Covid-19 kept cardiac patients at bay

Abdul Hakim suddenly felt severe chest pain late at night sometime in August last year.

The 65-year old retired government official from Habiganj was whisked off to a district hospital but only to be referred to Dhaka.

But upon reaching a private hospital in the capital city, the first thing he faced was questions on whether a Covid-19 test had been recently performed on him.

"Since my father required emergency treatment, the hospital authorities immediately performed a chest scan to see whether he was infected with the virus and after finding no symptoms of Covid-19, he was admitted," Rezaul Karim, son of Hakim, told The Daily Star.

Still though, doctors and nurses barely touched his father as there was panic all around over contracting the rouge virus.

"They performed an angiogram the very next day which revealed two blocks in his coronary arteries," Karim said, adding that the doctors then promptly inserted two stents in the affected areas.

During the height of the ongoing coronavirus pandemic, when the focus was firmly on Covid-19 and its treatment, many other ailments did not get due attention.

Hospitals saw fewer heart patients, who are more susceptible to suffer from severe Covid-19 infections, as many of them refrained from visiting hospitals in fear of exposure.

The coronavirus also forced the authorities of both government and private hospitals to bring some changes to their cardiac care procedures, which included curtailing routine and planned check-ups, and non-urgent procedures.

Most hospitals in Dhaka did not allow patients with cardiovascular diseases to gain admission without a recent negative Covid-19 test result.

If tested positive, the patients would be sent to the Covid-19 units for treatment. There were even some cases when hospitals in the capital denied emergency treatment to patients without a coronavirus test result.

The National Institute of Cardiovascular Diseases (NICVD), the lone specialised public hospital for cardiac care, provided emergency services to all patients even without Covid-19 negative certificates. However, the test was made mandatory for invasive treatments.

"During the pandemic, providing treatment to patients suffering from heart disease was challenging for health workers," Prof Dr Mir Jamal Uddin, director of the NICVD, told The Daily Star.

At the time, the standard procedure at hospitals worldwide was to divide patients into red and green zones based on their Covid-19 test results, which if positive would place them in the red zone while negatives went to the green zone.

"But we did not follow the procedure and only conducted surgeries after the patient tested negative," Uddin said.

He went on to say that all cardiac surgeries had been suspended for a while during the initial stage of the pandemic in March last year.

Now, healthcare professionals are aware of the situation and know how to tackle it.

"So, when the Covid-19 situation was at its peak this year, we did not stop our regular activities even for a single day," he added.

The NICVD director also said that the pressure on his hospital had grown significantly amid the pandemic as many private hospitals denied admission to patients, even those in critical condition, without negative coronavirus test results.

"We made Covid-19 tests mandatory for cardiac patients," said Dr AM Shamim, managing director of Labaid Group, one of the biggest private sector healthcare providers.

However, the hospital provided immediate intervention when patients arrived in critical condition, he added.

For example, a patient was admitted to the hospital with severe chest pain and his oxygen saturation was just 42, which is a sign of being Covid-19 positive.

"So, when we found a patient tested positive, we treated their Covid-19 infection first and only conducted cardiac treatments after they had recovered," Shamim said.

The number of cardiac patients recently increased as more patients that require regular check-ups or surgical intervention are now turning up at hospitals after the coronavirus situation improved, according to various health officials.

Besides, with travel restrictions in place all over the world, few cardiac patients were able to go abroad for treatment.

"This is a positive side of the pandemic as it shows that the peoples' trust and dependency on the local healthcare system has increased," Shamim said.

According to the Cardiac Surgeons Society of Bangladesh, the country has 42 cardiac care units in both public and private facilities, of which, 28 are equipped to conduct cardiovascular surgeries.

In Dhaka, the number of such hospitals is 20 (four public and 16 private) while there are four in Chattogram (one public and three private), two in Khulna and one each in Sylhet and Sirajganj.