Respiratory symptoms, as for the hitherto known medical knowledge, remain the main manifestation of the novel corona virus 2019, the causative agent of the Covid 19 pandemic that is devastating the world today.
The most common symptoms of corona (according to the World Health Organization) are cough, fever and tiredness. Severe cases may develop difficulty in breathing.
On the other hand, respiratory infections remain one of the commonest, if not the most common, ailment for which patients seek treatment. This is the case in the outpatient departments (OPD) of the public and private hospitals or in the government dispensaries or in GP clinics.
According to the Annual Health Bulletin, 2017, total government sector OPD consultations per year are 55,400,000. Assuming that 30% of these were respiratory infections (for the non availability of that statistic), on average, the total number of patients with respiratory symptoms seen in all government healthcare facilities per day will be 45,000.
Going by the government to private ratio of 45:55 with regard to the patients treated in outpatient settings, this means another 55,000 patients with similar symptoms are treated in the private sector, amounting to 100,000 patients with respiratory symptoms being treated (both in government and private) island wide on daily basis. Applying the initial guesstimate that respiratory to non-respiratory ratio of the outpatients is 30:70; it will mean that there will be around 235,000 patients seeking treatment from all outpatient facilities around the country a day. These macro statistics will speak for themselves the need to segregate the patients with non respiratory symptoms from the ones who have.
In addition to protecting the corona non-probable from the corona probable, a protocol with regard to the management of patients with respiratory symptoms will protect the doctors and other healthcare workers from corona as well. In this regard, while it is primarily important for the healthcare staff to adhere to the universal safety precautions at all times, they having an anticipatory position with regard to the patients will also help them in executing their obligations towards patients.
Within this backdrop, this author on 05.04.2020 wrote to Dr. Anil Jasinghe, Director General of Health Services, Ministry of Health with a copy to Dr. Sudath Samaraweera, Chief Epidemiologist, urging the need of issuing directives on dealing with the patients with respiratory symptoms in healthcare intuitions.