This is war and there’s no time to cry for our losses: PGI Covid panel head
‘I carry guilt in my heart... It is very difficult for us to choose between two patients... It is not like that we abandon the old patients, but we could have given them more intensive care... We could have pushed a little more.’
Dr GD Puri, a noted name in the field of anaesthesia, has been at the forefront of the battle against Covid-19 in the region.
Head of the department of anaesthesiology and intensive care at the Post Graduate Institute of Medical Education and Research, Chandigarh, he also heads the Covid-19 management committee of the premier tertiary care institute.
Having closely monitored patients requiring critical care at the institute’s Covid-19 dedicated block, he shares with Hindustan Times what it is like to deal with the unprecedented second wave, when resources run short and tough decisions are to be taken in the nick of time:
Q. What are the challenges in dealing with the new virus strains?
A. The main issue is the manifold rise in infection numbers and subsequent need for hospitalisation, which has overwhelmed our Covid-19 facility. In the last week of April, there was a tsunami of patients at our Emergency, and our resources got exhausted. Important medications went out of stock, we had to open new wards for patients, and all this sapped out our energy and motivation. We are even seeing young patients from Chandigarh coming with 70% oxygen saturation, as they could not arrange a bed or did not report on time.
Q. How is the patient load being managed? What are the criteria for admissions in critical care wards?
A. I carry guilt in my heart when I say this, but it is very difficult for us to choose between two patients for giving intensive care. You have to make this decision that if a patient is young and has no comorbidities, they will be shifted to the ICU at the cost of an old person, who let us say has kidney or liver failure. It is not like that we abandon the old patients, but we could have given them more intensive care. We could have pushed a little more. This is sad for us too, but you have to move on. This is war and there is no time to cry for our losses.
Q. Are you getting enough oxygen supply for Covid, non-Covid and surgical patients?
A. I can tell you with authority that we can increase our critical care beds, but the oxygen supply is limited. There has to be a holistic approach for distributing the resources, and it should be strictly as per the requirements. We are saving every unit of oxygen. Wherever there is a possibility of oxygen wastage, we have plugged it, and new guidelines have been provided to all departments on its judicious use.
Q. The fatality rate in the region is going up exponentially? What could be the reasons?
A. Since the infection number is increasing, deaths are bound to increase, but there can be other reasons as well. There is a need to ensure uniformity in treatment being given by smaller nursing homes. There is a lot of irrational use of drugs, steroids, and antibiotics, which results in deterioration of condition of such patients and decreases their chance of survival.
Q. When is the situation expected to improve?
A. From the example of Delhi, we can expect that after four to six weeks of restrictions, the cases plateau and start to decline. So, we can soon expect the outcomes of restrictions imposed in the region.