Shortage of PPEs, asymptomatic patients putting healthcare staff at risk?

At least 50 healthcare staff in India have been infected with the Covid-19 infection

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The Covid-19 crisis is a perilous time for healthcare workers. With shortage of Personal Protective Equipment, the danger of them catching the coronavirus infection is at an all-time high. Also, the rise in asymptomatic cases and the requirement of these healthcare workers to go into containment zones or vulnerable localities proves a big challenge to their health.

As cases rise, many instances of healthcare workers – nurses and doctors being infected, have emerged.

40 nurses from Kerala who work at the Wockhardt hospital in Mumbai, tested positive for the infection. It was alleged that they were forced to treat Covid-19 patients without enough protective gear and without taking any necessary precautions. One of the nurses who is critical, has now been shifted to a private hospital in Bandra. So far, a total of 53 healthcare workers working at the hospital, including doctors, have tested positive.

According to Jibin, a representative of the United Nurses Association (UNA) in Mumbai, a majority of the nurses at the hospital were from Kerala. He told the media, “When the first few COVID-19 cases were treated in the hospital, a few of the nurses attended to them without any precautions as they were not provided with any protective gear. Later, these nurses worked along with other staff, took the hospital van to go to their hostel and stayed in hostels with others. If they were allowed to stay in quarantine or were provided with personal protective equipment, the situation would not have been this worse.”

He also says that these nurses have only been informed of their condition and haven’t received their test results yet.

The Wockhardt Hospital has since then been locked down by the Brihanmumbai Municipal Corporation (BMC) and except for one, the other nurses are being treated there itself. “They are undergoing treatment in the same hospital. Since this hospital has been locked down by the Brihanmumbai Municipal Corporation (BMC), nobody is allowed to meet the patients and nobody from the hospital is allowed to come out. The hospital stopped taking new patient admissions,” he said.

The UNA has also approached the Supreme Court seeking to form a ‘National Covid-19 Management Protocol’ and petitioned that the Central government intervene and make sure that healthcare workers not only have adequate protection kits in isolation wards, but also provide financial assistance to them as they face the highest risk during this time.

Similar situation across the country

Apart from Wockhardt which was declared a containment zone, Jaslok Hospital in Mumbai too has been declared as one after five nurses tested positive for the coronavirus. They were said to have contracted the infection from an asymptomatic patient who was admitted to the hospital for a different illness, The Indian Express reported.

Hindustan Times reported that the Delhi State Cancer Institute (DSCI) too was shut after 18 of its healthcare workers, including two doctors and 16 nursing staff, tested positive for the coronavirus.

“As a precautionary measure, we have shut down various facilities of the hospital for conducting sanitisation. We are making arrangement to shift our 19 cancer patients to another private hospital. Talks are on with Dharmshila Superspecialty hospital,” Dr BL Sherwal, DSCI’s medical superintendent, said according to ANI.

These cancer patients are now being screened for Covid-19 before they can be shifted as they are extremely susceptible to infections. Talking about the infected healthcare workers he said, “Some of them are admitted at the Rajiv Gandhi Super Speciality Hospital. We are very cautioned about the health of our doctors and nurses and all measure are being taken and their contact tracing has also started.”

In Pune, about 40 surgeons and resident doctors of a prominent medical college in Pimpri were quarantined after they came in contact with a Covid-19 positive patient.

Earlier, a doctor at a mohalla clinic in Delhi’s Maujpur had tested positive for the infection and a doctor from AIIMS, with no travel history, had tested positive too.

Plight of healthcare workers

Sabrang India has previously reported about the shortages of PPEs that doctors and other healthcare staff are facing in the country. Today, the Hindustan Times reported that AIIMS has its staff involved in direct patient care to use the five N-95 masks allotted to each of them four times so that they can be used over 20 days.

The hospital has issued a circular asking the healthcare workers to do the same, but has not issued detailed guidelines on how to disinfect the said masks. Dr Srinivas Rajkumar T, General Secretary of Resident Doctors’ Association at AIIMS, said, “We have been writing to the administration about the shortage of personal protective equipment and N-95 masks since March. Not only have we not received any concrete answers on how they are dealing with the shortage, they have now issued guidelines for using the masks four times. How is a doctor supposed to carry the infected mask home? How are they individually supposed to disinfect it? This should happen at the hospital level to curtail the spread of the infection and even then only when there is no other option available.”

He added, “The circular does not clarify whether the same will be applicable for people working in the Covid-19 wards and those screening the patients for respiratory symptoms – as they are at a higher risk of carrying the disease home with the masks. If we are at this stage even before the community transmission has begun, what will happen when there is a deluge of patients. This will take active doctors out of duty.”

The World Health Organization (WHO) recommends the ratio of doctors to be 1:1,000. Currently, there is one doctor for every 1,457 Indians. WSWS reported that India needs at least 38 million masks and 6.2 million pieces of PPE for medical staff to protect them while dealing with the virus.

Doctors have been seen wearing raincoats, helmets and plastic bags in hospitals due the shortage of these. The total health expenditure in India amounts to just 3.7 percent of the GDP, of which only around a quarter is government expenditure. According to Fitch Solutions, with 8.5 hospital beds and 8 physicians per 10,000 people, India’s healthcare industry is particularly at risk.

Just last week, there was an uproar after it came to light that India had exported medical protective gear to Serbia. The exports consisted of 35 lakh pairs of sterile latex surgical gloves and the list of other items exported was yet to be made public. The Joint Secretary in the Union Health Ministry was apparently unaware of this at first, however later sources said that no items from the ‘prohibited list’ were exported.

Now the European Pharmaceutical Review (EPR) has reported that with demands of key PPEs surging, the Indian government has now reached out to China to restore the supply of devices like ventilators and other vital components required for manufacturing.

It is imperative that the government take stock of the situation right at this moment. Though the government says it has all it needs to fight the coronavirus battle, doctors and nurses on the frontline, even now, have a different story to tell.

If  healthcare workers fall, the domino of destruction by the coronavirus will be extraordinarily difficult to contain and the sooner the government understands this scenario, the better it will be for the country to tide by the crisis.


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