Chandigarh’s Covid dialysis facility may hit other critical patients

Amarjot Kaur
Tribune News Service
Chandigarh, September 7

The UT Administration’s recent directions to the PGI on reserving two more machines for maintenance dialysis of Covid patients is likely to affect Covid-negative patients with serious kidney-related complications in need of emergency dialysis.

The number of patients on regular or maintenance dialysis in the city is pegged at 230. The PGI records have revealed that those needing emergency dialysis is more. The city has a total of 118 dialysis machines, 43 in government sector and 75 in private and charitable ones.

At present, the PGI was administering 30-35 dialysis daily on non-Covid patients, said Dr HS Kohli, Head of Nephrology. PGI. The PGI has three stations for 16 Covid patients on dialysis. Also, staff, who monitor dialysis to Covid patients, were only assigned to non-Covid patients after being tested negative and a break of five to seven days, he said.

Previously, Dr Kohli had communicated to the PGI administration, “At the cost of providing maintenance hemodialysis (MHD), we should not neglect patients with acute kidney failure following trauma, surgery, delivery and a host of medical conditions, pancreatitis being one.” Concerns over febrile illnesses with multi-organ involvement in July, August and September were also raised.

He had said, “There is need for a dedicated MHD centre for Covid patients with end-stage renal disease (ESRD), who do not require ICU care or active medical interventions, so that these patients continue to receive procedure.”

It was also proposed that Shri Dhanwantry Ayurvedic College and Hospital, Sector 46, a designated Covid care facility, which had a functioning dialysis unit (with 4-8 dialysis stations) and infrastructure could be adapted to make it as a dedicated Covid-19 MHD unit without any significant inputs.

The administration had, in an August 19 order, directed two private dialysis centres — Rahi Care Dialysis, Sector 22, and Dharam Hospital, Sector 15 — to reserve two dialysis machines each for Covid patients on maintenance dialysis.

However, they are yet to comply with government’s orders.

UT Adviser Manoj Parida said, “First of all, dialysis patients don’t require any extra staff, only laboratory technician-type fellows. If they need more staff, they will get more staff.”

He added, “Out of the total of 230 patients on maintenance dialysis, I assume only 10-15 patients could be Covid positive. For these patients, we have ordered GMCH-32 and two private nursing centres to reserve two machines each. Thus, the PGI has also been asked to keep two more, so six machines will be enough for Covid infected. We will issue a letter to the PGI in this regard.”

Reserve isolated area with machines for Covid: Expert

On an idea model for managing Covid positive patients on dialysis, Dr Vevikanand Jha, president of International Society of Nephrology and chair of Global Kidney Health at Imperial College, London, said, “There is simply a matter of anticipating this issue. It was foreseen and solutions were described early in the course of the pandemic. Professional societies had brought out guidelines.”

The strategy emphasised preparedness — screen patients using reliable and efficient methods, pick those who are positive and provide them treatment (dialysis) in a separate area that is isolated from the uninfected.