Winter break cancelled; join duty immediately. This was the message from the All India Institute of Medical Sciences, Delhi, to its staff earlier this week.
The third wave of Covid-19 is upon India. And like the last time and the time before that, it is doctors and nurses who will be at the forefront, tackling it – night and day. India has already witnessed its first official Omicron-related death and with this variant far more infectious than earlier ones, the medical fraternity is bracing itself for an onslaught of cases.
“Life is again back to where it was but hopefully it will not be as bad as it was last year,” says Rommel Tickoo, director, internal medicine, Max Healthcare, Delhi. Demands on doctors like him have shot up again. “Our schedules have gone haywire,” he says. “Late-night consultations at 1 or 2 am are happening but we have not had any serious cases so far.”
Memories of the second Covid wave are still fresh in the minds of the doctors: days when the exhausting and emotionally draining shifts ran up to 12 hours; when there was barely any time to eat; when the long hours in PPE (personal protective equipment) kits would not allow them even water breaks. With Omicron, doctors are hoping hospitalisation rates will remain low as compared to the previous waves. But no one knows with any certainty how it will play out.
“We will soon be entering the third year of the pandemic, and it has been emotionally stressful and physically demanding, especially for a lot of junior medical staff who came into the workforce during Covid,” says a doctor from Apollo Hospitals, Delhi. “There is fatigue and a lot of people are also experiencing burnout, definitely.”
Adds Ritu Vohra, group medical director, Kailash Healthcare, Noida, “We have started seeing a rising number of cases in the OPD since last week, but we haven’t seen many admissions. These may increase in the coming weeks and while there is no shortage of workers at the moment, we might face such a situation later on.”
However, even with lower hospitalisation rates, work is increasing and shifts are bound to get longer. Resource crunch and high mortality rates during the second wave, which gave rise to feelings of helplessness, have also affected the mental health of doctors and nurses.
Says a junior doctor from Safdarjung Hospital, New Delhi, asking not to be named, “The 14 days of the second wave’s peak were the most difficult of my life. After those eight-hour shifts, when we used to be on our feet constantly and also had to keep talking to patients to boost their morale, I started to feel hollow. I have become much more of a recluse since.”
Seeing people hoard essentials, including medicines, during the critical time and the government failing to crack down on such hoarders and black marketeers “led me to develop severe anger issues,” he says, adding, “I have exams coming up but I feel so disillusioned. I can’t study. Now with a third wave, I’m just hoping that things don’t get as bad as earlier.”
Gopi Krishna Yedlapati, pulmonologist and thoracic surgeon with Yashoda Hospitals, Hyderabad, echoes the feeling. “As doctors, seeing people die in front of our eyes, and that too young people, was the most traumatic experience of our lives. It definitely affected doctors and nurses psychologically.” At one point, the 1,000-bed Yashoda hospital had 700 Covid patients.
Yedlapati says, “We would plan how best to rotate our staff so that one could rest and spend some downtime with family. Spending time with family was the best way to fight off the stress of the crowded wards.”
For many, however, this too was anxiety inducing. “Going back home every night, I would worry, ‘What if I am carrying the disease home? What would happen if someone in the family fell sick? Or if I fell sick, what would happen to the 130-odd patients in my care?’” Yedlapati recalls.
It happened with Ravi Malik, paediatrician and director of Radix Healthcare, Delhi, who was admitted in the ICU for seven days with Covid-19 during the second wave. His family of doctors, too, caught the virus as did “my six-month-old granddaughter. It is the price we pay for being in this profession”.
While cautiously hopeful that this wave won’t be as devastating, the medical fraternity admits there is a sense of resentment and anger towards the authorities and the callous behaviour of the people.
“During the peaks, the nurse-patient ratio rose to 1:15 in many places. They were working without breaks and would often be dehydrated and nauseous,” says Joshy Mathew, president, United Nurses Association, Delhi-National Capital Region chapter. “A lot of them also contracted the virus. Many didn’t even have proper washroom facilities at their hospitals. There was no financial benefit they received for working in such risky conditions.”
The association says it has written several letters to the health minister and the chief minister, but feels the authorities are not concerned about healthcare workers.
Meanwhile, doctors and nurses are back to the practice of wearing double masks and face shields. “And it is not easy,” says Jayshree Sundar, director, obstetrics and gynaecology, Madhukar Rainbow Children’s Hospital, New Delhi. “My only solace is that most of my patients are vaccinated, so it should give them some protection, but we are dreading it (the third wave). I have scolded, cajoled and coaxed all my pregnant patients to take both doses (of the vaccine). I am hoping the pregnant health workers will also take their booster shot.”
Wisdom gained from the previous waves is coming handy. “Having been in this profession for 22 years, it was after the second wave that I realised the importance of having buffer staff,” says Jagdish Hiremath, chairman, AASRA group of hospitals, Bengaluru.
“The second wave taught us a lot in a very painful way,” adds Abhijit Chowdhury, gastroenterologist and member of West Bengal’s Global Advisory Board for Covid-19 response. “It got us much more organised infrastructurally. With the third wave not looking that aggressive, I don’t see the second wave kind of crisis right now. But Covid is such a baffling entity. We are learning each day.”
The story of doctors and nurses has been of grit and resilience in an incredibly difficult time.
“There is also a sense of, for the lack of a better word, accomplishment at having seen the country through this challenge,” says the doctor from Apollo Hospitals, New Delhi. “There is also a bit of resentment at the general behaviour of the public. While we understand their frustrations at being locked up, the ultimate burden falls on us.”
As Malik says, “People can show gratitude to healthcare workers by getting fully vaccinated.” And by masking up, washing their hands and abiding by social distancing norms. Buisness Standard