Doctors were attending to their work 18-20 hours a day. After months of crushing journey, perhaps now better treatment facilities are available. Looking back and seeing my colleagues now, I see terrible weight loss in them with sunken eyes, cheeks, uncontrolled blood sugar and blood pressure.
DR SHEELA MATHEW MD
When the epidemic due to Corona virus began last November 2019 in China, there was no panic. The belief was that, as usual, the microbe will be identified and quickly we would be able to control it, and the remedy will be detected soon. What happened during the next few months scared all – the disease was spreading beyond borders, and was affecting millions of people, killing a substantial number with no drug, no vaccine, no treatment centres! All these were threatening to me and my colleagues.
When China was sending back their foreign citizens, my friend commented that Kerala will be kicking the first goal and it came true! With the slow response of other states, we expected a terrible attack in India and in Kerala too.
As far as Kozhikode medical college was concerned we had lot of fears. It was catering to enormous number of patients from 5 districts of Kerala. Almost every family from these districts have people outside the state or country. Hence, doubts on how we would conquer this threat were haunting throughout. The struggle was not mine alone but of all administration and all departments. Just like creating a new path through a dense forest, each step was having obstacle.
These were the immediate works undertaken during the initial weeks – creating total isolation wards, separate entrance and exit with no mingling of patients and staff, availability of PPE kits and training to wear them, separate rooms for donning PPE, separate rooms for removing PPE, arranging video demonstration, room construction near exit so that health care worker could take the kit and get out of the ward, measures to prevent spread from among patients – positive patient to negative patient, arranging beds in prescribed standards to prevent spread in adjacent patients, training of whole staff in medical college and even the staff from peripheral government and private hospitals, educating public forums regarding measures to identify disease and prevent spread, arranging treatment protocol. Several hours and days were spent for materializing this with sleepless nights.
The State government and ICMR brought guidelines a little later. Till then we had to have our own protocol. Continuous phone calls gave us a lot of trouble. Heart began to thump with each ring wondering what would be the content of the call. So many Whatsapp calls and messages with frightened emotions of public in panic. It was not easy to answer them all.
We were dealing with a disease, which we had never treated earlier. Hence we had to read a lot. So many information coming through Whatsapp and even 48 hours a day was not sufficient if we had to read them all! The number of webinars increased but could not attend a single one because of the lack of time as we had 4 to 5 meetings per day. After that reaching home during odd hours, I forgot my whole family. I had to face others keeping social distance from me as a doctor working at Covid centre.
The pressure from authorities was also high. All deaths due to unknown cause had to be screened for corona. It created a lot of dead bodies accumulated exhausting the capacity of mortuary. The delay in getting Corona test report was none of our fault. Getting the report and releasing the body was time consuming, for which public and administration blamed hospital staff. For suspected patients, for the foreign returned, for aircrew and for the dead bodies the only testing centre was the medical college! There was no facility to test such large numbers. After testing results had to be sent to government who announced it the following day evening and then the concerned doctor gets report. Nobody realized these inconveniences but complained about doctors who were attending to their work 18-20 hours per day!
It is very true that people were not willing to accept when one is diagnosed with a communicable disease. If we tell them that he or she is having a contagious disease, immediately they become aggressive and start a fight while even cancer is acceptable to them! After treatment one expresses a word of thanks to the treating doctor normally. In the case of infectious disease it is the other way round. When they leave the hospital they pass an adverse comment! Most of the staff working in this department are at risk of getting the disease. They are not immune to all diseases as patients may think. The outcome of any infectious disease depends partly on medications and partly on patients’ body response. The body response will depend on the interplay of promoting factors and adverse factors secreted by the body. If the adverse factor is more the outcome will be poor. Here the treating hospital or doctor will not be responsible for that.
As far as Corona was concerned it was a prestige issue for the authorities that there should be no death in our institutions or state. And when death occurred, there was continuous blaming on the treating doctor. Of course we were targeted as non-responders. Sometimes we observe the family relaxing after sending the patients to the hospital, as the hospitals were not allowing other caretakers. When adverse event occur or patients turn serious we would not get the mobile connections, nobody to answer our calls. Several times we approached local police for getting the contact needed. At the same time the same family accused the hospital that no information was given! Indeed it was tragic!
In some cases, the isolated life in hospital affected the mental balance of patients. There had been borderline or disturbed personalities who became violent. Several times the staff were injured badly and needed hospitalization. It was better if relatives informed the psychiatric background of such patients.
After duty, doctors were in quarantine for another 2 weeks. Away from family altogether for 3 weeks was suffocating for the doctor more than the PPE kit. After 5 months of crushing journey, road is clear now. All treatment facilities are available. Looking back and seeing my colleagues now, I see terrible weight loss in them with sunken eyes, cheeks, uncontrolled blood sugar and blood pressure.
All readers, please act responsibly, wear a mask, keep social distance, avoid crowding, and clean hands frequently till the virus is under control. Let us discard some of our luxuries and fight the enemy together.∎
Dr Sheela Mathew MD, FRCP, is additional professor and unit chief, infectious diseases department, Calicut Government Medical College, Kerala.
