health talk:with Dr Johannes Marisa
Covid-19 has lately been spreading like veld fire, taking less than 36 hours in order to reach 100 000 cases. Mortality now stands to above 50 000 people and this is a real tragedy. The United States stands on top of the ladder with over 230 000 cases followed by Italy and Spain, which have also entered the 100 000 mark thanks to widespread testing done in these countries. Africa remains with quite a few confirmed cases, but some of the numbers are questionable considering the low levels of testing in Africa, which has been attributed to unaffordability and poor accessibility to the tests. We all assume all is well in Africa.
Covid-19 has left a lot of medical professionals dumbfounded, with many showing great reluctance to attend to other patients with different ailments. So many patients are suffering today at homes because they cannot access medical treatment for their usual problems. This has been astounding and if the trend that I witnessed during these past days continues, then we are doomed on medical conditions that emanate from the chest like tuberculosis, pneumonia, asthma, bronchiectasis, heart failure, all of which can present with respiratory distress.
To begin with, let us take a look at the common symptoms and signs of Covid-19. Remember people may be sick with the virus for one to 14 days before developing symptoms. At this stage, they can still transmit to the next person. The following are some of the common symptoms:
lHigh fever.
lDry cough.
lTiredness.
lPersistent pain or pressure in the chest.
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lNew confusion or inability to arouse.
lAbdominal pains and diarrhoea.
lDifficulty in breathing (severe cases).
Remember that most people (about 80%) recover from the disease without needing special treatment. However, the disease can be more serious and more fatal in older patients or in people with other underlying conditions like asthma, diabetes, heart disease or advanced immunosuppression. Please be considerate about these people by observing quarantine, social distancing and lockdowns. Make sure our grannies are safe. Covid-19 is there for sure.
The degree of fear among medical professionals in our country concerning Covid-19 has, of course, been aggravated by limited testing, leaving clinicians with hanging diagnoses. It was a pity that I came across an asthmatic patient who had been tossed around because she was wheezing terribly. It seemed no one wanted to even clerk her, from the clinic, she was referred to Wilkins Hospital, then back to the clinic until her symptoms worsened. All that she required was stabilisation of the asthma with such things as nebulisation, intravenous steroids etc. That was just one example. On the other hand, we have suspected Covid-19 cases that fit into case definition that we usually get stuck with. Upon referral to responsible centres like Wilkins, they are returned home and told to come for results two or three days later. If it is Covid-19, then we are doomed as the transmission may already be 100 times in 72 hours. I see no congruency on the current management of patients who have chronic conditions. Clinicians, let us all work for the benefit of our people. We cannot allow TB patients to die because we do not want to attend to them because we suspect it is Covid-19 yet clinically from a distance you can see an ailing patient. Know your obvious symptoms of coronavirus infection.
How disgusting and moronic it is even for funeral parlours to dictate the pace of things? As far as I know, people do not want to have their relatives die in homes. When even chronically-unwell patients die at medical centres within 24 hours, we have problems with body removals even if the deceased has been followed up. Usually, people who die within 24 hours of being seen at medical centres are classified as BID (Brought-in-dead) and they have to be vetted via police and government pathologists to rule out foul play. A local funeral services company demands completed BD12 forms even from surgeries which I am sure is a nightmare to get. We are having a difficult time to have bodies removed. Let those who have passed on rest in peace! It does not mean that whoever demises today it’s due to coronavirus infection. It is becoming a cumbersome task to treat patients and the war seems to continue when a patient dies. Let us cooperate for the benefit of the nation!
Let us all know the symptoms and signs of Covid-19. Not all who are sick have Covid-19. Let us screen our people well, handle them well in a dignified manner. Funeral services should respect the dead as well.
lDr Johannes Marisa is a medical practitioner, an educationist and public health expert who can be accessed on [email protected]
