Overuse of Antibiotics: Wrong analysis # Rebuttal Times of India


     The Times of India today   carries an editorial by Mr Sandeep Bansal on over prescription of antibiotics. Although there are few points which may be correct, but the article fails to highlight the basic reasons for the problem, which it was supposed to address.

    The reason for failure to find the correct reasons can be the distant analysis. Someone working in London and trying to analyse the grass root problem of India may not be a perfect idea. People need to work at ground level to identify the real issues. Otherwise the analysis remains half-baked and gives a glimpse  of the bias, which celebrities use commonly for gaining popularity by finding faults of doctors.

 

     The overall picture has to be understood to identify real reasons and hence the proper solution to the problem. The correct steps taken would settle the issue; otherwise the analytical article would   just remain a piece of paper and an matter of discussions for Arm chair preachers.

over prescription of antibiotics

   The author failed to highlight the factors like easy availability of antibiotics. People can directly approach pharmacist and get whatever antibiotic they want.  Pharmacist can sell whatever brand, doses and kind of antibiotic. The uncountable quacks, doctors of alternate medicines use all kind of antibiotics with impunity. Tons of antibiotics are consumed without any proper medical advice. Self-medication by people themselves, as it is easily available can’t be ignored as an important cause.  

       The reasons written by the author in TOI, actually constitute a minuscule fraction (5-10%), as far as use of antibiotics is concerned. By writing imperfect article, without knowing actual problems by a distant analysis, such article provides real misguidance rather than actual solutions to the problems.

         Someone to do justice to such complex and important issues, one has to work at the place and be aware about real issues and ground problems. Otherwise it just remains a method to gain cheap popularity.

   Sadly, in present era, people who do not treat patients,  are away from  truth, but they can influence the treatment of thousands of patients  just by doing an ‘On Table’ analysis.

        Wrong analysis, hence incorrect conclusions can lead to wrong decisions.

     Advantages-Disadvantage of being a doctor

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     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Doctor’s assault a medical emergency: Silence of authorities appalling


    Attacks and assaults on doctors is an indicator of a lawless, uncivilized society, poor governance and broken health system. Doctors have become punching bags for all the malaise prevalent in the system. A failing system which is unable to provide  health to the people and security to doctors. The rickety system hides behind their hard working doctors and presents them as punching bags. The impunity with which attendant easily and brutally assault doctors is really appalling, should be shameful to law enforcing agencies.

      Are we a lawless society? More problematic is the government apathy and silence of human right commission. Here comes the point that what is the role of our doctor’s organizations, human right organizations, parent hospitals and institutes.

       Role of media, celebrities, film stars and prominent personalities in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable. They projected single stray incident   as an example and portrayed as generalization just to earn money and fame for themselves.

    Hence by selective projection the blame for deficiencies of inept system, powerful industry, inadequate infrastructure and poor outcomes of serious diseases is shifted conveniently to doctors, who were unable to retaliate to the powerful media machinery.   

        The demonstration of the cleft that separated doctors from the actual overpowering controlling medical industry and administrators is not given, in order to maintain the prejudice with its dangerous bias towards doctors, who are in forefront and are visible to public.  

           Unwillingness or failure of government to prevent such attacks on doctors will have deep ramifications on future of medical profession.  Role of doctor associations, parent institutes have been spineless and not encouraging.

         Such bestiality should create havoc in minds of civilized people but this apathy to such incidents clearly indicates otherwise. Have we become so uncivilized that an incident such as this just remains as a small news item in a local paper? Can’t we see that such incidents are harbinger of many more in future? It is important to realize that this is the time to unify and condemn such episodes vehemently and prominently so that the miscreants realize that they cannot get away with it.

  Doctors in remote area, where there are minimal medical facilities, doctors are at more risk than ever; they are at mercy of local goons with no protection.

        Silence of lords is a death sentence to the medical  profession as a whole.

    Doctor assault is definitely a poor advertisement for the medical students, who want to be doctors or others who want to buy a private medical college seat by paying millions. Why should one become doctor or  pay millions and bear risk of being beaten or killed, while doing such a stressful duty. People will be fearful to be doctors on a free seat, leave alone on the paid seat.

 The People who rue the scarcity of good doctors, should now introspect, “do they deserve to have good doctors?”

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Allopathy-Ayurveda debate: Media’s Misplaced priorities


The doctors, nurses and healthcare system have been relentlessly hauled over the coals for last one year and further battered emotionally by the cruel adverse media insinuations and taunts. At the peak of pandemic, when the powerful media should be discussing the core issues to control pandemic; issues like oxygen supply, vaccination and improving the health infrastructure, it has found more interest in a futile Allopathic-Ayurveda debate. Even if someone wants to start this kind of discussion, media should have shown more wisdom not to make it a dominant issue. There are more important, urgent and pressing issues where media can play a vital role.

By many media narratives, an impression is being fostered that doctors have made a mess and forfeited their moral right to treat. Suggestions of ineptitude were gleefully aired, causing demoralization of the warriors, who were immersed in the pool of Covid patients, trying to save them.


         Their role should be as facilitators to help doctors to save more lives. One hospital death of out of millions saved, is projected as failure of doctors. They are so distant from the ground reality.  To control the health system, media has a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.

 Hence by selective projection the blame for deficiencies of inept system, powerful industry, inadequate infrastructure and poor outcomes of serious diseases is shifted conveniently to doctors, who were unable to retaliate to the powerful media machinery.   

        The demonstration of the cleft that separated doctors from the actual overpowering controlling medical industry and administrators is not given, in order to maintain the prejudice with its dangerous bias towards doctors, who are in forefront and are visible to public.

      Media people, who have never treated a patient in their lifetime, sway opinion and treatments of the millions just by game of projection and perception. The news items and the content are guided by idea of creating sensation in a quest to sell news, be it a selective negativity. Such  negative and selective projections are causing discouragement and demonization of the medical profession. It is the biggest  tragedy to the medical profession in present era.

      Normal treatment of the sick patients is being projected as gruesome atrocity, inflicted by doctors. Media could have done better in helping to take off spectacles fogged with bias against doctors and recognizing them as real saviours, just as deserving of justice.

       National Media could have helped, had they fueled the right and constructive discussions. The TV channels  could have countered the pandemic with better imagination, sobriety, and exemplary performance rather than creating sensation by cynical and futile debates, which are absolutely inappropriate at this time.  

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

Facilitators turn administrators: Biggest tragedy to medical profession in present era


14 Doctors in rural Unnao resign alleging mental harassment and misbehaviour by administrative officers over COVID-19 work.

       Administrators, who have never treated  a patient in their lifetimes, but control treatment of thousands of patients. The  biggest tragedy to the medical profession in present era, causing discouragement and demoralization of medical profession.
         Their role should not have been more than facilitators, but they have become medical  administrators. They are so distant from the ground reality.  To control the health system, administrators have a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.
The vulnerability that is  intrinsic to the  doctors’ working makes them sitting ducks, an easy target for harassment and punishments and  is exploited by everyone to  their advantage. Administrators use this vulnerability to  suppress them. It is used by  media and   celebrities who projected  themselves as Messiah for the cause of patients, and  sell their news and shows by labeling the whole community of doctors as dystopian community based on just one stray incident.

     The blame for deficiencies of inept system, powerful industry, inadequate infrastructure and poor outcomes of serious diseases is shifted conveniently to doctors, who were unable to retaliate to the powerful administrative machinery.   

        The demonstration of the cleft that separated doctors from the actual overpowering controlling medical industry  and administrators is  not given, in order to maintain the prejudice  with its dangerous bias towards doctors, who are in forefront and are visible to public. Clearly separating the role of health workers and the hidden administrators would not only settle the matter, but is actually essential to project the reality. The correct perception of two fundamentally different components would reveal a real gulf and would help to address the core issues.

    A wish to govern, regulate and punish the medical professional by administrators is not new. Hammurabi 4000 years back had initiated to write the cruel rules of the game, which possibly initiated a change in the global perception and regulatory system and formed the basis for cruel regulation in radical and unprecedented ways.

      In  a quest to control  this difficult area,  which encompasses life and death, deals with extremes of poverty and riches, mortality and morbidity, pain and relief, sadness and happiness, smiles and sorrows and uncountable emotions, intertwines with financial aspects and  the  amalgamation of intricacies of science with legal complexity, doctors are burdened with over-regulation and administrative pressures.

               Consequently the  doctors are the sufferers, as they feel enslaved and suffocated. But ultimately who would be the sufferer, does not need an Einstein brain to guess.

14 doctors resigned, alleging harassment and misbehaviour by administrative officials.

More than a dozen doctors posted in rural hospitals in Unnao district of Uttar Pradesh collectively resigned, alleging harassment and misbehaviour by administrative officials.

The doctors, numbering 14, posted at community health centres and primary health centres submitted their resignation letters to the chief medical officer (CMO) of the district on Wednesday. Speaking to the media, one them said that while their teams would work on the field from noon to 4-5 p.m., isolating COVID-19 positive cases in their home, distributing medicine and carrying out sampling, the local SDM would summon them after that seeking a report of their work. The doctors would have to drive back several km to the tehsil from their place of work just to “prove that they are working,” said the doctor. “Despite continuously working, it has been made to appear like we are not working and that due to this, the COVID-19 situation is going out of control,” he said. The doctors also alleged that they were not provided sufficient drug supply from the government and often faced verbal harassment at the hands of the CMO and the CMS. If the field teams were unable to trace down patients because of submission of wrong phone numbers and addresses, they should not be held responsible for it, said the doctors.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

New book: ‘The Real Issues’ through ‘fictional narratives’


“AT THE HORIZON OF LIFE AND DEATH”

Find it on Amazon :

Description

         This book comprises of stories that capture the pivotal moments in the treatment trajectory of the critical patients facing death.  The times that force the doctor to confront the saddest moments, while battling a terrifying, unbeatable foe, the death monster alongside families’ fears, gloom, indecisiveness, dilemmas about future and saviour’s own predicaments intertwined with medico-legal intricacies and consequent complex emotional interactions.  

        The situations depict ‘the real issues’ through ‘fictional narratives’. 

       The stories reflect life of a doctor in the present era, amidst sick patients in an imposed legal milieu, a mystic journey, an arcane odyssey punctuated with pain and pleasure in the narrow and uncertain lanes at the horizon of life and death, carrying the burden of various vicissitudes like consumerism, legalities, unpredictable course of diseases, mistrust and blame for poor outcomes.   

        The narratives try to unmask the eternal latent vulnerability that is intrinsic in doctor’s work, which is exploited by media, law industry and even celebrities to sensationalize and sell their news and shows. The vulnerability turns more evil as the delineating cleft that separates doctors from the invisible overpowering medical industry is not shown, thus ensuring to sustain the prejudice with its dangerous bias towards health care workers. 

        One negative news story through a ‘portrayal effect’ generates unbridgeable gap in doctor -patient relationship, painful burden of mistrust loaded on doctors, that would heal only if millions of unfettered, unprejudiced, unbiased facts are clearly projected. 

           The book tries to highlight a seemingly illogical and contrary nature of the conflict; the doctors are finding themselves increasingly being engaged into. The dense mazes of consumerism, extensive communication, documentation, unrealistic expectations, negative media insinuations, legal complexities are demoralizing to doctors and certainly counterproductive for patients.

         The futile discords emanate frequently, that are mundane in reality when compared to the actual disease and the real point of intention which is ‘The Treatment of the Patient’.

         But is this what the patients actually need? Does the entanglement of doctors in such a maze help the patients in real sense?

        The author felt morally compelled and attempted to find answers, embedded in a journey that was wondrous and inspirational, but with horrifying moments as well.

        Has the decision to treat human fragility become a mistake in present era?  No reward, if you win the match of life and death but sword hanging; if  one were to lose?     

       Patient will need to decide someday, whether to be a consumer or just remain a patient. 

       Being a consumer may be an overall loss-making deal for the patient.

Disclaimer

   The stories are fictional, but the depiction of the problems to the doctors, nurses and patients are real, based on day to day routine incidents. The episodes do not pertain to any single particular person, patient, doctor, nurse, hospital and organization. All the characters, names and dialogues in the book are figment of imagination of the author and similarity to any person, any situation or organization may be co-incidental.

            The stories are not against any law, word of courts, profession, any government or any organizational set up or rules of any country. They depict the problems commonly faced by doctors in performing their duties hence are likely to affect the patient directly.

Covid-Death of Doctor, nurses: No uniform support mechanism for families


87k health staff infected with Covid, 573 dead

Society, administrators and  Governments prefer to ignore  the fact that doctor’s  and nurse  life is at as much risk as a soldier while treating   infectious diseases. Corona has merely unmasked the risk but the danger has always existed  with other disease like  HIV, hepatitis B, open tuberculosis, Ebola and  half a dozen more communicable diseases.

Doctors and nurses have continued to work along with such risks  but the apathy shown by everyone towards health care workers, have left them  demotivated and discouraged.  

Corona deaths among health care workers are causing tremendous  anxiety.  Conditions under which they are forced to work  are giving   them a feeling  of being  victimised.  All of their years  of accumulated   medical knowledge does not make them  either invincible or  confident  about the future, as there is no uniform mechanism to support their families. The courts have also  failed to give  assurance of any kind.

Once health care workers, doctors and nurses, become a patient  themselves, they realise that their resources are scanty and they are  neither rich nor VIPs, and their families are not assured of a decent compensation.  In such circumstances they realise that they have been made scape goats due to their call of duty and society has no gratitude. A feeling of deep hurt creeps in. A feeling hurt of being  no more than sacrificial lambs in the end.

They feel let down and  abandoned by the world for no fault of their own.

WHY SUCH APATHY? There needs to be a uniform law to support families of  health workers. Moreover, health workers are crucial  for the society, irrespective of their place of work. They may be in Government sector private or in isolated practices.  The  absence of uniform support mechanisms is becoming evident and is enough to dissuade the aspiring doctors to take up challenging roles.

 Compensation given to family members of doctors after their death because of communicable diseases are trivial and  non-uniform. It is little in monitory terms as well as in terms of respect. Death of doctors and nurses has been passed off as something routine and trivial matter. Just for example, it is less than course fee of private medical colleges  or usual  compensations sought by patients in malpractice suits.

      Future medical students should note the trend and count this factor, when they choose to be a doctor.

87k health staff infected with Covid, 573 dead

NEW DELHI: More than 87,000 healthcare workers have been infected with Covid-19, with just six states — Maharashtra, Karnataka, Tamil Nadu, Delhi, West Bengal and Gujarat — accounting for three-fourths (around 74%) of the case burden and over 86% of the 573 deaths due to the infection, official data showed. Maharashtra alone, with the highest number of over 7.3 lakh confirmed Covid-19 cases so far, accounts for around 28% of the infected healthcare workers and more than 50% of the total deaths, according to the data. While Maharashtra, Karnataka and Tamil Nadu had tested more than 1 lakh healthcare workers each till August 28, Karnataka reported only 12,260 infected healthcare workers — almost half the burden in Maharashtra. Tamil Nadu reported 11,169 cases that included doctors, nurses and Asha workers. The three states together accounted for 55% of the total cases among health workers. A large number of Covid-19 infections and even deaths of healthcare workers in particular states is being viewed with concern by officials and public health experts, who say risks to frontline workers can jeopardise India’s fight against the pandemic.

21 occupational risk to doctor and nurses

Are doctors, nurses dispensable disposables

Story of the fight inside COVID ward #Indian express


 

At this time, where  CELEBRITIES and REEL HEROES are fighting the war on Television to prove their real worth in CORONA-TIMES as if they are of some use to society; entertain.  Trying to prove as if the name, fame and wealth  showered on REEL HEROES was not an overhype, INDIAN EXPRESS has been wise enough to publish the real fight in the wards and plight of REAL   HEROES. As the stories of the real plight remains confined to medical groups only.  This article has appeared on 12 April Sunday.  Now the time has come to worship the  REAL HEROES and not use them as sacrificial lambs, otherwise in next pandemic only REEL HEROES will be available for good dialogues, and not the saviors.

      The hazmat suit can get oppressive, the separation from loved ones painful, and fear of the virus paralyzing. The Indian Express recounts 24 hours in the life of four doctors and nurses on the frontlines of the battle against coronavirus in the Capital, armed with a few PPE kits, bottles of sanitizers, and — when the stress gets unbearable — Mohammad Rafi songs

Soaked in sweat after a grueling shift, every night, she returns to the Dental Block of her hospital to sleep.The goggles and mask stretched across her face all day leave bruises; the heat, she says, has set off pimples. Her limbs ache from wearing a PPE suit a size too small. What she craves then is a bath, but dreads it too.

“My room is not a dormitory, it’s a laboratory. There are three toilets, no bathroom… I use the jet spray to take a shower. Then I wash my clothes near the toilet and hang them on a railing where clothes of 17 other nurses — all of them exposed to  COVID 19 patients all day — are also left for drying. That’s the moment I break down every day,” says the 50-year-old nurse who was assigned to the special ward of a dedicated COVID-19 hospital. “Dar lagta hai, rona aata hai (I feel scared, I feel like crying)… But I just take a painkiller and sleep.”

 

In another part of the city, a 25-year-old doctor, who has been working in the COVID-19 ICU of a Delhi government tertiary care hospital since March 26, is relying on a pill to stay safe. “I have been taking a dose of  HCQS,  I went to 15 shops to get it, but it was not available anywhere. I finally had to borrow from a friend.

Its effectiveness in treating COVID-19 has not been proven but it’s recommended. I know it can have serious side effects. I read that a doctor in Guwahati died after consuming it. But I am taking my chances,” he says.
On a continuous 14-day shift in the COVID-19 ward before he gets a break for a fortnight of quarantine, the post-graduate resident doctor from the internal medicine department says he loves his job, but fears putting the lives of his elderly parents in danger. “The ICU is the most infectious zone. I have to insert tubes through the patient’s mouth into his airways, put food tubes, catheter, if needed… I am constantly exposed to their body fluids,” he says, adding, “My parents are very paranoid, and insisted on taking the hydroxychloroquine tablets too. But I didn’t let them.”

As the country remains in lockdown, with people barred from stepping out of their homes, a large army of doctors and nurses have been making their way to COVID wards each day and night, treating patients even as they fight their own fears. With the novel coronavirus cases in India crossing 6,000, the burden of treatment has largely fallen on the country’s creaking government healthcare system and its over-worked staff. In Delhi, with over 20 virus hotspots and 14 deaths, at least six hospitals/blocks have been dedicated to the treatment of nearly 1,000 COVID-19 patients, and thousands of suspected cases.

 

the six floors of my hospital are brimming with people, there’s hardly any social distancing that happens. Ambulances are dropping off family after family, all suspects. I am not in a PPE kit all the time, so when I first come in contact with suspected cases, I usually have only a surgical gown and a three-layered mask for protection. If any of them coughs, I shudder… At times such as these, I simply plug in my headphones, listen to Mohammed Rafi songs for a few minutes, calm down, and return to the job,” says the 50-year-old nurse.

Before the shift

These days, the 25-year-old doctor begins his day with a WhatsApp video call to his parents. Since the Cardiac Care Unit at his hospital was transformed into a COVID-19 ICU, he has moved to a separate floor of his house.

“I tell them to prepare my food and leave it at the door. I was given the option of staying at a hotel, but my family got extremely worried and insisted that I stay at home,” he says. He also makes calls to a few friends, mostly doctors, across the country, to catch up with them. “They have been my support. I have to admit that I have been calling them more than usual,” he says. The post-graduate resident doctor, who is now three years into his job, has been working in three shifts — 9 am to 3 pm, 3 pm to 9 pm, and the night shift every third day, from 9 pm to 9 am, after which he gets a day off.

Given the infectious nature of the disease, separation from family is a reality for many doctors across the country, like for a 40-year-old cardiac surgeon from a Delhi government hospital who has also been staying on a separate floor of his house.

“In the mornings, my daughters, 5 and 8, come out in the balcony and we shout out and talk to each other. They have also invented a game — they have named me corona and pretend like they are out to catch me,” says the doctor, who volunteered for a position in the COVID-19 ward in early March.

 

“The distance was necessary because my father, in his 70s, has both a lung and heart condition… I have worked in tuberculosis wards earlier, so my family is used to me taking precautions. But this time it’s a pandemic and so the stress levels are higher,” he smiles.

For the 50-year-old nurse, a diabetic mother and a 10-year-old son at home made her opt for the hostel facility at her hospital. “I have been in the profession for 22 years. I married late to focus on my career. My shifts have usually been long, but this is the first time that I have been away from home for this long,” says the nurse who hails from Goa

So now she spends her mornings talking to her child and husband, often “hiding my worries”. “They read about the staff at the Delhi State Cancer Institute getting infected, they ask me all kinds of things. I just say everything is fine. I have also told them that I don’t have a phone with me, so don’t call me till 10 pm. But I have one; I just don’t want them to call me when I am busy with the patients or when I am too stressed,” she says. “Since it’s Lent season, I also pray for the safety of my family before leaving for work. I have bought some dry fruits and fruits from outside which I eat to strengthen my immunity,” she says.

 

As she enters the toilet in the Dental Block to freshen up, she says, she cringes at the sight of the bucket, mug and towel. “They were used by the staff here before us. I don’t know if they have been disinfected,” she says.
But she is relieved that she does not have to go back home after the shift. “Two nurses at the hospital have been travelling from Noida every day. Their families are exposed to the virus. Once my 14-day duty ends, I hope they test me before sending me home. The 50 nurses who worked before us were not tested, just sent for 14-day quarantine.”

Inside the ward

As per norms, and accounts by doctors and nurses that The Sunday Express spoke to, the COVID-19 wards in the Capital are “well-ventilated spaces with beds placed at least six feet apart and no extra furniture”. They are disinfected with sodium hypochlorite several times a day. Separate toilets would be ideal, but at most places, at least three to six patients share a facility.

“The rooms cannot have air-conditioners because that would lead to stagnant air, an ideal environment for the virus to thrive. This also means that a doctor or nurse can’t wear a PPE suit for more than two hours, because it gets very uncomfortable in this weather. It is easier in colder countries,” says the 40-year-old doctor, whose first challenge upon arriving at the hospital is ensuring social distancing among the large groups of patients who arrive at the reception every morning. The 450-bed hospital he works in has 200 COVID-19 patients now.

“I take two rounds of the wards in the day. I use the stethoscope for auscultation, I have to come in contact with positive patients and suspected cases,” he says.

Around seven people, including nurses, security and cleaning staff, are present in the hospital’s COVID ward at any given time. When not in the ward — there are six COVID wards at the hospital, including the ICU and Flu Clinic — the doctor works from a ‘COVID-19 office’ that has been set up at the hospital recently.

“Recently, a man who had returned from Thailand and had COVID-19 symptoms kept holding his little son in his arms. I had to counsel him for long before he agreed to let him go,” he says. Patients with fever, cough and sore throat first arrive at the hospital’s Flu Clinic to get tested. At least 50 patients have been testing positive at the hospital every day.

 

“I then move on to take stock of PPE, about 15 of which are used in each shift, and then go through patient files, and finally brief all my staff — nurses, ward boys, cleaners — on how to deal with COVID-19 patients. I can also easily tell when one of them is scared, it’s on their faces. I try to be jovial with them, that helps,” says the doctor.

For the Goa nurse, the “fear” is mostly a sinking feeling as she slips into the pink kurta-pyjama uniform at her hospital every day. “It’s washed with clothes of all other nurses. I rub a lot of sanitiser over it,” she says. Her hospital has 600 active and suspected COVID-19 cases, while her ward has six positive patients.

“We are four nurses on a shift, and only the one who goes into the ward gets a PPE kit. The rest are in surgical gowns and masks. But suspected cases are walking into the hospital all day long,” she says. She is part of a group of 120 nurses working at the hospital in three shifts — 7 am to 2.30 pm, 2.30 pm to 10 pm and 10 pm to 7 am.
For a 32-year-old nurse, who is now at home after completing her 14-day shift, it was the “donning and doffing of the PPE that left me anxious… We didn’t have a separate room for changing, about six of us did it together. I washed my hand after removing each part of the equipment,” says the nurse who hails from Kerala and has been working at a Delhi government hospital for the past six years.

A single parent who lives with her elderly mother and child, she says she stays in a separate room at her house, uses a different toilet, and pours Dettol all over her shoes and clothes every day. “Unlike doctors, nurses are not tested after the 14-day shift ends. There was no thermal screening facility at my hospital either. So I am continuing with the precautions,” she says. However, she says, she is relieved that she doesn’t have to wear gloves until her next 14-day shift. “I am allergic to latex powder that is used while wearing gloves. My hands would remain itchy all day. I would wash them all the time.”

Washing his hands 20-25 times is also among the many precautions that the 25-year-old doctor takes every day as he begins duty. “Even in the 20 minutes that it takes to wear the PPE, I wash my hands five-six times. I then head to the ICU, where I have four patients now,” he says.

His three years in the job have seen him being posted in infectious wards before and he is “not scared of the work anymore”. “I once got pricked by a needle used for a suspected HIV patient. It was 3 am and I rushed to get a test. It took six hours for the results to come. Fortunately, it was negative. Such incidents will happen, you can’t avoid it,” he says. He will be tested for the virus when his 14-day duty ends.

With no family attendants for the patients, doctors and nurses end up doing a lot more work. “Changing diapers of elderly patients, emptying urine bags… all of this carries chances of infection.”

And then there are the “VIP patients”. “Some of these patients are frustrated at not having found a place at private hospitals. Food complaints are a constant,” he says.

 

VIP patients have made the 50-year-old Goa nurse’s “life difficult” too. “They all have mobile phones, and they keep calling the landlines and our mobile phones, asking for chai, juice, their reports. Once, a patient accused me of hiding his reports… They complain about the cleaner, electrician, ward boy, and they blame nurses for everything. Hum kisko bolein (Who do we complain to)?” she says.

She serves food to patients three times a day in disposable plates and glasses. “It comes from the hospital kitchen — roti-sabzi, dal-chawal. If a patient is diabetic or has any other underlying condition, the diet is changed accordingly,” she explains.

The 40-year-old doctor says it’s normal for patients to be frustrated.

“They are away from their family, there is no emotional support. For a significant part of my shift, I double up as a counsellor. Recently, a young patient sat on the window sill, flung his legs out and threatened to jump. I had to pull him in. I later realised he was a drug addict and was experiencing withdrawals,” he says.

As for his own mental health, says the 40-year-old doctor, “Knowing the science behind the spread of the virus, and not relying on ‘WhatsApp and Facebook science’ keeps me sane. I have been following reports from Wuhan and Italy. It’s going to be a long journey. We can’t lose steam this early. My thoughts are similar to that of any soldier.”
To keep his staff healthy, the 40-year-old doctor also ensures that they eat on time.

“I get my food from home,” he says, adding that the staff takes turns to eat, and ensure social distancing.
The 50-year-old nurse says food is one thing they don’t worry about. “We recently got meals from Taj Hotel. It was very tasty,” she says. However, she has been taking care not to drink too much water so as to avoid using the toilet. “We have to remove the entire suit to use the toilet, and then disinfect. Plus, going to the toilet, which the other nurses have also used, only adds to my stress. COVID shift mein physical se zyaada mental stress hai (There’s more mental than physical stress while in COVID shift).”

So what does she do to fight it? “Apart from listening to old Hindi songs, I lean on my friend of 22 years. We started out together as nurses. We share our concerns and motivate each other,” she says. “I like to take care of people and that is why I became a nurse. But we need some care too.”

After the shift

After a long day at the hospital — that can range between six and 14 hours — the 25-year-old doctor begins his “return home routine”. “I first take a shower at the hospital and inform my parents that I am leaving so that they can leave my food outside my room. There is a sanitiser in my bag, in my car, at entrance of my house, at the door of my room and in my bathroom. I use them all. I keep the used plates and my clothes in a polythene bag outside my room. There is a separate bathroom for washing these,” he says. “My parents often ask me if the risk is worth it. I think it is.”

How often does the fear of contracting the virus cross his mind? “I have thought about it many times. If that happens, I will get admitted at Max or Medanta Hospital,” says the 25-year-old.

As for the 50-year-old nurse, when she returned to the Dental Block on Thursday night, she was filled with hope. “There was a protest by off-duty nurses for accommodation. The doctors are being put up at five-star hotels, why not us? Today we were told that some of us will be shifted to a new place, where there will be two nurses per room and an attached toilet,” she says. “I want to take a proper bath.”

Till then, the painkiller and Mohd Rafi melodies will keep her company for another night.

 

Strengthen hands of medical staff

Over 150 healthcare workers, including doctors and nurses, have tested positive for coronavirus so far. On the frontlines of the battle against COVID-19, the country’s health professionals have so far flagged issues such as shortage of personal protective equipment and lack of accommodation, besides being stigmatised as carriers of the virus.

 For the government, this then is the time to acknowledge some of these concerns and strengthen the hands of the medical fraternity. The ordering of 1.7 crore PPEs in the past week is a step in that direction.

 

Inside the COVID ward- Indian Express

Reel Hero vs Real Hero

21 occupational risk to doctor and nurses

Russian Doctor arrested for Challenging Virus data. Administrator’s refrain


The police held overnight an outspoken Russian doctor, Anastasia Vasilieva, who was trying to deliver masks to an impoverished rural town.

MOSCOW — Russian authorities detained the leader of an independent doctors’ union, an outspoken critic of the Kremlin who has dismissed as “lies” the country’s low official numbers for coronavirus infections.

Anastasia Vasilieva, the head of the Alliance of Doctors, was stopped by the police on Thursday and held overnight while traveling from Moscow to an impoverished rural town to deliver masks, gloves and other supplies to a local hospital, a colleague who was traveling with her said.

Earlier a Chinese doctor Li Wenliang, one of the eight whistle-blowerswho warned other medics of the coronavirus outbreak but were reprimanded by the police, died of the epidemic on Thursday, official media reported. Li, a 34-year-old doctor who tried to warn other medics of the epidemic, died of coronavirus.

       Administrators and regulators refrain to study data that would establish and quantify the occupational hazards of being a doctor and nurses. Some of these hazards may be known, but there is no comprehensive analysis of workplace risk for physicians and nurses, like those that have been done for other professions. Perhaps society prefers to remain blissfully ignorant of the sacrifice and risk their doctors  and nurses take on.  Perhaps we  all despise to let reality and data shatter the illusion

The detention of Dr. Vasilieva, an eye specialist who has been highly critical of Russia’s response to the pandemic, added fuel to already widespread skepticism, particularly among Kremlin critics, about the accuracy of official figures showing relatively few cases of the virus in Russia. Her detention also increased skepticism about the readiness of Russia’s health care system to cope with the pandemic.

A group of doctors at a hospital in St. Petersburg, Russia’s second biggest city, released a video on Friday appealing to the public for help in obtaining the protective equipment they said they needed to treat coronavirus patients.

Maria Bakhldina, the head doctor at the hospital, speaking to Fontanka, a news site in the city, dismissed the doctors complaints as “untrue.”

Views on how far the virus has really spread in Russia and how prepared the country is have been largely determined by political leanings. The general public, which mostly supports President Vladimir V. Putin, has voiced little concern while many of the Kremlin’s opponents suspect a cover-up.

Aleksei A. Navalny, Russia’s most prominent opposition leader, recently accused the authorities of lying about the number of tests carried out and suggested that, as a result, the number of cases could be much higher than reported.

Russia has sharply stepped up testing and now says it has conducted more than 575,000 tests, but this includes cases of multiple tests on the same person, lowering the head count.

In an address to the nation on Thursday, President Putin, holed up for most of the past week in his country residence outside Moscow, praised health workers for “holding the line of defense against the advancing epidemic” but acknowledged the worst is yet to come.

Dr. Vasilieva, the detained physician, set up the Alliance of Doctors last year in part to counter the Kremlin’s claims of dramatic improvements in funding and other support for hospitals. She has treated Mr. Navalny as a patient and affiliated her group with his. The authorities arrested her last year for rallying opposition to the closure of a tuberculosis clinic in a poor region of southern Russia.

Mr. Putin’s approval rating, according to a recent survey by the Levada Center, a respected Russian polling organization, fell from 69 percent in February to 63 percent in March, near to what it was in 2014 before a surge in the president’s popularity after Russia’s seizure of Crimea from Ukraine.

In his last public outing early last week, Mr. Putin visited a new state-of-the-art infectious diseases center, Hospital No. 40 in Moscow, escorted by its head doctor, who this week tested positive for the virus. The Kremlin said that Mr. Putin has been tested regularly and that “everything is O.K.”

Russia on Friday reported 601 new infections, down from 771 new cases reported on Thursday, bringing the total number to 4,419. This is a fourfold increase over the past week but still far fewer than the more than 245,000 cases reported in the United States and nearly 118,000 in Spain and 115,000 in Italy.

Critics of the Kremlin, however, have questioned the official figures. Dr. Vasilieva, the detained doctors’ union head, said in a video late last month that authorities were lying about the true number of infections, accusing them of deliberately misclassifying people who had developed the disease as victims of ordinary pneumonia.

A few days later, she said she had been called in for questioning over her comments, declaring defiantly in another video that “You can send whomever you want to get me — the Federal Security Service, the fire service — but the truth will not change.” The real number of coronavirus cases, she said, “is much higher than the authorities say.” She provided no evidence of any cover-up.

Her medical workers’ union, warning that Russian hospitals were desperately short of masks and other protective equipment, recently started a fund-raising drive online to raise money from the public to buy supplies for hospitals and clinics.

The government, too, seems worried that it may need to do more to control the virus. On Friday, it suspended the last remaining flights into the country, halting even special flights bringing Russians home from abroad, the Interfax news agency reported. All land borders have already been closed.

Moscow, St. Petersburg and many Russian regions this week ordered residents not to leave their homes except to buy food and medicine or walk their dogs close to their residence.

Dr. Vasilieva was stopped by police officers on Thursday while attempting to deliver supplies by car to a hospital in Okulovka, northwest of Moscow, according to Natalia Kolosova, a colleague who was traveling with her. “They were clearly waiting for us,” Ms. Kolosova said, noting that police officers had set up a check point at the entry to Okulovka but stopped no other vehicles.

Dr. Vasilieva appeared in court on Friday charged with disobeying police orders and violating quarantine restrictions. She was released on Friday evening after being ordered to pay a small fine.

Natalia Zviagina, director for Amnesty International in Russia, condemned the detention, saying in a statement that: “It is staggering that the Russian authorities appear to fear criticism more than the deadly Covid-19 pandemic” caused by coronavirus. By detaining Dr. Vasilieva, she added, the authorities show “they are willing to punish health professionals who dare contradict the official Russian narrative and expose flaws in the public health system.”

Okulovka hospital’s head surgeon, Yuri I. Korvin, also a critic of the authorities, had been ordered to stay away from the hospital and self-isolate for two weeks because he had had contact with Dr. Vasilieva, Mr. Sokolov said. Police officers involved in her detention, however, were allowed to keep working, he added.

Mr. Sokolov said “nobody knows the real number of infections” and added that residents in Okulovka were alarmed by a recent flood of people arriving from Moscow and St. Petersburg. Fleeing quarantine restriction and high infection rates in their home cities, urban residents have been fleeing to rural towns like Okulovka to take shelter at country homes.

“None of us know where these people have been or whether they have been tested,” he said.

reel heroes vs real heroes

21 occupational risk to doctor and nurses

administrators refrain to study  risk to doctor and nurses

Lock-down essential to prevent knock-down


Imagine what would have happened if religious functions, social functions, conferences, marriages and birthday functions,  social gatherings or normal transport would have continued for many more days.

Social distancing is the key element to prevent the Coronavirus spread.  But not everyone among the masses has the ability to understand the urgency from the very beginning and own up responsibility for social distancing. It is the responsibility of each and every human being to prevent the spread. But a significant number of people failed to do it from the time that was crucial. The time for basic understanding and wisdom to prevent at individual level varies from person to person.

Social distancing to be successful has to be strict and imposed in a totality. Police patrolling, drone surveillance, camera surveillance may be needed for a longer duration in view of the current crucial phase that may lead to community transmission.

Online consultation or teleconsultations need to be strengthened to avoid unnecessary contact.

Doctors and nurses need to be protected as they can be crucial links for treatment.

As it is a totally preventable disease, so lock-down has to be more complete and strict. It cannot be left to individual wish to quarantine. Once it happens, doctors can not treat it, whereas people can prevent it from happening.

So strict Lock-down is much needed to prevent Knock-down from community spread.

How to implement strict lockdown

Global clap-doctor and nurses

Global clap for Doctors-Nurses; ‘God in only Corona-times’==Looks opportunistic & temporary


 

In times of Corona- war, what doctor and nurses really wish and need is uniform applause all times, genuine legal regulations,  freedom from industrial enslavement and sensible or true projection from media. Much needed are PPE’s,  good protective gear and an environment, where the voice of “every worker with patients” is heard.

An applause or clap for a specific and short time under the shadow of Corona looks opportunistic and temporary. The continued attacks on doctors, even on the doctors looking after Corona patients, just indicate, how deeply disrespect and hatred for saviours have been encrypted in the minds of people, especially by insensible statements from media and celebrities. The hatred and instigation had come from the people, who have not treated a single patient in their lifetime.

Before Corona episode exploded, doctors and nurses continued to work with the burden of mistrust, legal complexities and hurt. They were working and saving lives before as well. Despite doing good they were on receiving end of imposed consumerism, battling legalities, subject of public violence without much support from any quarter. The insult and assault on doctors were considered business as usual. The ridiculous attitude and beating of doctors were thought of as natural reactions of emotional mobs.

Most of Media and Celebrities earned applause, fame, money,  for themselves by spewing venom and citing stray incidents as generalization against the medical community.   Hence instigating and turning the opinion of masses against health workers.

Although it was good to see an overnight change in the attitude of people and media, as Corona-war was declared. But at the same time, continued episodes of violence against doctors gave an indication that it may be a temporary satisfaction for doctors and claps or applause may live only till Corona fear.

If it was a true applause, why it was not done before Corona exploded. After all,  doctors were doing their work before as well.   Sudden applause comes now in view of the risk to their life as a professional obligation, without proper PPE’s and deficiencies in protective gear.

Doctors and nurses just need PPE’s, good protective gears and a  safe environment.  Children of today, who inspire to be doctors, are watching with anxiety, the treatment given to saviors. An opportunistic or temporary applause without any concrete support will  not inspire good doctors or nurses in the future.

 

 

Reel Hero vs Real Hero

Blaming  doctors for the death of coronavirus patient family members attacked them Hyderabad 

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