Hospitals turning into containment zones will make fight against coronavirus tougher; India should prioritise safety of doctors

Doctors and nurses are the frontline warriors in the fight against the novel coronavirus outbreak. However, unfortunately, by the virtue of their roles, they are also bearing the brunt of the highly contagious disease.

A study on the Chinese response to the virus found that 29 percent of the randomly sampled patients were actually healthcare professionals who contracted the virus in the line of duty. In one particular instance, a patient with atypical symptoms managed to infect 11 healthcare professionals in China just because he was referred to the wrong ward.

 Hospitals turning into containment zones will make fight against coronavirus tougher; India should prioritise safety of doctors

Representational image. AP

In medium income group countries like India, where the healthcare system is abysmally underfunded and ill-prepared for a pandemic, the cost of each medical professional catching the virus is compounded manifold.

At such a time there have been instances where entire hospitals had to be shut off due to infection among doctors and nurses.

Healthcare workers at greater risk

Two private hospitals in Mumbai have been sealed after some of their medical staff, including doctors and nurses, tested positive for the novel coronavirus since Monday. Three doctors and 26 nurses tested positive for novel coronavirus in Wockhardt Hospital in Mumbai Central and the facility has been sealed off to prevent the spread of
infection, BMC health officials said. A similar story emerged from Jaslok Hospital where nurses had alleged that staff members had contracted the virus.

Likewise, the Delhi state cancer institute was shut down on 1 April after a doctor working there tested positive, leaving highly vulnerable and critical cancer patients exposed, who had to be shifted elsewhere for treatment.

When contacted, Jaslok Hospital admitted that a nurse who came in contact with a COVID-19 patient did test positive.

"The staff members handling COVID-19 patients are given protective gears like face masks, gloves, eye protection, Personal Protection Equipment for contact droplet and airborne transmission of pathogens, long-sleeved water resistant gown to ensure precaution. "

All the medical staff who came in direct or indirect contact of the affected nurse and the connected patient have been identified and quarantined as per the protocol, the hospital said.

As a precautionary measure, the hospital has suspended its OPD services and no new admissions are being taken for a few days, it said.

However, the move will impact hundreds of patients who throng these hospitals for treatment of various ailments, not to mention that it will also set the country behind in its fight against coronavirus.

Similar reports of doctors and other health professionals testing positive or having exposure to COVID-19 patients have come from Rajasthan, Karnataka, Uttar Pradesh, Bihar, and Kerala among other states.

These reports highlight a threat both to the individual healthcare workers battling the pandemic, and the overstressed healthcare system of India.

According to a government reply in Lok Sabha last year, there is one doctor for every 1,445 Indians as per the country's current population estimate of 135 crore, which is lower than the WHO's prescribed norm of one doctor for 1,000 people.

Another estimate suggests than an on-duty doctor takes care of 100 hospital beds in a week, and the same number of OPD patients in a day. With the virus forcing healthcare professionals to retire into quarantine, hundreds will be left without medical attention. This will also increase the pressure on already overworked doctors battling the pandemic.

Why are medical professionals more susceptible to virus

Firstly, the medical professionals are more exposed to viral particles and high viral load patients than the general public. Even with all the protective gear in place, the virus is one mistake away from making them sick.

Secondly, most healthcare professionals in India do not have access to full protective gear.

The rising number of cases among medical professionals only serve to underscore the severe shortage of personal protective equipment.

Using raincoats, home-made masks instead of PPE, Indian doctors woefully under-protected

A Safdarjung resident doctor told India Today that the shortage is so bad that even doctors in emergency wards are being given N95 masks instead of PPEs (personal protective equipment). An N95 mask survives in the contaminated environment for two to three days and then "cannot really protect us," the doctor said. "It is useless."

One report cited the case of a Bihar hospital where doctors attended to COVID-19 patients in regular surgical masks and homemade protective gear, because recommended suits were not available. Later, when some of the doctors started showing symptoms, they were quarantined but asymptomatic doctors were forced to remain on duty despite them highlighting that they all remain in close contact and share a common mess at the hospital.

Another report said that doctors at AIIMS Delhi, one of India's premium state-run healthcare facilities, were using self-made masks, while those in Uttar Pradesh were forced to use protective gear used to treat HIV patients. This was despite the fact that the contagion method of both diseases remains vastly different.

Times of India report also stated that at Medical College Hospital (Kolkata), and the Infectious Diseases Hospital, Beliaghata, medical professionals are being given raincoats instead of PPEs for protection.

At Howrah General Hospital, medics complained that they do not have things as basic as sanitisers and handwashing soap/liquid. Unfortunately, reports of such instances are galore.

An Al Jazeera report blames government mismanagement for such shortage. The report states that the government paid no heed to World Health Organization (WHO) warnings about impending global shortages of PPE on 27 February, and called on industries to ramp up production by just 40 percent only once cases started skyrocketing. The government also allowed export of surgical masks and gloves till February end and it was only on 19 March that the government banned the export of raw materials used to manufacture PPE.

The publication also alleges that the Minutes of the Meetings it has accessed suggests government is grossly underestimates the need for PPEs, with the current trend suggesting the need could rise to almost 5,0000 per day; the government is preparing to add 7,00000 PPEs till end of May.

Updated Date: Apr 07, 2020 21:48:20 IST



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