Dental, ENT and elective surgeries to be delayed for those people who have completed 21 days quarantine

There will not be any scaling down of services in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) for the general public. However, elective surgeries, ear, nose and throat (ENT) and dental procedures involving aerosol, nasal procedures will not be given to the people who have completed quarantine, except in emergencies.

The people released from quarantine have been asked to wait for 30 days before getting the dental, ENT procedures and even elective operation.

Medical Superintendent, Dr Gosar Pemba, said if the country goes into the red zone, then all the elective surgeries will be cancelled or postponed, and all the OPDs will be minimized. There is a chance that a person who has finished the quarantine period can test positive for COVID-19 after 21 days

According to Dr Gosar Pemba, dentists are at a high risk of getting infected while cleaning the teeth because of dental aerosolization that can cause transmission through the droplets. Similarly for ENT, examination of a patient’s nose and throat will increase the risk of infection.

JDWNRH has advised all the health staff not perform surgeries and any other medical procedure on a patient who has finished 21 days quarantine or less than 30 days, said Dr Gosar.

He said that a patient with COVID-19 has a higher chance of dying during a surgery or after the surgery due to the patient’s low immunity.

A person who falls sick in quarantine is examined in the observation ward and looked after by the nurses in the quarantine facility. No patient with either suspected case or chance of having COVID-19 is to be admitted to the hospital unless the person tests negative.

If there is community transmission in the country then no patient will be admitted directly to the hospital.

JDWNRH is screening all the patients as much as possible. A medical team wearing proper PPE, screens those coming to the emergency ward as well. A patient with a fever and cough is checked and tested in the observation ward. And if the test result is negative then the patient is brought to hospital.

“Patients with appendicitis and pregnant women who come for delivery will go to the normal hospital. There is still a high chance of people with asymptomatic visiting hospital,” said Dr Gosar Pemba.

There are immediate actions taken by JDWNRH to reduce the number of people in the hospital, as precaution to minimize the transmission of the disease. Patients with chronic diseases are given two to three months worth of medication. The radiology service is to be used less and repeat laboratory tests are advised only after two months.

If Bhutan goes into the red zone due to a massive local transmission cases, then elective surgeries are to be postponed, all dental and ENT services involving aerosol or nasal procedures are to be cancelled. All health staff will wear PPE for any medical treatment procedure.

JDWNRH has already set up a separate ward for handling the COVID-19 patients. There are medical teams assigned to take care of the patients. There is an adequate stock of medicines to last the public for another six to seven months.

“There is a shortage of staff due to deployment but it was not a major challenge. For now JDWNRH is handling the COVID-19 case and as well as patients in general ward smoothly,” said the Medical Superintendent.

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