COVID-19 in Tamil Nadu: Healthcare workers resolute despite risks, but incidents of stigmatisation remain a worry
Doctors in Tamil Nadu said people they interact with are generally cooperative. However, there have been instances of doctors being denied rental accommodation and being forced out of hostels.
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 ninth part of the series.
When Ratnavalli S, a 32 year-old nurse from Tirunelveli district in Tamil Nadu, returned home after completing her mandatory quarantine period in a hospital, she was in for a pleasant surprise. She said, "Before the lockdown, my children, husband and in-laws had shifted to their ancestral village. So, when I returned from the quarantine, some of my neighbours came to my house to give me a plate of fish curry. They thanked me for being the only person in the locality at work. I was overwhelmed."
Doctors and medical staff members from Tirunelveli Medical College Hospital who spoke with Firstpost said the initial period of the virus outbreak was a ‘nervous’ time for them but nearly two months later, they have accepted their changed routine and manner of work. “We are afraid of getting the virus but that’s a risk we have to accept,” said Dr Shiva Subramanian, Assistant Professor and surgeon.
The Tirunelveli Medical College Hospital has 45 patients in its special COVID-19 ward. Of these, 30 patients are from Puliyangudi village in Thenkasi district. This was after a 75-year-old senior citizen, who is diabetic was feeling unwell, visited the hospital. He was kept under observation but since he had interacted with the entire village, 30 others from the village too have been admitted to the isolation ward.
“All the 45 patients are asymptomatic,” said Dr Mohamed Rafi, Professor of Medicine and member of the COVID-19 core group. The first patient who was admitted to the hospital was a resident from Dubai who was quarantined in the hospital as a matter of government protocol. His test results were negative and he was discharged, said Rafi.
The COVID-19 ward is staffed 24x7 by a 25-member team comprising doctors, nurses and paramedics in four shifts of six hours each. After working for 7 days, they are quarantined in the hospital for 7 days and then are able to go home to be in self-isolation for 7 days, after which they return to work in the hospital.
In May, the weather is extremely hot in Tamil Nadu, and working for six hours in PPE kits in the heat is extremely uncomfortable, said Dr Dhanya, a third-year postgraduate student of medicine.
Further, she said that the spectacles that she wears as part of her PPE kit often get foggy. “There is nothing one can do about it,” she said, adding that one learns to work under these conditions over a period of time.
The doctors and nurses at the hospital said when they step out of the hospital, people in the community are generally cooperative. However, there are exceptions. For instance, a doctor couple — the Srinivasans —wanted to rent a house close to the hospital. They had a verbal agreement with a house owner and were to shift in mid-March. “However, when we called him to fix an appointment and give the token payment for the house, we realised he had changed his mind. He said he did not want to give his house on rent to doctors during the pandemic which, he said, would be uncomfortable to others living in the locality,” the Srinivasans said.
The Srinivasans are now temporarily living in a friend’s house. “We understand the house owner’s concerns but it was not right to promise us the house on rent and turn us down at the last minute,” the doctors said.
A group of medical students in Perambur, north Chennai, have a similar story. They spoke about how they were asked to leave the hostel by its owner when he got to know that they were helping out in the care of suspected coronavirus cases. They said it took a lot of 'talks' over a few days before the house owner reluctantly agreed to let them stay.
A group of paramedics who were staying in a women’s hostel in Anna Nagar, Chennai were not so lucky, though. According to them, just before the lockdown, the hostel’s owner announced that the water tanker in the building (a common sight in Chennai, which faces chronic water shortages) would not be available from the next day. That announcement led to around 24 of the 30 inmates leaving the hostel immediately. But those who chose to stay back found that the water supply had not stopped. Later, the house owner stopped the cook and the domestic help from working there. However, he promised to drop fresh vegetables to the door. However, later, the electricity supply also was snapped unexpectedly, after which the paramedics were forced to leave. The paramedics believe that the hostel owner may have cut off the essential services for the hostel inmates.
What upsets medical personnel is being away from their loved ones, especially children. The concerns for Subramanian centre around his daughter and his wife, who are presently living with a relative. He said, “My daughter misses me and my wife is bored of staying away as it is over a month now,” said Dr Subramanian.
Velavan, an ENT surgeon at the same hospital, said his daughter is too ‘caught up in play’ to even talk to him for more than a few minutes. “I don’t know when I will be able to see them,” he said.
In the meantime, they are both bored stiff by the ‘long hours of doing nothing’ in quarantine and in self-isolation at home. “From the time we were in medical college, our days were packed with studies and later internships. The hospital work gives us a purpose.” They walk in the long corridors outside their rooms during quarantine. Subramanian has caught up with his favourite actor Vikram’s films. “But that’s only so much one can do. We read a lot on our iPads. But it is getting quite boring doing nothing,” the doctors said, looking forward to normal routine of work and family.
Experts call for ensuring enough diagnostic services, incident response systems
Dr Hari Balaji VR, a public health emergency specialist and a disaster management expert praised the co-ordinated efforts of the government, hospitals and medical colleges to reach out to every suspected case of coronavirus. However, he says, “With just 85,000-1,00,000 emergency department beds (for the whole of India), it will be a difficult situation to manage if 20 percent to 30 percent of the population gets affected by the virus.”
He suggested a few measures the government could take to make the treatment and control of the virus easier. These include:
-An Incident Response System to be set up by the Central and state governments to handle the situation till it eases up.
-Temporary medical structures to accommodate the sudden rush of patients
-Nurses who recently retired should be recalled for duties and final year nursing students should be enlisted to handle the surge of patients.
-Setting up temporary labs and ensuring diagnostic services are set up to handle increased flow
-Deploying clinical psychologists for counselling family members of patients and medical professionals
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