Fully under the grip of the global pandemic, India is reporting cases of doctors, nurses, and other healthcare professionals, on the frontline of the battle, being shunned by others for fear of being infected
By: Neelam Jhangiani & Jayata Sharma
The new COVID-19 coronavirus has spread far and wide across the globe – bringing social disruption, economic damage, sickness, and death. In countries that have been severely affected by COVID-19, such as Italy, Spain and the United States, strained healthcare systems have reached their breaking points.
A scarcity of medical workers has also plagued countries that are struggling with the COVID-19 pandemic. The government of the United Kingdom asked 65,000 retired nurses and doctors to return to work, along with final-year medical students. Amidst all this, doctors, nurses and frontline health workers in our country have been under a spate of attack and abuse ever since the government imposed the lockdown to contain the spread of the virus.
Many doctors have been asked to vacate their rented homes by their landlords as they believe that doctors staying at their houses may make them more susceptible to COVID-19. Across the country, medical professionals have reported ostracisation by the public, who fear that they could serve as vectors for the novel coronavirus. Some doctors have faced threats and harassment as they attempted to travel to work under the nationwide lockdown.
While they serve on the frontlines to contain COVID-19, healthcare workers are realising they have to pay a heavy price for doing their job. Apart from heightened risk of infection, anxiety and being separated from their families, they are also increasingly dealing with social ostracism, harassment and even assault.
Healthcare force facing social stigma
Healthcare workers are at an increased risk of catching any communicable disease, including COVID-19 as they spend a lot of time up close with the patient doing high risk activities. During the SARS outbreak in 2002, one-fifth of all cases were in healthcare workers. In addition, the overworked Indian medical professionals are now increasingly fighting on a whole new front in the COVID-19 battle: Social stigma.
Fully under the grip of the global pandemic, India is reporting cases of doctors, nurses, and other healthcare professionals, on the frontline of the battle, being shunned by others for fear of being infected.
It is an encouraging sign that the importance of medical professionals and other frontline workers in the fight against COVID-19 does not seem lost on the government. The officials have been swift in making arrangements of protection and facilitation, either by way of making harsh policies or by way of punishable laws. The battle against COVID-19 is leading to a whole new level of stress as these professionals undergo, and not just physical but emotional as well.
While not everyone needs psychological intervention, just someone who can listen can be enough. To ensure this, hospitals such as Cloud Nine have installed internal helplines for the staff, to enable calls with experts and seniors. There are also regular meetings on Zoom to keep the conversation going.
The public at large needs to think rationally as there are chances that these warriors can develop suicidal tendencies. And in case they continue to work in these professions, they won’t deliver services with empathy but with a vengeance, say experts in the industry.
Now, the longstanding failures of India’s under-supported healthcare system have been thrust into the spotlight with healthcare workers staring down a rapidly approaching crisis. Without a surge of government funding and attention, medical professionals have little reason to believe that they will be protected or supported as they serve on the frontlines of India’s response to the pandemic. The already-strained workforce is at risk of collapsing under pressure and the consequences of this would be disastrous.
Hospitals doing their best for Corona Warriors
PD Hinduja Hospital & Medical Research Center
At P. D. Hinduja Hospital & M.R.C., we believe that the safety of our staff is our priority because only when our staff is safe can they ensure the safety of and impart quality treatment to our patients.
Our Infection Control team has formulated guidelines for infection control, cleaning protocols and use of Personnel Protective Equipment based on National and International standards.
The hospital also supports our staff by ensuring there is no discrimination at their residences by supporting them with help from BMC and Police whenever required. Hinduja Hospital has offered staying facility for its staff and we have arranged for transportation for staff who have difficulty commuting for work. We also have arranged for separate facilities to house our staff who are positive, so that they can be isolated safely away from their families.
Finally, mental health is very important at the time of crisis, we continuously encourage our employees at all times and our dedicated team of psychiatrists provides tele-consultation to our staff for stress management.
Manipal Hospitals (Dwarka), Delhi
This pandemic has changed the way we think and behave in more than one ways. The epidemic and the subsequent response in fighting this disease has brought back the focus on Medical Services and healthcare workers. The selfless work of medical fraternity is being honored and celebrated all across the world. At the same time it is disheartening to see that health care worker are also being stereotyped and discriminated against due to ill-informed perceptions amongst certain sections of the society. For us at Manipal Hospitals the safety of our team members is of utmost importance. The organization has taken several steps like providing accommodation to those doctors and nurses who are working in isolation wards. It will help ensure that they do not have to go back to their residence again during such duties. Conveyance facility is also provided for ease of commuting at odd hours. Liaison with concerned satudiatry bodies police helps us to provide the safety net required during these times.
In terms of safety of our health care workers from infection, the hospital is following all guidelines being promulgated by MoHFW from time to time. Rigorous training in infection prevention and control practices, mock drills of real scenarios and availability of PPE and Sanitizers at all care points is some of the steps we have taken in this regard. There is also 100% thermal screening of all persons entering the hospital and a dedicated flu clinic is also being run to screen any suspected patients before they are seen by consultants.
Yashoda Super Speciality Hospital, Kaushambi, Ghaziabad
We, at Yashoda, initiated a series of actions through the command centre during early month of March 2020 for strengthening safety measures and efforts to improve social well being of healthcare professionals and the patients.
The hospital had routed all incoming patients for OPDs /Emergency and attendants through single entry point after thorough screening along with relevant history taking to rule out possibility of any suspect/confirmed COVID-19 case as our hospital is a non-covid facility and accidental exposure can adversely affect the functioning of the hospital in addition to transmission of infection. Use of central air conditioning system catering to common clinical areas were stopped in order to control chances of transmission of infection, if any. Visiting timings were abolished to control human traffic.
Staffing of clinical area has been organized in such a way that not many healthcare professionals are exposed to certain Covid 19 susceptible type of patients. Thus, we ensured safety of our staff and reduced number of staff being quarantined. Also, suitable replacement of staff has been made available from the reserve for maintaining the roster of duty.
All levels of staff have been provided extensive training and we have also issued advisory to consider each patient as a potential risk. All high touch surfaces are disinfected every two hourly and on ‘required’ basis. Hospital premise, perimeter and all patient transport ambulances are disinfected twice daily and after each patient transportation.
The hospital staff who were unable to commute across Delhi-NCR border during lockdown period were provided accommodation in hostel and nearby area along with food, so that hospital functioning is not disturbed and the staff is able to do their duties without stress. Those staff who were not willing to be accommodated in hostel or nearby areas were also provided transport to ferry them to the hospital and back home after the duty with the permission of administration with passes issued by the concerned authorities. Issues if any, pertaining to the rented premise of the staff with the landlord were handled by the hospital management through local administrative authority.
The hospital infection control committee was instrumental in building capacity of human resource across all levels on infection prevention and control, clinical management of patients, logistics and other aspects related to safety issues. Online trainings and webinars including iGOT-Diksha platform were utilized to ensure that uniform trainings can be conducted for healthcare professionals of the hospital and fear factor, if any, regarding the pandemic situation can be abated. The leadership team of the hospital was regularly interacting with the staff and tackling issues arising on daily basis and also motivating them in rendering services.
Fortis Healthcare has taken various steps in this direction across all our 28 hospitals. Firstly, a task force has been set up at each unit, which oversees operations and monitors developments on hourly basis.
Investments have been made for upgradation of infrastructure to ensure separation of suspected and positive patients for the safety of healthcare personnel and minimizing transmission between patients. Strict protocols on sterilization, infection control, PPE, isolation ward management, staff rotations and quarantines, waste disposal and manpower planning have been implemented at the hospitals.
Fortis has invested in technology to enable tele-consultation or video-consults so as to minimize exposure of doctors as well as patients. On an average, 450 e-consults are conducted daily across 28 hospitals of the Fortis network. We have also procured Video Laryngoscopes for the protection of our clinical personnel. In addition, robots have been deployed for screening visitors and disinfection of premises in certain hospitals.
We are also regularly conducting mental health and stress management sessions for staff. Fortis helplines and e-consults are also accessible to our employees to help them cope with anxiety issues and depression during these uncertain times. We are ensuring that our staff members are follow hand washing, respiratory etiquettes, proper disposal of PPEs and bio-
medical waste management and disposal processes. Quarantine rooms have also been
designated all units in case any staff member has suspected symptoms. Special focus is being
given on nutrition for our frontline staff, who are being given a healthy, high-protein diet. We
have made arrangements for transportation of staff and where required, arranged for the
boarding and lodging of critical staff.
Our HR teams are ensuring availability and outreach to immediately any address challenges being faced by staff members relating to transport, lodging, harassment by landlords, stigmatization by neighbours or any other issue through swift action.
Handy tips for healers
- Take a break from the news
- Create a constructive routine for personal self-care activities such as exercising at home, spending time with friends, family and children—online or over the phone
- Speak to other doctors/healthcare workers about how they are coping
- Understand that this phase will end
- Ask for help if you feel overwhelmed or concerned that this is affecting your ability to care for your family and patients as you did before the outbreak
- Monitor yourself for symptoms such as difficulty in sleeping and concentrating or a sense of fatalism