Doctors in COVID Duties : Dying as Disposables
Biggies of Healthcare defend PM Modi’s handling of Pandemic
New Delhi: After ‘1000 and counting’ deaths, doctors in COVID duties in India seem to be under siege in the killing field of Corona Virus. Such is their plight that when they are ambushed by the prowling virus while treating COVID patients, they do not get beds for their own treatment in their own hospitals. They have to fend for themselves, imploring for oxygen and making plea for room for treatment. They are discarded as if they were disposables. The tragic situation of unwelcome working conditions and thanklessness has caught them by the jugular. Young doctors are succumbing to the nasty pathogen.
With number of sick and dying doctors climbing up daily, the spectre of dearth of skilled doctors for treating corona infected patients is looming large. It is being forewarned, and rightly so, that in upcoming waves India might soon have to confront famine of skilled doctors like that of oxygen if fatigue and felling of doctors continue unabated.
Doctors in COVID duties seem to be whistling past the graveyard, given the virulence and killings capacity of Corona in its second wave, like soldiers in a pitched battle against Corona always in danger of being caught unawares by the airborne enemy. Hospitals for them have turned into a veritable minefield and no one of them knows when they would be pounced upon by the lurking virus. In the treacherous terrain of hospitals, they constantly tempt fate. The doctors’ community in India is through unprecedented trauma. The fear for life among doctors can be gauged from the fact that Managing Director of a renowned hospital in Gurgaon, the most sought-after destination for Who’s Who COVID 19 patients has not visited his hospital for over 20 days on a trot in the second wave and has not stepped out of his home.
Death of Dr K K Aggarwal on May 17 despite being jabbed twice has deeply shocked and traumatized the community. Though he duly got hospitalised in AIIMS and best doctors attended on him, his death aggravated the fear of life among doctors. While treating hundreds of thousands of COVID 19 patients in his daily online OPD, late Dr Aggarwal would often boast that if patients connected in time, he would not let anyone die of Corona. He would say treatment well begun was half done. The irony of ironies is that he himself failed to assess the danger on his own life. Dr Aggarwal died despite every facility on a platter. Think of lesser frontline health workers, mostly frontline resident doctors, dying for want of oxygen and timely treatment.
Going by IMA (Indian Medical Association) count, so far close to thousand doctors have succumbed to COVID. But IMA keeps tab on the death of only member doctors which number only 3.5 lakh. Non-members doctors are more than 12 lakh. As to how many from them have lost to COVID 19, is yet to be accounted for. So, numbers of doctors losing life could be much higher. According to IMA’s COVID 19 registry, 748 doctors succumbed to the infection in the first wave of pandemic. On May 18, Dr J A Jayalal said 270 doctors have perished just in last two months due to COVID in second wave and numbers are adding up daily.
At 78, Bihar marked the maximum number of death of doctors followed by 37 in Uttar Pradesh, 29 in Delhi (updated number 60) and 22 in Andhra Pradesh (22). 50 doctors died due to COVID19 in a single day all across India. By a rough estimate, Telegana has lost 19 doctors, Maharashtra 13, TamilNadu 10, Karnataka 8, Odisha 8, MP 5 Chhatisgarh and JK 3 each and Assam Gujarat and Kerala 2 each. Dr Jayalal said that the second wave of Pandemic is turning out extremely fatal for all especially for healthcare workers who are at forefront. He also bemoaned the delay in vaccination of doctors. Estimated 40 percent doctors have so far been infected.
As figures of dying doctors are being updated, it emerges that doctors In Delhi are among the hardest hit with at least 60 doctors succumbed to the coronavirus in the current wave so far
Their working condition is very pathetic during pandemic. They have to work nonstop for unspecified hours. They have almost forgotten about their families and children. Talk to such doctors, eyes of many of them would well up. Doctors, mostly residents are being stretched to the limit. They are working in inadequate and deeply unequal medical system. Resident doctors who are at the forefront have little incentives. Even meagre salaries are being delayed. They also face intimidation and violence with videos showing angry family members thrashing medical staff in hospitals halls.
Dr Devy Shetty, renowned heart surgeon, MD Narayana Health and member of national Task Force instituted by Supreme Court to help Centre efficiently tackle the pandemic, has warned about upcoming human resource crunch in future COVID management efforts. Dr Shetty, a key opinion maker in Healthcare, says soon we might run out of skilled personnel to treat COVID patients. After addressing oxygen shortage, the next headline could be – ‘patients are dying in ICU because there are no nurses and doctors. Dr Shetty has recommended a number of ways to cope with impending crunch of skilled healthcare workers. He has also recommended vaccinating parents quickly in view of impending third wave.
In Dr Devy Shetty, PM Narendra Modi, being targeted unfairly, has found a great supporter to fall back upon. Dr Shetty is openly defending Indian government in the midst of raging blame game. Hailing Indian government’s COVID handling, he has said no country can manage the astronomical numbers that India has.
Uday India talked to some prominent Healthcare leaders on wide range of issues relating to covid-19 Pandemic, namely, sorry state of doctors at COVID Duties, emerging new challenges in pandemic management, the way pandemic was addressed so far, way ahead, going about pandemic preparedness and Vaccination et al.
Dr D S Rana, Chairman of Board of Management, Sir Ganga Ram Hospital, is member of the National Task Force set up by Supreme Court to help Centre with scientific solutions in Covid-19 management. Talking to Uday India, Dr Rana said, “Death of doctors in COVID duties are a matter of concern but you cannot wish away such professional hazards. Treating TB patients entails same kind of hazard and there is no way to escape but, yes, their protection must be our priority. Fatigue has surely set in among frontline healthcare workers. Stopping further escalation of infection like wildfire is the only solution. Process of Mass Vaccination must be accelerated because that seems to be the only solution for now.”
Dr Rana further says, “Complacency, which landed India in such crisis, should have no place while we are dealing with pandemic of such proportion. ‘We have won the battle’ kind of overconfidence is going to push to another catastrophe. Also blame game will lead us nowhere. We can win this battle only with the spirit of cooperation. We might have erred in the past for which we have suffered the brunt. but we must learn lessons for way ahead. It is expected that we won’t repeat our mistakes in the impending pandemic waves. Private hospitals which are doing utmost are unfairly targeted. Punish the guilty if some wrongdoing is happening.”
Dr Deepak Shukla, CEO, PSRI
(Pushpawati Singhania Research Institute) hospital, said, “Death of doctors are happening at two levels, of those junior doctors who are on COVID duties and those who are old and seniors. That should be a matter of concern because we already have shortage of doctors. If on duty doctors get infected and some of them die, it will certainly impact handling of COVID patients. The protection of doctors on duty is a must. They must all be vaccinated but doctors have to do 9-10 hours duty at a stretch, they are so hard up of time they hardly can think about vaccination. I assert that in the event of death, doctors’ family must be adequately compensated. The protection quality for them must also be improved. Duty bound doctors must be vaccinated, 100 percent of them on priority.”
Dr Shukla further said, “When COVID Pandemic started, the world was at wit’s end. We had no experience of dealing with the pandemic of such enormity. Management protocol evolved and is still firming up. Hydroxychloroquine drug which former US president announced he was using for his COVID treatment is not part of the protocol now. In the second wave, due to variant strains, infectivity is so very fast and the virus has become more lethal. But now we have armamentarium in place to deal with it and we should do it in earnest.”
“Alertness should be key in further need of response. Coordination between Centre and State governments is of utmost importance. We expect that there be no laxity in this coordination. I do not point figure to anyone but lack of this coordination has been the problem which made a mess of the situation. The Centre had given money under PM-cares fund to Delhi government for installation of 8 oxygen generating plants. Why Delhi government did not install? And if it did not, why the central government remained a mute spectator. The central government needed to keep tab on how state governments are going ahead. In first wave there was little demand of oxygen, in second the need of oxygen spiked suddenly. There should have been planning in place for such eventuality. Educating and monitoring mass is must which can not happen merely by giving TV adds. I have hunch we have confronted a biological warfare for which the govt must keep its people in readiness. Vaccination is the only way forward. It is only solution whole world has consensus on. Make vaccination top priority, added Dr Shukla.”
Dr Shukla made a strong case of PM Narendra Modi being unfairly targeted. Dr Shukla said, “PM Modi handled the first wave so excellently no other country in the world could replicate. This was exemplary and even US failed outcompete India. The second wave was exacerbated by mutant variants of pathogen. It is a scientific failure, not political failure. Blaming PM is totally uncalled for.”
Dr Sahjanand Prasad Singh (Patna), President (Elect), Indian Medical Association also suspects it might be biological warfare inflicted on India. Expressing concern for the deaths of duty-bound doctors, Dr Sahjanand said, “Yes, duty bound doctors are bearing the brunt and even losing their lives but their sacrifices will not go in vain, we will win the battle against pandemic. I only want that doctors who are dying must be given adequate compensation in the range of Rs 50-60 lakh. It is the least that should be done for their family in return of their sacrifice.”
Speaking on India floundering badly in second COVID wave, Dr Sahajanand said, “We should not have let our guards down after first wave. We erred on that. ICU beds should not have been removed after end of first wave. Since it has exploded in the air, people should rarely step out of home. PM Modi has done his job well and blame targeted towards him is ill founded. The way ahead is only vaccination. In four to six months, India must be vaccinated at all cost.”
Dr Vinai Aggarwal, former IMA president, and one among senior doctors who PM Narendra spoke to recently, said, “Doctors had done commendable job in the first wave. Like in 1962 war with China, we sent our doctors without armour and weapons to fight the pandemic. We did not even have PPT kit. And they did not disappoint us. Doctors who died made supreme sacrifice that must be adequately recognised especially in terms of adequate compensation. Second wave is proving more deadly for them. It is a matter of concern. There are no dearth doctors in this country, delay in appointment is resulting in the kind of crunch we are witnessing. Doctors must be given incentives for the deadly duty they are doing. Delhi government’s 15,000 rupees per day for COVOD duty which adds up to more 4 lakh a month is something to be emulated everywhere. Such compensation for them is the need of the hour. Instead, what I see is contractual and ad hoc appointments at meagre salary is becoming the norm. It is shocking to see that when they become infected during COVID duty, there are no beds for them in their own hospitals.”
Commenting on missteps leading to present predicament, Dr Aggarwal said, “It is totally unfair to target PM Narendra Modi. In a country where PM has to intervene for arrangement of oxygen for gasping patients, one wonders why luminaries around him are there. PM is becoming victim of others’ incompetence. Union Ministry of Health and Family welfare has abysmally failed in doing its duty. The crisis was an opportunity for this ministry to assert its relevance but instead we saw it busy in refuting remedisvir and plasma therapy. AIIMS Director Dr Randeep Guleria unnecessarily makes the statement that one CT scan meant going through 400 X-ray tests.” Dr Aggarwal suggested that vaccination process should be streamlined as soon as possible because that is the only way out.
Dr SCL Gupta, MD, Batra Hospital, New Delhi came down heavily on incompetence of the ramshackle healthcare system in coping with COVID pandemic, while fiercely defending PM Narendra Modi. He imputes the blame on state governments. He said PM’s leadership is unquestionable. He also assailed the way doctors on COVID duty are being treated. According to him, in second wave, the famine of oxygen, non- availability of beds for the sick, medicine disappearing from the market, non- availability of RTPCR tests – such scenario was so depressing.
Talking to Uday India, Dr Gupta in a no hold barred interaction, said, “We should understand how hard it is to become a doctor. A doctor’s life is very precious. Instead, in the name of humanitarianism, we take a doctor for granted but they are meted out most inhuman working conditions. They do long hours of duty without any let up. There are no incentives for their risky duty. Mere vaccinating frontline doctors is not enough. I hear a lot of talk about steps being taken for the welfare of duty-bound doctors but all prove to be hot air, mere lip service. I think doctors who die deserve adequate compensation.”
Defending PM Narendra Modi, Dr Gupta said, “Health is a state subject. The grim situation in the second wave is the result of abysmal deficiency in states. Had there been well equipped Primary Health Centres with 24X7 availability of doctors and medicines, there wouldn’t have been such sorry state of affairs. Developing healthcare system is state’s mandate, not that of PM. He is being unfairly targeted. Vaccination can not happen in one day that too in huge country like India. We need to have patience. Even USA is only 50 percent vaccinated so far. At 19 crore vaccinated people, we are not lagging behind.”
Raman Bhaskar, Hospital Director, HCMCT Manipal Hospital Dwarka said, “During this pandemic all the Doctors, Nurses and medical staff is going beyond their Call of Duty in the fight against Covid-19. It is a matter of concern that the crisis has taken a toll on healthcare workers. They must be protected at all cost and on priority. At HCMCT Manipal Hospitals Dwarka safety and well-being of our patients, doctors and other healthcare professionals are of utmost importance. Therefore, we at Manipal Hospitals have implemented all the necessary protocols & guidelines. Some of the important steps we have taken includes:
- “Forming Covid Response Committee which is responsible for implementing protocols, regular analysis and improvisation
- “Safety training & expert rounds on covid floors to ensure all safety protocols are implemented
- Regular training for donning & doffing and also created separate donning and doffing areas on each floor
- “Separate AHU’s (Air handling units)
- “Vaccination for all the staff members
- “Providing all necessary safety material like PPE kits, masks, sanitizers.”
BY DHANANJAY KUMAR