It’s very difficult to get 33-year-old Rakshit Pratap Singh—a paediatrician from New Delhi—to talk. When he finally does, his first words are, “I am suffering.”
The first registered case of coronavirus infection in India was reported on January 30, 2020. A few days before the first positive case came up, several government hospitals in India’s capital New Delhi were turned into COVID-19 consultation centres, one of which is where Singh works. Doctors were asked to serve their country by joining the fight against the deadly novel coronavirus.
The doctors started their fight, but without any armour.
Singh, who is working 18- to 20-hour workdays at a government hospital, is among the thousands of healthcare professionals across the country on the frontlines of this fight. In India though, a country currently on a 21-day lockdown, the doctors are not just fighting the virus. They are also fighting the stigma that comes from them doing their job, one that others around them fear will get them infected, and leading to doctors and nurses being thrown out of their apartments as well. One of them was even assaulted by the police on her way to the hospital, thanks to a lockdown which doesn’t still have a system to make sure people are out for the right reasons. And to top it all is India’s notoriously overworked and under-resourced healthcare, which sees less than one allopathic doctor per thousand people—the minimum recommended by the World Health Organisation (WHO)—and only 1.7 nurses per thousand people, again well short of the WHO-recommended three-per-thousand.
Regardless, most of them are continuing the fight, with those like Singh taking on up to 300 cases a day, every day of the week. “Even those who are a little anxious about their condition come to us because we are a government hospital and they know that treatment here is free,” he says. “But we have no means of checking (if they are coronavirus positive or not). The only thing that I can do is check the person’s body temperature, and travel history, and then recommend home quarantine.”
When making a judgement call based on just two factors, ones that are not even sure-shot indicators of infection, Singh faces a conundrum. “If I start marking all those who have a body temperature above the recommended level, then I’m sure the number of ‘positive’ patients will increase exponentially, because my patients range from those with a fever to those with a cough and cold. How do I stay true to my profession, and make the right decision when it comes to my patients?”
Given the situation at hand, and the vast number of patients that he is seeing, it is obvious that Singh is scared. “I have been pleading with my supervisors to give us PPE. I face the threat of infection every day.”
PPE or Personal Protective Equipment are the essentials required when treating people with transmittable infections. Different viruses have different PPE protocols. According to the WHO, the PPE required for the novel coronavirus includes: Gloves, medical masks, goggles or a face shield, and gowns, as well as for specific procedures, respirators (i.e., N95 or FFP2 standard or equivalent) and aprons.
“But they have only given us normal masks,” says Singh. What he means by a normal mask is a 2-ply surgical mask that needs to be discarded after a maximum of four hours of use. But the hospital that he works in has limited the number of masks allocated to every doctor. Moreover, the overalls that are provided to these doctors are the OT disposable scrubs that offer protection from body fluids like blood, lymph fluid, and saliva. But they are no good against the coronavirus. “If I encounter a positive patient, the mask that I have been given will be of no use.”
Singh says that he has seen the stock of PPE in his hospital and has also confronted his superiors about it. But all that they have told him is that they will be given the equipment once a COVID-19 positive person actually walks through the doors.
“I understand that the equipment is important. But, what about my health? How will I know which patient is COVID-19 positive? And how will I save myself from getting infected? It is a frightening situation. We have masks and other protective equipment in the hospital but we are not being given those.”
The doctors at this government hospital are not allowed to take the COVID-19 test as well. “There are no testing kits. At the end of a gruelling workday, we just check each other’s body temperature. That’s about it.”
Various doctors from New Delhi government hospitals had sent in a request to the medical superintendents demanding better protective gear and methods of screening, but the demands weren’t met.
Apart from his own health, Singh has other worries as well. “I have elderly parents at home,” he says. “My father is a diabetic. My mother had a stent put in. They are sick, and they are vulnerable. And they spend their days worrying about me. I cannot even contact them regularly because of my working hours.”
According to WHO, although people of all ages face the threat of getting infected with the coronavirus, “older people, and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus.”
Compounding Singh's troubles is also the fact that by talking about the situation, he is at risk of losing his job as well. “I don’t want to name my hospital. What if I lose my job, and then fail to get a good recommendation from my seniors?”
As of March 30, the number of coronavirus positive cases in India stands at 1,071. The number of deaths stands at 29. More and more doctors are also testing positive for it. As cases have increased, the ministry of health and family welfare admitted that India is in the “limited” community transmission phase. But many experts believe the number of positive cases in the world’s second most populated country is this low because of the extremely low level of testing we’re conducting. In fact, many doctors believe it’s only a matter of time before the virus sweeps India.
“I know that the government is constantly announcing measures that it will implement for the safety of us doctors," says Singh. “But I am yet to see those implemented. I am scared but these are unprecedented times. I need to speak my truth.”
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