We’re facing the worst pandemic of the century. So far, 26,57,000 people have got COVID-19 with 1,85,353 people losing their life because of this infection. Initial reports were not alarming saying that its case fatality rate is 2%. But when it spread to western countries like Italy, France, UK and US case fatality rate has increased beyond our imagination with case fatality rate reaching over 7%. However, as a larger portion of people are having ongoing active infection, to comment case fatality rate as a proportion of total deaths to total no. of cases will be erroneous. If we calculate case fatality rate from the no. of cases (9,15,321) which had outcome, its goes to a whopping 20%. Case fatality rate is of more importance in infectious disease which tells the killing power of the infection. So, this COVID-19 pandemic has a case fatality rate which exceeds the CFR of the previous pandemic by SARS (10%), but lesser than that of Ebola (25%). This pandemic has shaken the entire world and destroyed the economy, making the entire people to panic about its progress.
What is the scenario in India? Right from the beginning, India tried its maximum, starting from screening the international travellers coming to India, isolating/quarantining them if needed, creating awareness about the infection through media/telecommunication/social media, enforcing nation-wide lock down and providing health coverage to the patients and health care workers affected by COVID-19. Its almost going to become a month of lock down. Currently where are we standing? There are more than 21,500 Indians affected by COVID-19 and more than 680 losing their life while battling against the disease. The developed countries were in a similar situation few months back. None knows how the trend will change in India whether the curve is going to become flatten or going to become steep?
What is expected from the public? If everyone would have done 14 days of strict home isolation, by this time there shouldn’t be no case, as the incubation period is maximum of 14 days for this virus. But in the contrary, daily there is increase in no. of cases by over 1500 in India, which is a sign that people didn’t follow strict home isolation. When the entire professionals are freed from coming to office and a certain group of professionals are made to work from home, only the health care workers are leading from frontline fighting against this pandemic. In fact, they are only at the risk of contracting infection and to spread the infection further provided they are not given appropriate personal protective equipment (PPE). The course of the disease depends mainly on how Indians are going to behave in the remaining period of lock down. Few weeks back, the scenes were worse and infact made our health care workers depressed to see the general public going as mass on streets and ringing bells and hitting plates, and bursting crackers and celebrating as if COVID has been eradicated from the nation. What the Prime minister told is different as he asked to do ring bells and show torches only in home as a solidarity to show support to the health care workers in the fight against COVID but the general public broke the primary goal of the entire period lockdown by their unwarranted behaviour for those 30 minutes…
In the previous paragraph, I’ve mentioned about PPE and I’m certain that general public are pretty aware about the PPE and that’s the reason why I could see them roaming with N95 masks in the streets while we the health care workers are running out of the stock of N95 masks and working in ICUs with a simple surgical mask… It’s the time in which general public has to extend their support to the health care workers and not to steal their resources… We all know that anyone can get serious illness from COVID and if we die of COVID, even our family members won’t be let in to see and people with full PPE will bury our mortal remains within few hours… But still, we are in the frontline fighting against this deadly disease… But what we expected from the country is to provide us good quality PPE to provide us utmost prevention… Whether we are provided? Every states have established COVID hospitals and trying their maximum to provide adequate PPE. But still, many Health care workers are not getting appropriate PPE and many are screening the patients with a simple surgical mask, and examining with a simple surgical mask. Reports are coming from many parts of our nation that many health care workers including doctors and nurses getting the infection and few even losing their life. But we are hearing from the administration putting the blame directly on the doctors saying that they’ve contracted the infection because of the carelessness. Everyone knows that they’ve contracted infection because of no proper PPE provided.
I’ve provided below my photo in the PPE, being provided in PGIMER, the second topmost central government institute of the nation… Here we are provided with two-three-layer protection with a surgical scrub followed by Hazmat suit and a gown if needed for procedure. In addition, goggles, N-95 mask and visor are provided to give full protection… This is called full set of PPE and HCWs working in COVID areas particularly in ICUs are expected to be provided with this full set and whether every HCWs working in COVID areas are provided with the same all over the nation??? People are feeling this suit of fancy and it’s definitely, not… If there is a breech in any of this, while working inside the COVID area, its like getting exposed to the infection… None knows the pain we’ve to undergo rather it has become a joke for the people that’s why sub-registrar’s office in Salem is being provided with PPE kit while many HCWs are still lacking the same… The duty hours extend from 6 hours to 12 hours in many areas. Since there are more than 1000 resident doctors in PGIMER, our duty hours have been made to 6 hours. Before duty, we hardly drink water to avoid getting our urinary bladder full inside. Since ours was centralised AC, it was made off to avoid circulation of virus. Practically with no internal air circulation with fan, AC made off with doors and windows being closed, everyone gets suffocation inside. After a hour the goggles presses and starts producing pain above the ears along with the headache. Its difficult to perform procedures with double to triple gloves and a visor, but we got used to accept the difficulties. After returning from the duty, you could see the impression of N95 remaining over the face with the nasal septum continuing to have pain… This is just the experience from the premier institute with 1000 resident doctors. Just imagine the situation in other state hospitals where there are limited doctors and they are made to do 12 hours duty in a shift… But none of the general public understands our difficulty. If you have understood, you wouldn’t have hoarded the N95 masks which forms the vital in our PPEs; the vendors and the pharmacies wouldn’t have sold at huge cost to the general public with the motto of making money at this crisis time. For general public, a cloth mask/surgical mask is more than enough; Social distancing and hand washing are of prior importance in preventing the infection… I don’t expect the public now to volunteer and to return the N95 masks which you’re hoarding in home; But if you are doing, that’s the best thing you will do for our HCWs working in frontline battling against this infection…
The another news which came as a big blow to the entire medical fraternity is how the public payed last respect to Dr. Simon Hercules. Dr. Simon Hercules, a renowned neuro-surgeon in Chennai, died after battling against COVID for two weeks. At the crematorium, near about 300 people gathered and started pelting stones at the ambulance driver and health care workers and prevented them from burying mortal remains of Dr. Simon Hercules. The society he served for decades failed by ‘denial of dignity in death’. It has brought depression to all the frontline health care workers fighting against this pandemic. HCWs who are martyred in this battle need to be pain due respect and homage. Though Government has come up with new laws and legislations, nothing will change unless the general public change. So far, we have already seen a lot of legislations in the last two years but not even a single culprit who assaulted doctor was punished in the court of law…
This post is more of an emotional one and I activated my facebook account after two months to write this post while becoming depressed by seeing how my own people reacted to the death of my fellow doctor… Still medical profession is a noble profession… The world never appreciated us that we didn’t have enough food/water/sleep, hardly spent time with the family or friends, did continuous duties for more than 36 hours, worked our heart out to save our patients… But, we never worked for getting appreciation and the smile of the recovering patient was enough in most of the time to heal all our pain and sufferings… Only request to the general public and the Government is we’ve risked our lives in fighting against this deadly infection; We expect only one thing from you – proper PPE and little bit of respect… People, kindly follow strict home isolation and social distancing and please help our nation to recover from COVID-19… Its time for me to get ready for my night duty in COVID ward and to wear again the PPE and hazmat suit… Bye….