Plight of a Covid-Nurse; who died Reusing PPE


The Covid 19 does not differentiate whether the health worker, who is at war  with the  virus,  is  in a government sector or private sector. Whether it is in Europe, USA or Asia,  although conditions of Covid warriors may differ. Their protective armour may differ from place to place, even hospital to hospital. But the enemy virus remains ruthless and attacks, whenever on slight opportunity.  Although there are plethora of rule and regulations dealing with health care workers and  many times health workers themselves do not know or aware about, what to do in a given situation?

But more importantly, among this chaotic situation, whether rules are being followed or not, how administrators or managers are doing can be any one’s guess rather than an  assumption that of  following a uniform  system. The possibility of chaotic and inept  management due to economical or intentional compulsions  may be a real possibility often rather than exception.

Health care workers may be subjected to moral and legal blackmail or pressure to perform their duties in sub-optimal conditions. Such pressures can be tremendous in private sector because of financial complexities.

Is the payment made to doctors and nurses is commensurate to the risk to their life and work they do? Who will pay them and how much in case harm occurs to saviors   themselves,  administrators refrains to discuss.

 

Nurse’s death: Colleagues say had to wear used PPEs

A senior nurse at   the Hospital claimed, “While the doctors were given fresh PPE, the nurses were asked to reuse PPE. If we raised objections, we were told that since this is not a designated Covid-19 hospital, we are at little risk, and can reuse PPE.”

 

A day after a 46-year-old nurse at a private hospital in Delhi succumbed to Covid-19, her colleagues have alleged that the hospital made nurses “reuse personal protective equipment (PPE), including gloves and masks”.

On Sunday afternoon, a nurse at the  Hospital, was admitted and  died at Delhi’s Safdarjung Hospital, where she was admitted on May 21. She is the first nurse to have died of the virus in Delhi.

The Indian Express spoke to 10 nursing staff at the hospital, where she worked as well as nurse’s son, and all of them spoke about PPEs being reused during duty.

A senior nurse at the Hospital claimed, “While the doctors were given fresh PPE, the nurses were asked to reuse PPE. If we raised objections, we were told that since this is not a designated Covid-19 hospital, we are at little risk, and can reuse PPE.”

The Indian Express spoke to the owner of the hospital, who denied the allegations and said that adequate PPE and hand sanitizers were being provided to all employees. “I have not received a single complaint from any staffer. If there is a single discrepancy, I will investigate and take strict action,” he said.

A senior nurse, who said she was close to the nurse, alleged that on her last day at the  Hospital a week ago,  she  got into an argument with the nursing in-charge about “not getting fresh PPE and masks”. Another senior nurse who worked in the ICU with her  confirmed this.

Her friend and colleague claimed that she was working until May 18, when she did a morning shift and refused to do the night shift as she was feeling sick. “At night, she had fever, a bad throat and body ache, so we advised her to rest. On May 19, too, she was sick, and on May 21, she had difficulty breathing, so she was taken to Safdarjung Hospital,” said the nurse.

She died on the afternoon of May 24.

Her son said “My mother’s condition deteriorated so rapidly… I couldn’t understand how to get here sooner. Over a week ago, she mentioned that the hospital was making her reuse PPE and charging money for masks. I got agitated and told her to just stay at home, but she didn’t listen to me. She continued working, and now she is dead.”

 

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Balancing Immunity in Corona Times


Any substance is considered effective only after rigorous testing through randomised clinical trials with Covid-19 patients, and additional laboratory analyses.  The substances that are merely propagated on social media or claims of company or advised by quacks will not help and merely remain as part of immunity business. They provide a false hope and thereby earn money  because of fear in the minds of masses.

  As there is no definite treatment or prevention against Covid-19, people need to depend upon their own body resistance and preventive strategies. There are advisory in respected papers about the same in The Hindustan times and The Wall Street Journal, that may be helpful.

 

 

Scientists bust myths about ‘immunity-boosting’ substances in fighting Covid-19

Indian scientists on Thursday released a statement against the promotion of “immunity-boosting substances” to protect oneself from being infected with the novel coronavirus. Citing lack of scientific evidence, scientists said consuming mustard oil or tea, homaeopathic solutions or ayurvedic preparations, or modern medicines like hydroxychloroquine that are claimed to provide either immunity or cure “do not provide any known and/or validated protection against Covid-19”.

Additionally, drinking cow urine, wearing talismans, exposure to ultraviolet light or injecting disinfectants are harmful to the human body, while excess consumption of supplements such as zinc or datura seeds can prove to be fatal.

Aniket Sule, astrophysicist at Homi Bhabha Centre for Science Education and one of the signatories, said, “Since the beginning of Covid-19 epidemic, several statements have propagated ‘immunity-boosting’ substances. Some assertions were also supported by a few government functionaries at the Centre and in various states; and we, therefore, wanted to place scientific facts in the public domain.”

The most severe cases of Covid-19 are made worse by an overreaction of the immune system. So trying to boost general immunity using untested methods may be risky.”

Facts (and Myths) About Boosting Your Immune System

It’s crucial to stay healthy as the threat of coronavirus spreads. Here are the best strategies.

As the new coronavirus continues to spread across the country, having an optimally functioning immune system is more important than ever.

Medical professionals say it is important not to rush to buy supplements and vitamins that promise to enhance your immune system; there isn’t much evidence that such products do any good. Instead, they say, stick with the more mundane, but proven, approaches:

  • Keep your stress levels down.It’s a bit of a vicious cycle, of course: The more you stress about the virus, the more likely you are to suffer from it. “Stress can certainly hurt your immune system,” says Morgan Katz, an assistant professor of infectious diseases at Johns Hopkins University. “Do not panic, try to minimize stress.”

Andrew Diamond, chief medical officer of One Medical, a nationwide network of primary-care providers, says the stress hormone cortisol turns off cells in your immune system. He recommends engaging in activities that people find relaxing, such as meditation.

  • Exercise.Low- and moderate-intensity exercise naturally lowers cortisol levels and helps with immune-system function, says Dr. Diamond. One Medical recommends 30 to 60 minutes of exercise a day. If you’re apprehensive about germs in the gym, walk or run outside.

But it is important not to go overboard. A recent study found high-performance athletes have an increased risk of infection, says Elizabeth Bradley, medical director of the Cleveland Clinic’s Center for Functional Medicine. “Exercise helps boost the immune system, but we have to be careful not to overexercise because it can weaken your immune system,” she says.

  • Get adequate sleep.For adults, that means getting seven to eight hours of sleep a night. Children should get more, depending on their age.
  • Make sure your vaccines are up-to-date, especially the flu vaccine.
  • Eat plenty of plain yogurt every day.“It’s really an easy way to boost your probiotics and help support your microbiome,” Dr. Katz says. “It helps to support the good bacteria that live in your body, which help to fight bad bacteria or viruses.”

Dr. Katz also suggests avoiding antibiotics unless you must take them because they deplete the good bacteria in the system, leaving you more vulnerable to other infections.

Other foods that can help support the microbiome include garlic, onion, ginger, sauerkraut and fermented foods, says Dr. Bradley.

 Watch your diet. Stick to a healthful, balanced diet filled with lots of colorful fruits and vegetables to ensure you’re getting enough zinc and vitamin D and other important vitamins and minerals. Most experts say you should be able to get enough of these vitamins and minerals through your diet, and extra supplementation isn’t necessary. But because vitamin D deficiency is relatively common, experts do recommend supplementation if levels are low.

Dr. Bradley recommends eating lots of dark green, leafy vegetables and berries, as well as nuts and seeds, and to minimize foods with sugar and trans fats, which aren’t as nutrient-dense.

Your immune system needs fuel, so avoid ultralow-carbohydrate diets, experts say. In addition, drink lots of water and reduce alcohol consumption, which can disrupt your sleep.

  • Stop smoking or vaping.Smokers and those with respiratory disease have a higher rate of serious illness and complications from coronavirus. “Anything that is challenging to your lungs is going to work in the wrong direction,” says Dr. Diamond.

 

 

 

Grief : Death of AIIMS Covid warrior; raises questions


What happened to my father shouldn’t happen to anyone: Son of deceased AIIMS sanitation chief

 

Two days after his father, senior sanitation supervisor at AIIMS New Delhi, died of COVID-19 at the institute’s trauma centre, his son is still in shock.

Amid conflicting versions from the family and the institute administration, it’s unclear where the truth lies. What’s clear is, COVID warriors remain vulnerable to the disease and must do all they can to protect themselves.

The complexity associated spread and treatment  with Covid-19, is beyond the present day medical science. Although global efforts are being done on war footing, but it may take few months or a year to have some reasonable control over virus.

 

“My father got the infection on May 15 and passed away on May 24, within nine days.He was still on duty when he first developed uneasiness and illness. Routine checks were done at AIIMS on the morning of May 15. COVID test was not done and the doctors on duty suggested that my father should return for a COVID test after he develops symptoms. By the time visible symptoms developed around May 19, my father was already in need of a ventilator,” says his son urging asymptomatic people to get tested as soon as possible.

Every day is crucial in the fight against this disease as it doesn’t give you any time to respond, says the young man who, like his father, is a permanent staffer at AIIMS.

The son  also raises the question of quality of protective gear available to sanitation staff, cleaners, sweepers, ward boys and other workers at the institute.

While acknowledging the pressures of COVID management on AIIMS, the distraught son says that the N-95 masks provided to the sanitation workers at AIIMS were of low quality.

“We are all given four N-95 masks with four envelopes for 15 days and we a supposed to use one each day, store the others and then repeat the cycle. Since the COVID outbreak, I’ve only received eight masks till now. My father also had the same mask and its quality is very low as compared to the quality of filter N-95 masks you get in the markets. We do not get gloves. Sanitizers are also not freely available and we are mostly encouraged to use soap and water. But because the sanitation staffers’ job is prone to infection they should get the best quality masks, head caps, gloves and full disinfection kits. What happened to my father should not happen to anyone,” he  said, urging the government to increase testing of asymptomatic people.

Sudden demise of the front warrior has now brought the lens on the safety of cleaners and ward boys across top COVID hospitals.

Questions also arise on whether he had received Hydroxychloroquine preventive drug against COVID considering

ICMR recently revised its HCQ guidelines to include asymptotic COVID warriors in containment zones.

When contacted, AIIMS medical superintendent ruled out laxity on the part of AIIMS in handling the the case.

AIIMS medical superintendent also said AIIMS had issued HCQ for all its COVID warriors much in advance of ICMR’s revised guidelines covering all frontline staffers in containment areas and provided its staffers with all the necessary protection.

“Why wouldn’t we care for our own staff? We managed the case  the moment he came to us,” said  AIIMS medical superintendent

Amid conflicting versions from the family and the institute administration, it’s unclear where the truth lies.

What’s clear is, COVID warriors remain vulnerable to the disease and must do all they can to protect themselves.

21 occupational risk to doctor and nurses

covid 19 unmasks risk to health workers, administrators refrain

disbelief to grief

Disbelief to grief & hypocrisy# Doctor’s death in Mumbai #Covid-19


 

Covid-19 has unmasked the real danger to medical professionals, doctor and nurses while doing their duties. But it has also laid bare the hypocrisy, the denial of dignity by society to doctor and nurses, even to those who lost their lives in service of patients.  Medical professionals had signed for the occupational hazard willingly, but not to be an object of violence, undignified, and ignoble behaviour.

At this time, if anyone is there and surrounded by patients, with or without appropriate PPE,  it is the only doctors, nurses, and front health care workers. Even in non-COVID hospitals or outdoors, it is impossible to differentiate which one patient is carrying the deadly virus.

There were countless reports of health care workers being assaulted, all over before Covid-19, as well.  It was being taken as a routine. Covid-19 has not only helped to unmask the real danger to doctors and nurses but also sounded them of being an object of the undeserving ignoble attitude and hypocrisy of the society.

Mumbai: 36-year-old doctor dies of multiple organ failure, samples test positive for Covid-19

A 36-year-old general physician, who consulted at two private hospitals in Mumbai’s Govandi, succumbed to the novel coronavirus infection on Thursday. He is likely to have contracted the virus from a patient at the hospital.

“My brother had to be shifted on oxygen to Raheja as no cardiac ambulance was ready to transport a Covid-19 patient,” said the doctor’s brother.

The doctor did not have any co-morbid conditions and died of Acute Respiratory Distress Syndrome due to Covid-19 along with multiple organ failure. He was declared dead at around 1:55 am on Thursday at SL Raheja Hospital. The doctor started showing symptoms such as loose motions and breathlessness on April 13.

He was admitted to the Sion Hospital in the wee hours of April 15 where he was tested for Covid-19. As his condition was deteriorating and an ICU bed was not available at Sion, he was shifted to Somaiya Hospital in Vidyavihar. At Somaiya hospital, his breathing improved but he needed dialysis.

As he was a suspected Covid-19 patient, Somaiya hospital administration said that he will have to be shifted to Raheja hospital as they have dialysis for Covid-19 patients.

“My brother had to be shifted on oxygen to Raheja and no cardiac ambulance was ready to transport a Covid-19 patient. He was on a ventilator. After looking at his deteriorating condition, we shifted him using a normal ambulance. His samples have returned positive for Covid-19,” said the deceased’s brother who is also a doctor.

The doctor’s condition kept deteriorating. He had a multi-organ failure with deranged liver function test, acute renal failure, and bleeding disorder. His condition further worsened on Wednesday night. Despite multiple efforts of resuscitation, he could not survive and was declared dead.

“We did not get a chance to speak with him to understand how he contracted the virus. Before going to Sion, we tried to get a bed at Kasturba hospital, but we were told no beds are available,” the doctor’s brother added.

“This is something we need to be very careful about. If healthcare workers are infected like this, we should be able to provide them with the best of care,” said Epidemiologist Dr Om Shrivastava.

21 occupational risk to doctor and nurses

Covid-19 unmasks the risk to health workers

Noble doctor-ignoble death

Noble doctor-Ignoble death #Chennai doctor death #Covid-19


 

Chennai Locals Pelt Stones at Ambulance Carrying Body of Popular Doctor Who Died Due to Covid-19.

Hercules, who ran the New Hope private hospital in Chetpet, battled against the disease for 15 days at the Apollo Hospital in Chennai before succumbing to it.

 

Chennai: Locals at an upmarket locality in Chennai pelted stones at an ambulance ferrying the body of popular doctor and medical entrepreneur Simon Hercules who died due to coronavirus after a 15-day struggle with the disease.

Hercules, who ran the New Hope private hospital in Chetpet, battled against the disease for 15 days at the Apollo Hospital in Chennai before succumbing to it.

The ambulance driver and a sanitation worker were wounded in the attack that happened late on Sunday night. Police sources confirm that 20 people have been arrested.

According to a relative of Hercules, locals opposed their attempt to bury the body despite the fact that permission was granted. “They refused to allow the cremation of the body. I make this teary-eyed post to all you that a sincere doctor who died treating Covid-19 patients does not have the space for a decent burial,” said Dr Bakiaraj.

This is the second incident of a doctor being disallowed a decent burial in Chennai. Recently, in Ambattur, a doctor from Apollo Vanagaram was not allowed space for burial by locals.

 

The incident at Chennai is not only disheartening for doctors but dissuades others to carry out the noble work and discourages many to take responsibilities of medical care. This brings forth the narrow-minded nature of public, without realizing their own loss.  Doctors are not  God and are simply human beings. They may become victims of the diseases, while they try to save the patients while putting their own life at risk. This incident not only unmasks their vulnerability to catch diseases, the adverse circumstances they have to work, but sadly victims of underserving public wrath.

If such is the behavior of the public towards doctors, why children should become doctors at all? Why doctors should put themselves at risk while in pursuit to save lives?

21 occupational risk to doctor and nurses

Altruistic professions not respected in the present era

What is plasma therapy for Covid-19


 

As the world is suffering from pandemic by Covid-19, the effort to find an effective treatment is on a war footing.  Few drugs like HCQS, Remdesvir, and Tocilizumab are being tested, vaccines are being developed. A vaccine may be a mainstay in the future , but till that time, how to control mortality.  Convalescent plasma therapy has been found to be useful in China.

Convalescent plasma is an antibody-rich plasma product prepared from the blood donated by the patients, who have recovered from Covid-19 infection recently. These patients are tested twice negative and ELISA can also be done to check for antibodies. The antibodies are proteins with the capability to fight infection in the body and are important component of the immune system

  Antibody rich plasma can be taken after two weeks after  the patient has recovered. The plasma of such patients has the potential to treat or lessen the severity of Covid -19. Plasma taken from one patient may help three to four patients. A donor can again donate after one week. The subsets of patients who may benefit are sick patients in ICU, on the ventilator and are having a risk of death.

The plasma therapy was used for diphtheria and tetanus  about 120 years ago and  used for viral infections like EBOLA

ICMR has permitted  for clinical  trials  of plasma therapy for Covid -19

FDA  has also permitted to pool the donor volunteers.

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