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.”

 

25 factors for expensive medical treatment

Altruistic professions are not cherished in present era

21 occupational risk to doctor and nurses

Being doctor or nurse- a disadvantage in present era

 

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.

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

Reclaim of Lost Territory by Mighty Nature #COVID-19


 

         For thousands of years, humans have achieved tremendous progress and evolution, which was reflected in advancement and modern science. The evolution was used to acquire natural wealth and the environment to the materialistic advantage of mankind. From butchering animals to control sea waters and skies, humans tried to control everything around. Modern medicine was discovered to attack the germs, bacteria, and viruses in a pursuit to prolong life and interfered severely in natural processes of nature without knowing the bigger picture. A sense of holding masterly gained by possessing superior intelligence prevailed in the modern world.  Except for humans, everything living or non-living was being considered as a captive resource to be exploited and consumed. Animals and birds were farmed, tormented and mercilessly killed in uncountable numbers.

        In a few weeks of invasion by COVID-19, the world looked changed. Greener plants, no air pollution, transparent waters, and clear sky looked, no traffic on roads, as if nature claiming back the lost territory without being even seen.

         All living and non-living elements form an ecosystem. Birds, animals, plants, sea life, the environment on earth, non-visible germs and bacteria form an ecosystem and form a balance. How we have affected this balance, that is still unknown.  Germs have been there before humans and are armed with strange powers to mutate and attack humans if balance is disrupted. The real barriers between deadly nano predators and human beings are still undiscovered. When we pollute and destroy the hills and jungles, deserts and oceans, icy glaciers and lush rain forests, use antibiotics to kill micro- and nano-life for our evolved requirements, we force the barriers to be broken.

     The rapidly recurrent coming pandemics may be warning for the behavior of the human race, and point towards a need for more sustainable evolution. The mighty nature deserves more respect to be kind to humans.

     Human beings need to prove that they are truly evolved. Considering that the current invasion by COVID -19 is not the last one that befell us, there can be many more in future, we need to check our pattern of choices to suit the nature and not vice-versa.

21 occupational risk to doctor and nurses

reel heroes vs real heroes

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

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