Homecare for Covid patients: Evercare takes the lead

On August 31, Mahmudur Rahman came across a signboard advertising homecare services by Evercare Hospital Dhaka as he queued up to test for Covid-19 at the private facility. 

His temperature rose the previous night but no other symptom appeared. 

The result came out that evening. It was positive. 

The 37-year-old, who works as the head of export operation at RFL Plastics Ltd, quickly signed up for a homecare package.

Throughout the next two weeks, he was guided through his physical and mental conditions by senior doctors of Evercare. The hospital also provided him with a pulse oximeter and advised him on how to monitor his blood oxygen levels in regular intervals. 

Even though Mahmudur did not suffer any complications, he felt safe to be regularly monitored by doctors over zoom conferences and by telephone calls. 

The hospital launched the homecare programme about a month ago. And within this time, over 100 suspected and confirmed Covid-19 patients enrolled for the service. 

This has happened at a time when hospital beds for treating Covid-19 patients are vacant more or less in every designated hospital.

One reason why people are now reluctant to go to hospitals might be that they watched many die after being denied treatment by healthcare facilities amid a lack of preparation in the initial days of the pandemic.

Staying aloof from family also seems daunting, when the contagious disease has already forced a person to stay separate from any other human being.   

"There is the fear of catching other infections at a hospital," said Arif Mahmud, head of medical services of Evercare that also encourages Covid-19 patients to stay at home. 

Since 80% of patients who have contracted the coronavirus show little to mild symptoms, they can recover from the disease at home. The rest who suffer from moderate to critical conditions must be admitted to a hospital for close supervision. 

However, it is hard to tell who falls under which group, except for the elderly people and those who have ailments like diabetes, hypertension and renal failures. They also often prefer home to hospital because being with loved ones gives them a sense of protection, love and care when their physical and psychological health falters. 

In the USA, hospitals began providing homecare in the wake of a mounting pressure of in-patients, as reported by The New York Times. 

Critical patients were given constant oxygen supply at home and they were regularly visited by doctors and nurses to check on them. 

The scenario in Bangladesh, however, is quite different. 

While recovering at home, patients should get doctors' advice and follow-up treatment because things may turn worse even a week after one is infected. 

"Nowadays, more and more patients are getting admitted late to both public and private hospitals. This may threaten their life because many treatment procedures, including plasma therapy, work best at early stages," said Dr Arif of Evercare.

Under homecare, doctors can recommend hospital admission when they suspect anything to be unusual. 

Moreover, patients with illnesses like diabetes and hypertension may suddenly require urgent medical attention, which is possible when they have immediate access to healthcare.  

Evercare offers two packages – one for 9-day intensive monitoring at Tk13,000 and the other for 14 days at Tk15,000. The first one is for suspected patients and if a person tests positive for Covid-19, they can switch to the second package. 

Many other health facilities like Square Hospital and Praava Health give telemedicine services and collect samples from home for tests, but homecare services have added advantages. 

Patients can communicate every day with a doctor, a nurse, a nutritionist and a psychological counsellor whenever they need help. They are also advised on how to stay in isolation, without transmitting the virus to other family members.  

"Many patients call 20 times a day. That forges a bonding between healthcare providers and a patient. We see this in a positive light," said Arif, head of medical services of Evercare.  

The aim of the homecare programme of Evercare is "to reduce morbidity and mortality", he added. 

Thirty-two out of every 100 patients who get intensive care at Evercare die. The mortality rate has been reduced over a few months from 42 percent, which Dr Arif said, is a remarkable achievement.  

So far, sixty people have died from Covid-19 at Evercare, among 700 patients who have received treatment there. 

According to Arif, the hospital readied its infrastructure, put in place a triage system to segregate Covid-19 patients from others and acquired all the logistics needed before opening its door to Covid patients on April 20. All this helped to contain deaths, he claimed. 

Homecare service is a new addition.