ISLAMABAD/RAWALPINDI: The Pakistan Institute of Medical Sciences (Pims) Young Doctors Association (YDA) reduced the presence of its members in various departments on Wednesday to warn the hospital it could strike if its demand to close the outpatient department (OPD) is not accepted.

The YDA’s Rawalpindi chapter, however, refused to go on strike, called by its central body, against the alleged lack of medicines and COVID-19 testing kits across Punjab.

The Pims management has closed the evening OPD and decided to reduce the number of elective surgeries and admissions to the hospital. The YDA’s move to reduce hospital staff led to long waits for patients trying to seek medical treatment.

Pims YDA President Dr Fazal-i-Rabbi told Dawn that Sindh and Khyber Pakhtunkhwa have closed hospital OPDs while Punjab has decided to switch to telemedicine.

“We have demanded that, if it is not possible to close OPDs, the management should introduce telemedicine just like Punjab did. We can provide 1,200 doctors at Pims to facilitate patients over the phone, and only those patients would be called into the hospital who really need to be seen by doctors,” he said.

He said steps should be taken to reduce hospital visits, as one doctor contracting COVID-19 could transmit it to hundreds of patients.

“We are vulnerable because we do not have personal protective equipment (PPE). We are willing to work but should have the proper equipment. I am working in an isolation ward where COVID-19 patients are kept. I even went to Gilgit with a team from the National Institute of Health and we trained the Gilgit medical team, but here we have become vulnerable because of the lack of PPE,” Dr Rabbi said.

He said that moving to telemedicine would protect both doctors and patients.

Pims media coordinator Dr Waseem Khawaja said staff are being provided PPE. He said: “I hope the doctors continue working in the best interest of the patients and the country.”

According to a circular, elective surgeries and admissions will be minimised at the hospital on the recommendation of Pims consultants. Another circular states that the evening OPD has been closed with immediate effect.

All department heads have been asked to minimise leave on medical grounds and medical rest for employees, while the hospital’s chief pharmacist has been directed to provide doctors posted in the isolation ward with N-95 masks.

Dr Ayesha Isani Majeed, the head of the radiology department, has issued a letter stating that a number of measures have been taken to facilitate COVID-19 patients and ensure the virus does not spread in the hospital. She said an X-ray machine and a CT scan machine have been dedicated for COVID-19 patients; X-rays will be performed on a formal written request and patients will be brought using a separate route.

In Rawalpindi, the YDA refused to strike despite a call issued by its central body. YDA Rawalpindi President Dr Rana Azeem toldDawnthey would continue to provide medical care to patients in this hour of crisis.

In Lahore, the Punjab YDA had threatened to shut emergency wards of all teaching hospitals in Punjab over an alleged shortage of testing kits and the non-provision of other precautionary gear to paramedics.

Dr Azeem said that the YDA Rawalpindi had made its decision in the wake of the health emergency imposed in the country.

However, he said the YDA Rawalpindi has demanded that the Punjab government provide PPE to doctors working in outpatient and emergency departments.

“We are refusing the call of the strike in the larger interest of the people as it will create a mess in hospitals,” he said.

Criticising Punjab Health Minister Dr Yasmeen Rashid, Dr Azeem said the minister claimed that there was no need to wear face masks but according to the World Health Organisation’s standard operating procedures, health professional must wear masks while dealing with COVID-19 patients.

He said the OPDs in the garrison city could become instrumental in spreading the virus as the hospitals have not made any arrangement to deal with the situation.

Meanwhile, the Pakistan Islamic Medical Association (PIMA) demanded the government ensure the safety of healthcare workers.

PIMA expressed its deep concern over the unsafe working environment for doctors and paramedics in various public and private hospitals.

In a statement on Wednesday, PIMA Central President Dr Mohammad Afzal Mian said doctors and paramedics were facing a real threat as they were working in unsafe circumstances without safety tools.

Published in Dawn, March 19th, 2020