While our Critical care colleagues, Infectious Disease Experts and young doctors were put on round the clock duties in ICU and Covid wards, in most cities under the “Epidemic Act” majority of Beds in Hospitals were taken over by local municipalities.
By Dr. Deepu Banerjee,
What a year it was and still is!
On Doctor’s Day last year, we were already into the 4th month of pandemic. It was a time in our profession we were not prepared for. Initially there was fear from the experience of some western countries specially Italy, where there was high casualty amongst health care professionals. Our healthcare infrastructure was not prepared to cope with it. The life of a doctor changed from multiple perspectives. I will discuss some:
Professional work: While our Critical care colleagues, Infectious Disease Experts and young doctors were put on round the clock duties in ICU and Covid wards, in most cities under the “Epidemic Act” majority of Beds in Hospitals were taken over by local municipalities. With Lockdown in effect across the country, professional work for routine medical care had come to a standstill. While some of us in the vulnerable group of fifties & sixties willingly stopped work to protect ourselves from infection the training of medicos in undergraduate and post graduate courses suffered significantly as they were drawn into covid duties for almost the whole year. Certain procedures thought to generate high infective aerosol in the surrounding were either stopped or modified. Many procedures that were not emergent were postponed for months. Medical profession was drawn into a dilemma between self-protection and providing optimum surgical care in these trying times. Guidelines were changing on a daily basis, confusing the doctors.
Patient management: We were not sure if a routine surgery would endanger a patient to the risk of contracting Covid infection in hospital. Would the Doctor or the Hospital be liable for this. To operate on for long hours wearing a PPE 3 was exhausting and difficult. Same for doctors and Nurses in ICU and wards. When is it safe to operate on a Covid recovered patient? Is it 4 weeks or 7 weeks as some publications reported? Since there was restriction on attendants in hospital, communication with relatives was a big issue especially if the patient was deteriorating. Once the 2nd wave hit the country, healthcare went for a spin. Oxygen and medicine supply became a major issue. We were not prepared to take the painful decision of deciding whom to connect to oxygen or ventilator and whom to deny when there was a severe shortfall of these along with Covid beds. While the public was largely irresponsible in Covid appropriate behaviour and delayed hospitalization till the patient was serious, they expected immediate attention once hospitalised and not willing to accept any untoward outcome. The HCW were often overstretched to deal with such huge numbers. Several instances of attack on Hospitals and Medicos have angered and demoralised the health care workers.
Society and Govt: Govt/Media and society did hail and appreciate the hard work and sacrifices of HCW and designated them Frontline Warriors. In the initial days Govt. did arrange for suitable stay in Hotels for HCW and even many social organisations and private enterprises like Taj Group provided support and food at the place of work for many months. However, the promise of adequate protective gear in the initial days to adequate remuneration for extra duties and health/life insurance as promised was mired in bureaucratic lethargy. While approx.1500 HCW have died in line of duty hardly 150 of their families were provided with much promised 50 Lakh compensation. The open criticism of Modern medicines and promoting unsubstantiated medicines as a cure by some groups without a scientific basis with the Govt looking the other way has hurt the profession in these difficult times. This has not only confused the public but has promoted Vaccine hesitancy in the population.
Family Life / Psychological impact: It has been tough for frontline workers to balance work and family. Many stayed away from family for months to keep the children and elderly safe. There was a high rate of infection amongst HCW in the initial phase and they needed to stay away. There was a constant fear of transmitting the virus to the family. The stress of long working hours and dealing with death on a daily basis without the support and comfort of family had a telling effect on the psyche of the HCW. Many young medicos roped in this crisis were still not mature enough or experienced to face this grave situation were the worst to suffer from breakdown. Like many professions, HCW too faced a financial crisis. Especially those who were on their own and taken loans to start a practice or other loans.
July 2021: How wise or prepared are we today? We know more about the disease and how to protect ourselves and patients. Better guidelines for management are in place. We are sure of the drugs to be used and in what settings. Vaccinating the population is a challenge but there is a promise. Though we failed to anticipate the second wave and be prepared, we have learnt a hard way from the misery and death of a large population. Still the delta plus mutation is a concern. No one is sure what turn the Virus will take but we are prepared to serve mankind and will not fail to deliver. That’s a promise on Doctors Day.
(The author is Neurosurgeon, Jaslok Hospital & Research Centre. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.