“It’s not even the peak of the third wave yet....I don’t know how we will manage,” says a resident doctor from the All India Institute of Medical Sciences, Delhi, one of the busiest COVID centres in the country at the moment.
This is a looming fear being echoed by doctors in COVID wards across the country.
As cases skyrocket in India, healthcare workers testing positive by the hundreds, in the throes of dealing with an influx of patients, has left hospitals seriously understaffed.
The question arises, how did we get to this point a third time around?
Can the booster doses that are being rolled out for frontliners help make the ordeal less harsh?
FIT speaks to resident doctors about the challenges that they are facing as the country scrambles to contain yet another COVID wave.
Some of the resident doctors we reached out to, refused to comment because they feared backlash from their administrations. Others requested anonymity.
Too Many Patients and Not Enough Doctors
While no official numbers have been released by the institute, according to an anonymous source, at least 320 resident doctors in AIIMS are currently COVID positive. Many others, he says, have symptoms but are still at work because they haven’t got their test results back.
"Overall the situation is very exhausting for all residents in AIIMS right now. Many of the departments are working with half to one-fourth of the workforce."Resident Doctor, AIIMS Delhi
A similar situation has gripped Vardhman Mahavir Medical College & Safdarjung Hospital, another Government hospital in Delhi where COVID wards are running in full capacity.
"16 of my batch mates are positive right now," Dr Ankush Garg, PG resident department of Anaesthesia and Intensive Care at VMMC & Safdarjung Hospital, tells FIT.
"The rest of us are doing double duties. There's no junior batch, so it's really difficult," he says. The delay in NEET PG Counselling has only added to the short staffing crisis.
Back to Burnout: 'Longer shifts, Shorter Isolations'
"We generally have 24 hour duties once in a week. Now we are doing more of those. Also, generally there's one resident per OT (operation theatre) on one floor, but now one resident is looking after 2-3 tables."Dr Ankush Garg, PG resident department of Anesthesia and Intensive Care, VMMC & Safdarjung Hospital
Dr Garg adds that at Safdarjung Hospital, those who are currently COVID positive have been asked to join back after the stipulated 7 days of isolation irrespective of if they have symptoms or not.
According to sources, COVID positive healthcare workers in Faridabad's ESIC Medical College & Hospital are being asked to join back after just 3 days of home isolation.
Circular at ESIC Medical College& Hospital, dated 10. 1. 2022.
(Source: Anonymous)
Moreover, the circular passed on 10 January states that doctors and other members of the staff will be required to pay 1500 per RT-PCR test.
This, when the price for RT-PCR tests in private labs in Haryana was capped at Rs 450.
"This is not even the peak of the wave. As we approach the peak, as the number of patients increase, the number of healthcare workers getting positive will also increase. So at that point of time, if we continue to get exposed by doing surgeries, by seeing patients in regular OPDs...I don't think we will be able to manage in like the next one or two weeks," Dr Ashok Kumar (name changed) told FIT.
“When we have drivers for only 10 vehicles, how can we drive 11 vehicles?”Resident Doctor, AIIMS Delhi
Could the impact of the omicron variant on healthcare workers have been softened if booster shots were allowed for them sooner?
Boosters: Too Little Too Late?
On 25 December, after much debate, the Union Government allowed COVID vaccine booster shots to frontline workers in light of the highly transmissible Omicron variant and waning vaccine immunity. This was to be rolled out starting Sunday, 10 January.
On the first day of the drive, none of the residents that FIT spoke to had got their booster shot.
While two of them were COVID infected at the time, the third resident said he couldn’t make it in time because he got off his shift too late.
Even if they are to receive boosters in the next few days, the doctors are not optimistic about their impact.
"They (healthcare workers) have mostly mild symptoms but for a few days they are knocked out from being able to work. So staffing requirements is becoming a big problem,” says Dr Sumit Ray, Head of Department, Critical Care Medicine and Medical Superintendent, Holy Family Hospital, Delhi.
“The boosters are not really going to stop that significantly," he adds.
"By the time the effect of the boosters for the healthcare workers starts kicking in, I think the peak of the wave will be going down."Dr Sumit Ray, Head, Critical Care Medicine, Holy Family Hospital, Delhi
Besides, says Dr Ray, "I don't know how effective the boosters will be in preventing infections and to what degree."
Twice Burnt, No Lessons Learnt?
According to Dr Rahul (name changed), complacency in the beginning of the third wave was a major reason for cases snowballing out of control the way they have.
“I don’t know how this narrative that this time the variant is ‘mild’ came about. The general workers and even us healthcare workers didn’t take it seriously at first. But if we are all infected, who will attend to the patients?”Dr Rahul (Name changed), Resident Doctor, AIIMS Delhi
“When you’re posted in non COVID wards, you tend to not be as cautious. When the cases started going up initially, no hospital, including AIIMS stopped physical OPD. And now everyone in the director’s office is COVID positive. Because we don’t know which patient is infected and who isn’t," he explains.
"We’re mingling with doctors who have been seeing patients (presumed to be non-COVID) all day, and in 24 hour duties we're eating and resting in the same space. This is how a chain of cases among the doctors was created."Dr Rahul (Name changed), Resident Doctor, AIIMS Delhi
“We had one Junior resident come into work, and his entire team became positive in a couple of days. One of the doctors who didn’t have symptoms came back to work, and other people were infected as a result," he says, adding, "this is something that's happening in all hospitals."
Dr Rahul also alleges that the PPE kits being issued to the healthcare workers at AIIMS are of a poor quality.
“On paper they say good quality masks and PPE kits should be available to the frontline workers but here at AIIMS, the PPE kits we are getting are of poor quality at the moment. We, the doctors, nurses, and the staff have raised this issue.”Dr Rahul (Name changed), Resident Doctor, AIIMS DElhi
A similar complaint of poor quality masks and PPE kits at AIIMS was also made back in 2020, which was dismissed by the institution.
Complacency & Mismanagement
Apart from this, resident doctors at AIIMS say there is a lack of strict distinction between COVID and Non COVID duties which further helps accelerate the spread of the virus.
"We have written orders to turn the Trauma Center into a COVID centre, and yet, we have non COVID OTs continuing here," says another resident doctor at AIIMS who does not wish to be named.
“Even now, just yesterday, in the trauma centre a non COVID OT (operation) was underway, and the same doctor had to attend to an emergency COVID case (wearing a PPE kit) before returning the non COVID patient.”Resident Doctor, AIIMS Delhi
"At this time, we really need to take this virus seriously and not be casual thinking that it is 'mild' because we already can't keep up with it," he adds.
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