National Doctor’s Day 2020: Health workers combating stress, sleep disorders and COVID-19 together, says casualty ward doctor

His weight was 76 kilos before the pandemic, and it’s now 68 kilos. His urine is a dark yellow - which all healthcare workers who wear PPE kits for shifts lasting six to eight hours are likely to have as well, due to dehydration and accumulation of toxic wastes in the body. Double masks, protective glasses and double gloves on top of the heat and humidity that Delhi has seen this summer, and yet doctors like Sneh Mohan Soni continue to set their personal lives and needs aside to serve patients during the COVID-19 pandemic. To say that these are hectic times for doctors is an understatement. Dr Soni is a Junior Resident in the Casualty department at the Delhi’s Indira Gandhi ESIC Hospital in the Jhilmil area and is serving as the Chief Medical Officer during the COVID-19 pandemic. In an interview on the occasion of National Doctor’s Day - which is celebrated on 1 July every year - Dr Soni explained how it’s not just doctors serving in the COVID-19 wards who have had to face many challenges. Early days, early anxieties “When you work in a COVID ward, you know all your patients are positive and you have to take every precaution. A casualty ward witnesses the inflow of all types of patients, suffering from ailments from fever to tuberculosis,” he said, further explaining that until the test results come back, you can’t tell which patients have infectious diseases and which don’t. This means you have to constantly take all precautions, be aware of your surroundings and make wise decisions during shifts that can accumulate to 24 or more hours of non-stop work. “During the early days of the pandemic, a close contact of a confirmed patient came in with an ESI card - we are an insurance hospital after all - and waited in the ward for about six hours, before going off to another hospital to get tested. She turned out to be COVID-19 positive, and our entire casualty ward had to be quarantined,” he says. “Of course, we worked through that and many other similar scenarios donning our PPE kits.” Wearing PPE kits does protect the doctors, but donning them for long hours can have immense repercussions on the health. When he does finally take off his PPE kit and double gloves, Dr Soni says his hands are as wrinkled as someone who’s done a whole village’s worth of laundry. Physician, heal thyself In one particularly scary instance, Dr Soni recalls that a patient with COVID-19 symptoms came into the casualty ward just as he was wrapping up a shift. “We asked him to put on a mask, sit and wait a while. I had taken off my PPE, mask and every other protective gear because I was just about to leave. The patient - who still hadn’t put on a mask despite our insistence - came up to me and coughed on my face while talking.” Frightening as this situation can be, Dr Soni stayed on point like every professional healthcare worker is expected to. “I started showing some symptoms after that, got tested for the first time, and went through the necessary quarantine until the second test was also done,” he explains. “Both came negative, thankfully, and I was able to return to duty immediately after that. But this incident ensured that no doctor in the hospital interacted with patients - any patients - without proper PPE and masks on.” Incidents like these indicate that doctors naturally have a lot of stress. Dr Soni reveals that he has developed sleep-related problems and a resultant elevated heart rate. “But we cannot take time off to deal with these issues,” he insists, explaining that this is why doctors need to take extra precautions right now. “There’s a pandemic raging and we have to put our personal problems in a different category right now. Drinking hot water, kadha and other measures to boost immunity are not possible to do throughout the day while you’re in protective gear. A nutritious diet, proper hydration, rest and taking hydroxychloroquine prophylaxis doses as and when the medical community recommends it - all of this is as vital as supporting your colleagues when in need.” Looking forward and not to the past But what can the rest of us do to support doctors as they battle the novel coronavirus? Take your health and all precautions very seriously, Dr Soni recommends. “You can’t assume that simply because your immunity is comparatively strong, you can get away with it. This is a severe disease and it has had a huge impact on the existing healthcare system. Even if you have typhoid symptoms today, hospitals will ask you to get tested for COVID-19 first, and then give you a thorough checkup or treatment.” So, unless there’s a vaccine - which is at least a year away, he says - taking precautions is the best thing you can do. “Something as simple as wearing a mask has to be done right,” he says, recalling how he had to point it out to a lady without a mask on in the waiting room of the ward one day. “She immediately covered her mouth and nose with her pallu. Now, how often do I explain to people that that is not enough?” There’s a difference between literacy and education and Dr Soni believes that it’s high time we make basic healthcare education a must for all. “There are countries where learning basic first aid, CPR and other medical emergency protocols are compulsory for all. In case a doctor is not at hand, lives can still be saved in an emergency situation,” he explains. “If basic healthcare is taught in schools and colleges just like other subjects are, it would definitely make a huge difference.” The onus, Dr Soni says, lies on all of us. “We have to stop being spectators and take charge of educating our population, making them understand that healthcare is a basic right and not something you should ever take lightly.” For more information, read our article on Signs of other diseases you shouldn’t ignore during the COVID-19 pandemic. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.