| Ikram Khan

Rashmi (name changed) a nurse at a government isolation hospital for Covid-19 patients reports for duty at 8.00 am. An hour or so before she gets into her Personal Protective Equipment (PPE), she has to prepare. Stay off too much water despite knowing that it will be another seven hours before she can have a drop of water or any liquid.

Once she gets into the suit, there can be no bathroom breaks. She must load up with enough complex carbs so that she does not feel hungry till her shift ends. Her six-hour shift will require her to be in the suit all the time. The only time she can get out of the suit is when she completes her shift.

Then the suit is either disposed in special bins for toxic medical waste or incinerated. Some nurses and medical staff who work in isolation wards suit up with diapers if they can’t avoid regular bathroom breaks.

Distanced from families

But thousands of doctors and nurses are not shirking this big new challenge. Health workers, doctors, nurses and technicians are sacrificing their personal comforts for this high risk combat. Every one of these health workers works a six-hour shift and after their shift they retire to rooms in specific designated areas of their hospital campus. After seven days, there are moved to Ramanashree hotel for a two-week quarantine period. It effectively means that no doctor, nurse or technician will be allowed to visit his or her home for a three-week period.

The Dean of the Bangalore Medical College & Research Institute (BMCRI), Dr C R Jayanthi proudly says that all the health workers are stretching every sinew to obtain optimum results. “It’s not easy. In this tense atmosphere the task on hand poses a big challenge and one needs to be constantly on the top of his or her game. You just cannot afford to drop guard for a moment. That’s how tough it is. But I must tell you that the health workers are doing a fine job and the BMCRI team so far has proved equal to the task,” said Jayanthi.

The Dean revealed that Victoria Hospital, designated Covid-19 patient care facility is ready with 550 beds including 50 ICU beds with ventilators. “On March 26 the first patient was admitted here and today we have 31 positive patients including two in the Intensive Care Unit (ICU),” said Jayanthi, pointing out that the patients are admitted initially in Emergency & Trauma Care Centre Block.

The patient profile is important and it includes international patients also. All patients admitted are managed as per standard clinical protocols and divided into three zones, Green, Orange and Red zones. Appropriate treatment is given as per guidelines. All health care workers are provided prophylaxis in addition to their personal requirements,” said Jayanthi.

Smitha Segu, Nodal officer and Professor Plastic Surgery, said, “The frontline medical workers are giving it their best shot. The BMCRI team is doing a commendable job. The team has been prepared to treat more patients, if the number increases. Each one understands the task on hand and the role he/she is required to play to attain the desired results.”

Dr Madhu, Assistant professor, Anaesthesia at Victoria Hospital has just finished her one-week frontline stint. Doctors don’t scare easy but even Dr Madhu admits that her resilience has been tested. Patients in an isolation room can behave erratically despite counselling. Some have rushed out of their beds and demanded to see their families. The feeling of being caged, isolated from their loved ones and the fear of the disease and the symptoms of the disease itself – high fever, fatigue, cough, breathing difficulties – can test the bravest hearts.

In the first week of isolation ward duty, all health workers struggle despite the meticulous planning by the Core Management team, says Dr Madhu. “It gets a little spooky in the isolation rooms and your resilience is tested. Every distressed patient reacts differently and despite counselling from psychiatrists on a daily basis, some patients are difficult to handle,” says Madhu.

It’s hot inside a PPE

The anaesthetist disclosed that to learn to wear the PPE kit and stay in it for six hours is itself a big task. “It is a threelayer kit and on the first two days you end up sweating profusely. It’s hard to breathe inside until you get used to it. The fact that no fan or air conditioners are allowed and it is summer time makes it all the more difficult. The health workers in the afternoon shift are struggling to cope with the mandatory gear,” said Madhu.

“The one good thing all health workers appreciate is that the dean and team leaders including the BMCRI principal Dr. Ramesh Krishna are leading from the front. Monitoring the Green, Orange and Red Zone, which is critical care zone requiring oxygen, is a big task and it is all happening smoothly,” said Madhu.

In the critical care zone, nine doctors and 14 nursing staff are required while the number is considerably less in Orange and Green zones. At Victoria Hospital, there are four six-hour shifts for doctors and nurses, for seven days, before the two-week quarantine. What’s promising is that despite the challenges and the fear of stigma, a number of health workers are coming forward to care for patients, and this is the silver lining we all need to hear and remember.