New Delhi: Novel coronavirus has in the last six months has posed major challenges, specifically for India’s healthcare system. The most vulnerable age group from virus is the senior citizens. However, children too, are increasingly contracting the infection. With an extensive experience of almost two decades, Dr Prameela Joji is the Senior Consultant Paediatric ICU and Emergency Department as well as the Medical Superintendent at Kerala Institute of Medical Sciences (KIMS Health), a private hospital in Trivandrum. Dr Prameela has been part of treating children who test COVID-19 positive in the city.
Children getting infected with coronavirus is less when compared to adults, but we are seeing an increase in children suffering from the virus as it is a community spread now. The main thing I have observed is the fear among them. Even the children are hearing so much about coronavirus that they and their parents get upset when they test positive and we have to repeatedly reassure them.
Dr Prameela said that usually most of the children admitted have been discovered positive during the contact tracing from their parents or close relatives. In most cases, the children are admitted in the same room as their parents who have also tested positive. So that they remain in positive spirits.
Their symptoms and disease is usually like a common flu, so it is extremely important to keep children’s morale high. It is not that serious disease for children, if cared for properly, she said.
Dr Prameela, who pursued her MBBS and DNB from Trivandrum Medical College, says that her team works round the clock, ensure the children have 24×7 assistance. Dr Prameela has divided the shifts in such a way that there is not much burden on a single healthcare worker.
Dr Prameela credits her team for all their efforts, and says that it was due to the teamwork that they were and are able to function smoothly amid a pandemic. Her team includes consultants, registrars, post-graduate students, nurses, nursing assistants and house cleaning team. She explains,
We have our team functioning round the clock, the night shift is for 12 hours, while the day shift is for a maximum of 6 hours for nurses and sometimes 8 to 12 hours for doctors. However, in order to help protect them from contracting the coronavirus, we have rotational shifts, wherein each worker is on COVID duty for a week, then one week in reserve pool and then the next week on non-COVID duty. This helps control our exposure to the virus. Also we test ourselves after corona pool and once negative only we join for duty so that our non-corona patients are safe.
Dr Prameela declined to share the number of children suffering from the disease, and availability of beds and PPE, due to hospital’s policies on sharing this data with the media, but assured that they were not facing any shortage in access to healthcare or PPE.
Thankfully, our hospital has a great provision for PPE kits other facilities required to prevent us from catching COVID-19. We feel fully taken care of as our preparedness started in March. So as of now, we don’t have any major issues in that area. We are always in PPE, gloves and all precaution stay accessible and I always feel I am protected in my hospital than in the community.
The primary challenge being faced by healthcare workers and her personally, she says, is the mindset of the COVID patients. She says that there is a fear engrossed in the minds of people about the dangers of COVID, while in reality 85 – 90 per cent COVID cases are asymptomatic or mild. She also asserts that the fatality rate in Kerala is ‘very very low which is almost 0.3 per cent while the recovery rate is on the higher side.’
But still when patients get tested positive for COVID, they have immense fear in them and they are extremely demotivated. After receiving the counselling and care for 2-3 days, I have noticed, with both adults and children, they start feeling relieved. This is also because of all the negative news floating around regarding COVID, there’s hardly any good news to read or see. People are more concerned with the rising cases of COVID-19 and the death toll, instead of focusing on the recovery rate and fatality rate. We can only help as much when people come to us so when they are so scared and demotivated.
She also talked about the stigma attached with COVID-19 with people hiding their status and symptoms. Dr Prameela said,
It’s a pandemic with more than 20 million cases across the world. Why do we need to be ashamed or alienate the patients? Kindness and compassion amid such a time is what is needed the most. So we need to clearly promote this message, instead of instilling fear with the number of cases and death toll.
When asked about healthcare workers across the nation who are contracting the disease, Dr Prameela says that protecting them should be prioritised.
We need to ensure all the doctors are provided protective equipments and are following all the necessary protocols to avoid contracting the diseases. If you are properly protected and the hospitals are ensuring rotational shifts, and have specific duty hours, it will be much easier for them to prevent the virus. If this cycle is continued healthcare workers will be on a safer side, which we need to ensure in order to beat this pandemic. Healthcare workers too, should be confident instead of being scared.
Lastly, Dr Prameela says that Kerala’s positive situation is a group effort of the government, the doctors, citizens and healthcare workers, who did their homework on the pandemic very well. She says,
When it was first reported in Wuhan, the state government had an idea of their people who are actually staying in various parts of the world and could come back home amid the outbreak. So using the experience from Nipah virus outbreak, we all were instructed to make arrangements accordingly. We didn’t know to what extent the pandemic can be dragged, but we had an idea that it is a serious issue. We were prepared to tackle the virus before we had the first case. The lockdown and surveillance by the government in particular helped greatly till now to keep the death toll low.
Dr Prameela says that she feels really proud and thankful for the state of Kerala for their treatment of the pandemic, the COVID patients and the frontline warriors like herself.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.