“Senior and junior residents work at the frontlines and are they equipped enough?”
Frontline healthcare workers have been the unsung heroes of the novel coronavirus pandemic. In India, healthcare workers - especially those at the forefront of this battle like ER doctors and those from General Medicine, Pulmonary and Geriatric Care - have been overburdened while fighting this epidemic.
“In this critical time, we have to show our vocational responsibility,” says Dr Adarsh Pratap, a senior resident from the department of surgery from the All India Institute Of Medical Sciences(AIIMS) in New Delhi.
Dr Pratap is one of the doctors fighting the direct fight against the virus. He is also one of the doctors demanding the need for better protective gear or the PPE - personal protective equipment- as it is called.
He tells FIT, “ I noticed that some centres and wards do have adequate PPE equipment - like gowns, masks, suits, gloves etc., but some do not. We wrote a letter to the administration and they ensured that this will be given.”
Dr Harjit Singh Bhatti, the National President of the Progressive Medicos & Scientists Forum (PMSF) and current doctor at AIIMS says he is worried at the lack of proactive measures for doctors. “There are about 7000 nurses and other allied healthcare workers - like technicians, helpers who work the stretchers etc. They are also human and need protection.”
Dr Bhatti adds “Doctors are the first point of contact and we need the protective gear to stay safe. Just the other day a doctor in Lucknow tested positive, and he and his entire team have been quarantined.”
Failing to protect those who are protecting us also puts an excessive burden on India’s already overburdened public healthcare system.
A day after the letter was sent, the hospital administration conducted a meeting with the doctors on Tuesday, 17 March an followed up with another meeting on Wednesday.
“We asked that the RDA (Residents Doctors Association) be made a stakeholder in these discussions and met with the administration,” says Dr Pratap.
The Heads of Departments were present as were the unions of other healthcare professionals. “We have strongly trusted the administration to ensure a steady supply of stock - they have said they will listen to us,” he adds.
Another request was for a clearer protocol. Dr Pratap says, “How do we manage OPDs, or isolate other patients. WHO, ICMR and the health ministry are giving us new information every day and the guidelines are changing rapidly. We are trying to keep up and focus on managing this highly contagious virus.”
The outcome of the meeting was positive, says Dr Pratap. “We all agreed that we need to work together to combat this national crisis.”
There are no positive cases in AIIMS yet so no doctors are being tested he says, “but we are increasing capacity building, screening centres, ICU beds and isolation beds are being prepared. But for now, we need PPEs without interruption, otherwise, if we get infected it will be a catastrophe.”
Dr Bhatti says that he has “full faith” in the AIIMS director to fulfil their promise.
Are Doctors in Hospitals Across the Country Protected?
Dr AP Joshi, chief medical officer of the Indo-Tibetan Border Police (ITBP) and in-charge of India's largest quarantine facility confirmed to The Quint that there is a general dearth of PPE equipment in the market.
"We try to work for four hours at a stretch after wearing the Personal Protective suit because of lack of its availability. You might not know that it is not available in the market. What we have learnt that PP is manufactured in China. And the Chinese government has purchased it from its vendors at 3x price. So PP was exported from China. Hence there is a shortage of PP here with us. We use it very carefully. Where we see that 2 people can manage, we don’t send 4 people wearing PP suit. It helps us in two ways, less people are exposed and we are also saving our equipment."
In that interview, he confirmed that nearly 130 PP suits are used in a day.
Already, there have been reports of doctors who treated COVID-19 patients in the country testing positive. These reports have come in from Kerala, Lucknow and Karnataka. In this scenario, as the number of cases go up across the country, are we prepared to protect those who protect us?
Dr Bhatti says that there needs to be quick action sans the red tape. “The government needs to ensure proactive measures to protect us.”
Dr Pratap adds, “Hazmat suit prices are being increased in the market which is very bad in a national healthcare emergency. We need political commitment to regulate the market prices and that the government supports public health facilities with funding and resources. We need companies to step up and increase manufacturing at this time. ”
“At AIIMS, in this critical time, we have developed innovative solutions. Like we have started making a DIY sanitizer in the hospital itself from yesterday and have launched this hospital-based sanitizer,” he says.
More Private Players Needed
Another solution is for more private players to help out.
This ask comes after ICMR urged private laboratories to come in and offer free COVID-19 testing.
“We have 50-60 labs but 150 crore people, and the next 20-30 days are critical. If community transmission happens it will become very difficult. We need political commitments now to support public health systems,” says Dr Pratap.
He adds that these labs are adequate for the current scenario, but what about when the virus moves to stage 3 and more positive patients come forward?
The WHO urged nations worldwide to “test, test, test.” “Ultimately the issue is of testing - we need to move on this and protect the ‘aam admi’. Medical professionals and studies from countries worldwide are saying that preventive testing is vital to curb the spread of this virus,” says Dr Bhatti.
In a press conference yesterday, 17 March, the ICMR added that they were instead focusing on a “restrictive testing strategy.” ICMR’s Dr Nivedita Gupta added that the “goal was to avoid indiscriminate testing.”
“We are on stage 2 with just local transmission of the virus,” said ICMR Director-General Balram Bhargava to explain this move. Dr Gupta added that “Currently, 90 samples per lab per day are being tested. But this can be doubled to 180 per day per lab if the demand occurs.”
“But if we do not aggressively test, we will not know the true numbers and will not be able to deal when this goes overboard,” argues Dr Bhatti.