Thread by @AmbarishSatwik

Thread. Consider this a plea. Busy hospitals (some of them designated covid hospitals) and labs are being probed and barred from covid testing in the middle of a pandemic for testing asymptomatic cases (particularly those being admitted for other reasons). 1/n

Hospitals have to be allowed COVID testing prior to admission (for any ailment) to determine where to admit and treat these patients - in a designated covid ward / ICU or in a covid free area. 2/n

Covid and non-covid areas in the same hospital need cordons sanitaires and separate air handling units and a green zone between them for doffing and donning of PPEs.
3/n

Hospitals are duty bound to prevent COVID cross-infections as those sick enough to be admitted (for other conditions) in the middle of a pandemic constitute the most vulnerable cohort. 4/n

Nativity, other medical conditions, cancers don’t magically ebb away just because we’re beset by an epidemic. So, COVID testing isn’t only for housekeeping reasons and to protect HCWs. This was the NHS policy for all patients being admitted. It should be ours as well. 5/n

Surgical patients: as will be evident in this Lancet paper, the 30 day mortality in patients who tested positive for COVID is 23.8%. Pulmonary complications occurred in 51.2% cases. It is catastrophic to operate in the times of COVID, if the patient is covid positive. 6/n

This is irrefutable evidence in favour of mandatory pre-operative testing. 7/n
thelancet.com/pdfs/journals/…

And here is a consensus document - the ‘COVID-19: pandemic surgery guidance’ that mandates COVID testing for all surgical cases. 8/n
4open-sciences.org/articles/fopen…

There can be absolutely no justification for withholding any emergency manoeuvre or treatment for want of a covid test result. This shouldn’t be read as an apologia for anything of the sort. Most untested surgical and obstetric emergencies are being managed by HCWs in PPEs. 9/n

The ICMR document outlining strategy for COVID-19 testing in India hasn’t been updated since 18 May 2020. 10/n

We’re smack bang in the middle of community transmission and according to the said document, even a patient with symptoms of Influenza like illness (not residing in a containment zone and not a contact of a lab confirmed case) cannot get tested for covid. 11/n

I would submit that the ICMR guidelines on testing should not be considered as revealed commandments from a deity that are unalterable and cannot be questioned or challenged, particularly when you’re armed with evidence and scientific data that flies in its face. 12/n

These are 'guidelines'. They should be based on consensus documents that bear the collective wisdom of federations of physicians and surgeons treating covid and not the other way around. 13/n

I urge the powers that be and the people in the war room to please reconsider the decision about testing asymptomatic patients. Incalculable damage will be done if you prevent and proscribe hospitals from testing when (and in whom) they deem it necessary. n/n