criminalising of the treatment of COVID-19 patients outside isolation centres.

Their recommendations included the creation of emergency centres for COVID-19 related illnesses in government hospitals; a comprehensive preparedness checklist for coronavirus disease in hospitals; and accreditation and capacitation of more qualified private healthcare facilities as COVID-19 management centres.

They noted that with the provision of Personal Protective Equipment (PPE) and financing, private healthcare providers can offer service to all patients and identify those with COVID-19 for a referral to special treatment centres.

A consultant paediatric surgeon and Chief Medical Director (CMD) of Lagos University Teaching Hospital (LUTH) Idi-Araba, Prof. Chris Bode told The Guardian: “We lost a prominent relation in March. He was a cardiac patient who suffered a stroke and was referred to a teaching hospital in a nearby state. The teaching hospital did not open their gates, asking for a COVID-19 test result before they would attend to him. He was taken to a second teaching hospital a hundred kilometres from the first but was similarly rejected at 11:00 p.m. He died on the way to a third hospital after midnight. This was a father, husband, brother, and community leader. A human being!”

Bode said a number of related deaths could have been avoided if health institutions, private and public, had embraced elaborate, widespread training for their workers early enough.

An epidemiologist and Director General of NCDC, Dr. Chikwe Ihekweazu, said: “While we have to make difficult decisions to balance the demands of responding directly to the COVID-19 pandemic with the need to maintain the delivery of other essential health services, hospitals should not demand COVID-19 status before treating patients for other health conditions. Instead, hospitals should establish a process to screen for COVID-19 such as temperature checks and history taking. If an individual is suspected to have COVID-19, the hospital should have a referral pathway that does not prevent the individual from accessing care for other conditions.”