Editor's note: This series will focus on the difficulties faced by the medical fraternity at COVID-19 hospitals, their duty hours, access to protective gear, facilities they get during quarantine, how are their families coping with this new reality across different states in the country. This is the seventh part of the series.
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With Pune witnessing a rising number of coronavirus cases, doctors at various hospitals dealing with the disease have had to battle with their apprehensions and respond to the call of duty.
With around 1,505 infections and 92 deaths reported till Thursday evening, Pune has the second highest number of infections in Maharashtra after Mumbai and has been declared a containment zone. According to the Union health ministry, Maharashtra is the worst-affected state with 10,498 cases and 459 deaths reported in the state as of Friday morning.
Initially, two hospitals — Naidu Infectious Diseases Hospital and the government-run Sassoon hospital — were earmarked for the treatment of COVID-19 patients but as the number of cases continued to spike, especially in the tightly-packed Bhavani Peth area, the Pune Municipal Corporation (PMC) asked private hospitals in the city to allot wards for treating COVID-19 patients.
Dr Vrushali Khadke, a lung specialist and the nodal officer for coronavirus ward at the Poona Hospital told Firstpost that protocols prescribed by the ICMR were implemented in the hospital when it was asked to open a coronavirus ward almost three weeks ago. As per the protocols, the hospital has a triage area to segregate suspected coronavirus cases from other patients and ICU and isolation units to care for coronavirus positive patients. Personal protective equipment (PPE) is provided to the staff dealing with suspected COVID-19 cases. Doctors and staff at the Poona Hospital work 12-hour shifts for three days and are then given a rest period of three days.
The staffing, however, is different at designated state-run COVID-19 hospitals. They follow a rotational duty chart, under which doctors and paramedical staff work for 14 days and then undergo a mandatory quarantine period of a fortnight.
Challenges posed due to PPE, social distancing norms
Dr Sarika Godse*, a resident doctor working at the Out-Patient Department (OPD) in a private hospital, told Firstpost that all patients coming to the hospital are treated as suspected coronavirus patients, and all doctors and staff, even at OPDs have to take precautions.
She finds the PPE suits quite cumbersome and heavy. The mercury has shot up to around 40 degrees Celsius and the overalls worn on top of normal clothes, make for a sweltering six hours spent at the ward. Besides, once the overalls are donned, the doctors and the staff cannot drink water or take a bathroom break as each suit can only be worn once and is discarded after use.
However, the biggest challenge facing both doctors and patients, according to Khadke, is observing social distancing norms and treatment protocols.
Masks and protective equipment cover most of your face and it becomes difficult for the caregivers to establish a relation of trust with the patients and to reassure them, Khadke added.
Godse expressed similar views. A lot of a physician’s work involves touching a patient, examining their eyes, palpitating their abdomen and the coronavirus crisis had made exactly this part of a doctor’s work risky, Godse explained.
“I haven’t heard a patient’s chest in a month and a half,” she said, adding that the use of stethoscopes has been prohibited as they might play a role in transmitting the virus between patients.
Tough to fight on both fronts
Doctors and paramedical staff are not only worried about transmitting the virus to their patients but also to their family members. “The nursing staff do their household work and come for duty 12 hours a day. Plus, they also have to look after their children... There is a fear present amongst them, but I think they have overcome that with ease,” said Khadke.
“It's taxing to keep fighting on both fronts — work and the personal front,” said Dr Ameet Dravid of the Pune’s Noble Hospital, who has sent his nine year-old daughter to his parents’ home in another city.
“It is difficult to explain to her the intricacies of the disease and why she can’t meet her parents,” he said.
Dr Sayali Adhikari*, a doctor at the OPD in one of the two designated state-run hospitals in the city, hasn’t met her parents since the month of March.
“Since they don’t live with me, they are always worried about me. Even after I finish my duty hours, I am too tired to call them. So, I constantly have to reassure them and tell them not to worry about me. So yes, there is definitely a psychological cost associated with my work,” she admits.
Godse, who hails from Mumbai, says she last met her parents four months ago.
“That is unbelievable considering that Pune and Mumbai aren’t that far. However Skype and Zoom calls help,” she said.
However, living away from family makes Godse a bit less anxious about her work, especially since she is expected to begin working in the coronavirus ward soon.
“I do not have much to lose. I am a young healthy woman who doesn’t have diabetes or any other health conditions. If a 40-year-old man living with his family says he doesn’t want to work in the coronavirus ward, it is justified. But I am living alone and not risking anybody, if I was living in Mumbai that would have been a big thing. I would have been scared to go back home if I was in Mumbai because I could have been an asymptomatic carrier who could have infected my grandparents, for example,” she said.
The downside of living alone is loneliness and also the fear of getting evicted. In different parts of the country, doctors have been attacked or even asked to leave their houses as they are suspected to carry the virus back home with them.
Godse has not faced such direct hostility but the chairman of her housing society asked her about accommodation facilities provided by the hospital for doctors working in coronavirus wards. This added to her worries and made her think about finding alternative accommodation.
Rising over the cloud of fear
A cloud of anxiety and fear has descended over hospitals, especially since doctors and staff at a couple of hospitals in the city have contracted the disease. In Pune, at least 25 staffers including 19 nurses at the private Ruby Hall Clinic have tested positive while three nurses and a senior doctor have been found to be infected in the state-run Sassoon Hospital.
A senior doctor who works at a state-run facility, speaking to Firstpost on the condition of anonymity, said that team work and humour are essential for “rising over the cloud of fear" that surrounds COVID-19.
“When one person is unable to perform some task due to anxiety or fear, team members pick up the slack. That is one way to keep everyone motivated. Our workers have really risen to the challenge, right from carrying equipment to reassuring each other,” the doctor said.
Dr Adhikari too admits to have felt this fear but says that she managed to overcome her fears by reminding herself to abide by the rules of the profession.
“We cannot deny our duty on moral grounds,” she said, and therefore, she is not scared of returning to work after she finishes her mandatory quarantine period of 14 days.
“It is the toughest time of our lives,” said Dravid. However, he said, it helps to remember that doctors are not the only ones in this fight – policemen, sanitation workers, nurses and even administrative staff at hospitals have been doing a stellar job, and this is a source of inspiration to him.
Life under quarantine
Doctors from government hospitals undergoing their quarantine period said that they continue following developments related to the disease even when not working.
Adhikari said most of her time is spent discussing various patients and the developments in their condition with her colleagues who are also undergoing quarantine. “Wherever you go, these discussions are inevitable,” she said.
She has also stocked up her favourite books to help pass the time. Being fond of novels, she decided to utilise the time to read the final part in the Shiva trilogy by Amish Tripathi. Apart from that, she spends her time watching television and catching up with her family.
For Godse, duty at the coronavirus ward is yet to begin. But as routine procedures in the hospital have been drastically curtailed as a precautionary measure, she finds herself with a lot of time on her hands. She spends most of this time reading books or cooking.
*names changed
from Firstpost India Latest News https://ift.tt/2y62Pe9
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