New Delhi: “Our work is our personal life and we are proud of it. This is a pandemic/war-like situation, so we don’t mind working continuously. I think, mentally we will feel off duty only when we have control over the disease,” says Dr Manish, Senior Resident Doctor at Safdarjung Hospital. On the other hand, Padma Shri Awardee, Dr KK Aggarwal, President Confederation of Medical Associations in Asia and Oceania (CMAAO) and Medtalks, Heart Care Foundation of India adds, “In the first week of April, we lost one lady, she had pneumonia and other complications, which are now known as classic symptoms of COVID-19. But at that point in time, we knew very little about the disease and there was a delay in diagnosis and we lost her. Sometimes, I think, if we knew more about the disease, I could have saved her life. Seeing your patients die is one of the hardest things to let go as a doctor.” These are some of the anecdotes from doctors who are at the frontline and dealing with the coronavirus pandemic.
On the occasion of National Doctor’s Day, which is marked every year on July 1 in India to show gratitude to all the frontline workers who are selflessly helping people and saving lives after lives, NDTV speaks with these doctors to know about their learnings and experience in dealing with the Coronavirus pandemic so far.
Talking about Coronavirus Pandemic and its learnings, Dr Manish, who works in the department of anaesthesia and intensive care at Safdarjung Hospital and is also involved in managing critically ill patients in the ICU who are suffering from COVID-19 says,
The past few months have been life-changing for the entire world. And we are no different. With the lockdown and a growing pandemic, every day we have learnt something new. As far as patient management goes, there was a lot that we didn’t know about this disease when we first started to treat COVID-19 patients back in March. But even though we know few things about this disease, we are still not fully aware, we are still continuing to see patients having variable presentations and different symptoms of COVID-19 and therefore we learn something new every day.
Dr Manish’s typical workday includes a twelve-hour duty for four to five times a week, many times the 12-hour shift also converts to a 24-hour shift. Highlighting more about the disease, high-risk patients and the advice he will give to everyone out there, he says,
COVID-19 is a viral disease with flu-like symptoms and may have life-threatening complications, sometimes. People who are especially immunocompromised, are at an increased risk of mortality from this virus. The one advice which I will give to everyone out there – take care of your health, make sure your immune system remains strong, take as many preventive measures as possible like social distancing, self-lockdown, among others. The idea is not just to save your own life, but also to save the life of your near and dear ones who may not be as healthy as you are. Control of this outbreak, which we all are dealing with currently requires a multipronged approach. It’s not just the doctors treating the disease, it’s also upon the public/community where maximum spread occurs. Therefore, a self-lockdown is still necessary to control the spread apart from social distancing and hand hygiene methods.
Speaking about how vulnerable are the doctors, nurses, healthcare workers during this outbreak in India and what needs to be done to protect the healthcare workers from being exposed to the disease, Dr Manish says,
The mortality rate for the same age in the general population is 1 per cent due to COVID-19, while for health care workers its 10 per cent. So, all doctors, nurses, and paramedic staff are ten tones more likely to contract the disease and die from it. That’s how vulnerable we are. Control of the disease is in the hands of the entire population. An irresponsible act from anyone markedly affects the health of our entire system especially the frontline corona warriors. Social stigma is by far the biggest challenge faced by doctors in this pandemic. We have lost the war with our countrymen who evict us from our rented accommodation, cut our electricity and water supply and blame us for spreading the disease into the community at large, while they continue to sip coffee in marketplaces without any precautions as if the pandemic is a hoax.
Further talking about the healthcare system in India and how prepared we are as a country to deal with coronavirus outbreak, he added,
India was and will continue to be a developing country. We have always been a resource constraint country. With healthcare receiving a minuscule percentage of gross domestic product, we don’t expect to be on top of any disease as far as preparedness is concerned. Having said that, so far in my hospital at least the preparedness has been good and up to the mark. We have no shortage of medical equipment and supplies but I am afraid the same is not true for other hospitals/states.
Sharing the learnings of COVID-19, Dr KK Aggarwal adds,
I have dealt with more than 2,000 patients in these past few months for coronavirus. I have noticed a few of the patterns, for example, if COVID-19 patient has diarrhoea then he is at the stage where he can spread the infection at a much higher rate. Whereas, after 9 days, the virus becomes impotent, it cannot multiply. The patient will get COVID-19 positive even after the ninth day and he will have fever and symptoms but after ninth-day patient generally becomes better. On the other hand, day four and day five are known as serious and critical days, and in such cases, early diagnosis plays an important role. If the diagnosis is done after these days then the chances of mortality is high. Another crucial thing is that we need to treat the patient and not wait for the test results as they may take one day to come and then it can be too late to treat or cure the patient.
Talking about the symptoms in the patients which he has seen, he added that children usually have rashes, whereas in women it is diarrhoea and loss of taste and smell. He also adds,
Women have an absolute recovery rate from COVID-19. Also, no patient dies of COVID-19 just like that, a patient who is very critically ill only suffers the loss, at this point of time, we all need to remove the fear out of ourselves which we have for COVID-19. Simply follow the precautionary measures and keep the virus at bay.
Speaking about how vulnerable are our doctors, nurses, healthcare workers and how we can protect them, Dr KK Aggarwal adds,
You just cannot protect the healthcare workers, we all are very vulnerable. This is a professional hazard like if you are a pilot, you know the risks of a crash, it can happen, it might not happen. There is no 100 per cent guarantee, obviously, all precautions are taken and they are trained to deal with such situations. Knowing the risk factors, they still go on and work for that matter every one of us also take flights. Similarly, we cannot avoid this pandemic.
Talking about other nations like Singapore, Hong Kong and South Korea and how they have managed to keep the virus at distance till now, Dr KK Aggarwal added,
What these countries did as soon as the pandemic started, they made AAI full-form rooms which are called as negative airborne rooms, meaning in such rooms air exchange happens every 5 minutes; the air from the room is thrown out and the clean air is taken in. These countries made a mandate that all hospitals will only work in COVID-19 situation if they have AAI rooms and that’s one of the biggest reasons why you see less infection there. Currently, India does not have such facilities. Moreover, I think, we need a dashboard or online portal, where all patients’ information can be stored, this will help in seeing how patients are treated across the country. For example, if I have a patient with one symptom, there can be a similar case in down south, so, we can see how the treatment was done there and exchange notes for the treatment. This will considerably lower our mortality rate. Lastly, we need to start comparing data from countries like Sri Lanka which has a very low mortality rate due to COVID and not USA or UK or other countries where the cases are at its highest peak. The ultimate aim for all of us should be to have zero mortality rate due to coronavirus.
Dr Aggarwal signs off by saying that he is very sure death rates in India will come down due to COVID-19 in the coming few months. He adds,
India will see two drastic changes, courtesy COVID, first people will stop going to hospitals as there the chances of contracting the secondary infection is at the highest. Secondly, home care will become a new buzz word, with ambulances, medicines, treatment coming to you at your doorstep.
About National Doctor’s Day
National Doctor’s Day was established by the Government of India back in 1991 in honour of the birth and death anniversary of the great physician and the second Chief Minister of West Bengal, Dr. Bidhan Chandra Roy. In India, this day is organised by the Indian Medical Association (IMA), according to IMA, National Doctor’s Day 2020 is of special importance and is dedicated to the innumerable doctors who are serving during this pandemic in the primary and secondary care setups as well as the dedicated COVID care hospitals and making every single effort counts.