The Weekly Dose: What doctors confronting the coronavirus won't tell you

Taking a sanitised leaf out of Italy’s book, PM Modi has asked all Indians to gather on their balconies (!) this Sunday at 5 pm and applaud healthcare workers for their efforts during these trying times. While I appreciate the sentiment, I am not sure how much we understand the extent to which the epidemic has altered the fabric of medical personnel’s lives. 

Since most government hospitals are understaffed, all non-essential leave is being cancelled. As I wrote yesterday, many doctors are frustrated by the almost ubiquitous shortage of Personal Protective Equipment and essential testing facilities. The well-advised closure of all avenues of diversion like malls and theatres, and the scientifically sound diktat to avoid meeting one’s family and friends unless absolutely necessary, have sounded the knell for anything that could provide them with a few hours of relief from the stress and tedium of work.  

But I am yet to hear of absenteeism, or dereliction of duty. Medicos are staying put. Here are five young doctors - all working at public hospitals, which bear the brunt of the coronavirus burden - telling us about their own apprehensions, and how the professional has intertwined with the personal: 

A junior doctor at a referral centre for infectious diseases in West Bengal 

We are petrified. Most of us (junior doctors) don't know what to do and what not to do. I read everything I can, but my friends don't, so I am trying to dissipate information. When I was posted at a Primary Health Centre, I organised a session to educate our patients about hygiene. 

I live in the hostel, and live mostly in isolation; I’m not going to go back home for six months or so. But my friend, who comes to work from home, has an immunocompromised father (Individuals with weak immune systems are at greater risk of suffering a more severe course of COVID-19 infection). 

Physician at a tertiary care centre in Mumbai 

I am getting a lot of phone calls from friends and relatives with minor coughs and colds. A little restlessness balloons into full-blown panic. Non-medico family members are even more scared. People who have never called me have suddenly started getting in touch. 

There is a lot of pressure from home: Don't go to work, or quit and come home, no need to keep working there. My junior was sent to the airport for screening incoming passengers; his family has already started emotional blackmail: “We had just one son…”

A surgeon at a secondary care hospital in Western India 

When my relative gets back from Europe, she isn't going to want to spend two weeks in a public hospital for isolation. She will try everything in her power to escape this, and get admitted to a private hospital (since this interview, some private hospitals have created isolation units, which are yet to accept patients). But this shouldn't be allowed, as it will infect even more people. 

Someone I know is a student in Spain. Since all students were given a month's leave, he planned to come back home to India. But when he found out that he is going to be quarantined in Kasturba Hospital for Infectious Diseases (a public hospital, which the upper-middle class will wish to avoid), he asked me to call someone (using my contacts) and get him out of this. I told him, "Nothing doing. Follow the protocol". 

A physician in a secondary care hospital in Mumbai 

The coronavirus causes Severe Acute Respiratory Syndrome (SARS - which culminates in respiratory failure and requires intensive care); we cannot predict who will get it, or pass away. However, we do know which patients are at a higher risk of developing it: the elderly, asthmatics, those with underlying heart disease. In general, young medical personnel should not have a problem, but we can become carriers. 

My entire family may have already had a subclinical COVID-19 infection in January; I may already be bringing the virus home daily. But confirmed cases in a hospital add to the fear in everyone’s minds. I have family members with high blood pressure; I don't want to cause them any more stress. 

If I am posted to the corona isolation unit, I won't come home and risk infecting my grandmother, even if I am totally asymptomatic, as corona can be a subclinical infection. If one of our patients is found COVID19-positive, I will consider shifting to a room in the hospital campus, or a rented place nearby. 

A Medical Officer in Kasturba Hospital for Infectious Diseases, Mumbai 

Now that Kasturba is in the limelight, my family is concerned. They keep calling to ask if I am in 'that' building (which admits confirmed coronavirus patients). My friends don't want to meet me now. When I tell them I work at Kasturba Hospital, they say they'll see me later.  Relatives keep their distance when they realise that I am continuing work at Kasturba. 

Every call I get is about how the scenario is around me. Very few ask, "But how are you doing?"  I've explained to my family that I can't back out. This is the need of the hour, and I am going to deal with it. 

The mentality of people needs to change. Just washing hands and using sanitisers won't do; we need to stop unnecessary travel. I board a train to and from work, and there is still so much of a crowd commuting every day. Take the option to work from home, wherever possible. In Mumbai, both the rich and the poor travel by train; there is no other option. At least whoever can, should stay indoors; it will really help us all. The handkerchiefs and sari ka pallu around your face is not going to help; just stay home. Our administration is already doing a lot at ground level, everybody is struggling, doctors and nurses are working round the clock without bothering about their family, food, or even personal hygiene, sometimes. The least we expect from the public to curtail this is social isolation and distancing. 

Some of the patients we have admitted are well-off and well-educated but behave as though we are holding them against their will. They are demanding to know how they can go home. All they care about is themselves; it's high time they started caring about others around them too.