- Many doctors have been on COVID duty since March, 2020
- The second wave of the COVID-19 pandemic left the doctors feeling helpless
- Doctors have reported stress and burnout due to the severe COVID situation
New Delhi: “I vividly remember one of the afternoons from the second week of April this year, when India witnessed the peak of the second wave of the COVID-19 pandemic. We had run out of beds in our department but one of the patients needed oxygen so we had to make him sit on a footrest and give him oxygen. I still get goosebumps remembering those crying and helpless faces of the attendants during those times”, recalls Dr Sushant Chhabra, Consultant and Head, Department of Emergency Medicine, Manipal Hospital, New Delhi. Dr Chhabra has handled over 2,000 COVID-19 patients since the start of the pandemic in March, 2020 and he believes, one of the biggest challenges for him has been maintaining mental wellbeing when surrounded with all kinds of negative emotions – chaos, distress, sadness, and helplessness.
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We (healthcare workers) too broke down many times as it was emotionally traumatic amid this chaotic environment and there is this guilt of not being able to help people even when you want to, because of lack of resources, said Dr Chhabra.
Just like Dr Chhabra, lakhs of doctors and other healthcare workers have been fighting the COVID-19 from the frontlines. During this time, not only have they been exposed to the virus, but through them their families too have been at risk. But pressures of the job notwithstanding the doctors have tried to save as many lives as possible – from putting in extra working hours to staying away from their family to contracting the disease themselves and at the cost of their own physical and mental health.
On National Doctors’ Day 2021 that calls to ‘Save The Saviours’, NDTV speaks to multiple doctors to try to understand the challenges of working on the COVID-19 frontlines and the impact it has had on them.
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The Horrors Of The Second Wave Of The COVID-19 Pandemic
Dr Ravindra Mehta, Chief of Pulmonary and Critical Care medicine at Apollo hospitals, Jayanagar, Bangalore has been in the medical profession for the last 25 years and he thinks, “COVID is an experience of a lifetime, like never before and hopefully never again.”
Dr Mehta has been involved in the care delivery of over 2,400 patients with him being available 24×7 at least on phone. Sharing his work routine, Dr Mehta said,
We did not have the luxury of having a day off, as we were under-staffed, there was significant fear and attrition in the medical staff due to personal issues and COVID infection. Though in principle we would try to take Sunday off, the phone was on, available and engaged all seven days of the week, every waking hour. When admissions were at their peak, there were only two aspects to life, COVID and sleep. The downtime came in the inter-pandemic period and if one got COVID which was like an escape.
Similar to Dr Mehta, Dr Trupti Gilada, Infectious Diseases Physician at Unison Medicare; Masina and Prince Aly Khan Hospitals in Mumbai, also worked without a day off. In fact, Dr Gilada was working even a day before her delivery. She didn’t visit hospitals for three months post-delivery but continued telemedicine consultations throughout.
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Talking about what motivated her to brave the crisis, Dr Gilada said,
It was on the spur decision. Back in March 2020, my CEO called me asking if I would be able to help with managing COVID patients with this new disease and that they needed me. I was in my second trimester by then. It wasn’t too hard actually to decide but yes, I have had several anxious moments. I think we doctors have learned to push personal concerns to a quiet corner of the mind.
Before COVID, Dr Gilada used to do a regular 8-hour shift and dedicate the rest of the day to her family and children but as she says, during the waves of the pandemic, her days and nights all merged into one long eon.
There were months together where I hadn’t slept for 2 continuous hours. Meals, playtime with my kids and even sleep were inadvertently interrupted by calls from the hospital, frantic calls from friends and relatives pleading for help for a hospital bed, medicines or advice. But the number of people we could help, the lives we could save and the countless blessings we have received made every moment worth it, said Dr Gilada.
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The Impact Of COVID-19 On The Mental Health Of Doctors
While patients are their families were running from pillar to post, in search of the treatment and medical essentials, healthcare workers were equally strained and helpless. Dr Radhika Agarwal, Senior Resident at Nehru Homeopathic Medical College and Hospital in Delhi said that when in the medical profession, one automatically gets connected to their patients regardless of whether or not there is any direct blood relation. Sharing an anecdote from the second wave of the pandemic, Dr Agarwal said,
One Saturday night, at 11:30 one of my friends frantically called up and asked for help as his father’s SPO2 had dropped to 84. I had medicines at home so I gave them; he lives nearby. After three hours he called and said that oxygen saturation has shot up and he is stable now. I vividly remember this because, for those three hours, I was in panic mode. I couldn’t sleep because I was constantly thinking about uncle.
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Dr Agarwal has been involved in both COVID testing and looking after COVID isolation centre and was also giving online consultation for free. Since Dr Agarwal was on COVID duty throughout, she had to stay away from her family to protect them from catching the virus in any way. And living away from the family during the crisis did make her feel lonely. However, Dr Agarwal, who is also a food blogger turned to cooking and food styling and photographing food to keep herself busy during the isolation period following 14 days of shift.
41-year-old, Dr Tukaram Jamale, Professor and Head of Department of Nephrology, KEM Hospital, Mumbai resonated with Dr Agarwal and said,
My wife, Dr Prajakta, is working in Kasturba Hospital she is also managing COVID patients. We have two young daughters – 2-year-old and 8-year-old and as a couple, it became extremely cumbersome for us to manage both home and patients. The situation was emotionally draining; we faced stress both at home and work. We were getting burnout not only at the level of work but family also.
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Dr Jamale said that another reason that doctors, especially in government hospitals are reporting burnout and stress is fragmented COVID care. In government hospitals, due to lack of manpower, relatives of patients often help in getting tests done, carrying the report, medicines and other things. But, in COVID, this was completely lost so this created a huge gap in patient care and resulted in morbidity, said Dr Jamale. Since he is a practitioner of Vipassana, it helped him put things in perspective and get through it, he said.
Echoing the same sentiment, Dr Mehta said,
There are no friends in COVID, families also stay away, and for the first time we have people in hospitals all alone with only health care staff taking care of them. To add to this, seeing large numbers of people dying has been demoralising and difficult to deal with, for most healthcare professionals.
While talking about patient care, Dr Gilada emphasised on the missing ‘healing touch’ due to COVID. Elaborating more on it, she said,
In pre-COVID times, short chats with patients beyond their illness, just holding their hands or patting their back went such a long way in making the patient feel better. But this completely changed because of PPE (personal protective equipment) suits. Patients are not even able to see our smiles and are left all by themselves without their family when they probably need their support the most.
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The Support Of The ‘COVID-19 Frontline Families’
All the doctors NDTV spoke to credit their families for the undying support that kept them going. For Dr Jamale, his parents and in-laws’ support is of great help in taking care of his daughters while the couple goes to work. But to protect their elderly parents from COVID, the couple decided to send them to their hometown and manage both household chores and patients on their own. Dr Jamale said, the crisis actually helped the couple rediscover their relationship.
It all got chaotic initially. We divided the work and our shifts like I would do cleaning and babysit while my wife would cook and go to work. I would go to work only after she is back. We constantly juggled between hospital and home for 10 months straight. We lost complete touch with our daughters in the sense we couldn’t hug them or most of the time they were either studying or sleeping. My elder daughter is close to me but due to COVID, I was hesitant in coming close to her. I would try to explain to her that I can’t sleep with you. I would put her to sleep from a distance. It was taxing for her as well me, but gradually she understood. As a family, we fought all the battles and came out stronger. It made me realise that how casually we say or text someone, ‘I love you’. We drop a lovely text to each other on birthdays and anniversaries but what exactly does that mean? You should be able to give yourself for others, said Dr Jamale.
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Similarly, for Dr Gilada, it was tough to go to work while leaving her 3-month-old daughter at home but as she says, it was her kids that kept her sanity. Just coming home to them make us forget our worries, she said and added,
The families of the front liners not only offer the mental support but also off-load them from household responsibilities without making them feel guilty. It is only because of the ‘frontline families’ that we can give our 100 per cent at work.
Dr Mehta’s wife is a Pediatric Cardiology Doctor but during the pandemic, the couple decided that only one of them will do COVID care so that at least one person stays safe for the family, especially their two adolescent children.
On a personal note, a frank discussion with the spouse, ‘making our peace’ and ‘handing over all details of existence’ in case one gets admitted was the extra planning done, said Dr Mehta.
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While Dr Mehta had an open discussion with his wife, Dr Chhabra took the tough decision of sending his wife and children to his parental house. It was a difficult decision but as Dr Chabbra believes,
Tough times don’t last but tough people do. Being a human being at the end of the day I personally did broke down many a time and was lucky enough to get all the support of my family and colleagues at the workplace which helped me become mentally stronger to face the heat and help maximum people I can during these times.
Along with the support of the family, for Dr Radhika Agarwal, positive messages and goodbye notes from recovered patients motivated her and gave her the confidence to save more and more lives. After losing family members and friends to COVID, Dr Agarwal is of the opinion,
Grief will not go away overnight. We have to address it and deal with it. Also, the third wave of the pandemic is almost home because people are being careless in following rules. It’s time we prepare for the upcoming caseload.
Bracing For The Possible Third Wave Of COVID-19 Pandemic
According to the medical experts, the third wave of pandemic will come sooner or later and it’s the basic COVID precautions – hand washing, masking and social distancing that can protect us and prevent a severe third wave. All the doctors also emphasised on ramping up healthcare infrastructure so that we don’t have to go through what we did back in April and May.
We have to remember that ‘those who don’t learn from history are condemned to repeat it.’ Let us be mature, and assume individual responsibility to prevent sickness, death and demise, said Dr Mehta.
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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.