Excruciating hours, bad PPE doctors’ key issues
The problems persist even as the government has taken several steps to prevent attacks faced by several health workers – doctors, nurses and workers who go to neighbourhoods for disease surveillance.Updated: Apr 23, 2020 05:36 IST
Doctors and nurses at some of the main coronavirus disease (Covid-19) hospitals have said that they continue to work with substandard protective gear, lack access to proper meals, and have to pull in long, gruelling shifts, giving details of how those at the front lines of the pandemic remain vulnerable – from the disease as well as contagion-wary citizens.
The problems persist even as the government has taken several steps to prevent attacks faced by several health workers – doctors, nurses and workers who go to neighbourhoods for disease surveillance. The Union Cabinet decided on Wednesday to amend the epidemic disease act to lay down prison terms and fines for those attacking health workers.
Health care professionals said while the decision solves one part of the problem, another big area of concern remains. In the less than one-and-a-half months since the Covid-19 outbreak began in Delhi, at least 87 health staff in private and government facilities have contracted the disease.
In Delhi’s Lok Nayak Hospital, a resident doctor, who asked not to be named, said the personal protective equipment (PPE) bodysuits given to them is prone to tearing. Sharing images of his bodysuit torn from nearly chest to his waist, the doctor said: “I have not done much physical movement, the condition of the bodysuit is only from the regular checkups that I did today.“
The quality problem appears to be particularly acute in suits that were donated to hospitals after reports of shortages gained attention last month. “Earlier, the problem was that we were not getting ample supply of PPE kits in hospitals, but now a lot of NGOs and private individuals are donating these kits. Though the gesture is appreciated, there is no way of ensuring the quality of these PPE and such problems have been highlighted by several doctors,” said Dr Parv Mittal, president of Maulana Azad Medical College and Associated Hospitals’ Resident Doctors Association.
The association represents doctors of four hospitals: Lok Nayak Hospital, GB Pant Institute of Postgraduate Medical Education and Research, Maulana Azad Institute of Dental Sciences and Guru Nanak Eye Centre. Out of these hospitals, Lok Nayak is the biggest Covid-19-designated hospital in Delhi. It admitted 214 new positive patients on Tuesday.
PPE kits include several items: a bodysuit, a pair of shoe cover, disposable goggles, gloves, disposable face mask, a collection in which they are meant to be discarded, and a hand towel. A second doctor, who asked not to be named, said several of these items are often missing from the kits or are damaged, needing them to use crude quick-fix solutions like adhesives.
Multiple complaints have been sent to the hospital administration, central and state governments but the matter is still unresolved, the doctor added. “We have to reuse N-95 masks for three to five days at least. And we still do not know if those are N-95 masks at all. If questions are raised on the substandard quality of PPEs, we are asked to adjust or exchange the set saying that they are donated. If everyone is getting only donated items, what happened to the ones being procured by the government?” the doctor said.
Things have improved in some hospitals, but the distribution of protective gear is still erratic and limited to only selected staff members, he added.
Responding to the complaints, Delhi’s health minister Satyendar Jain said that since the donations of PPEs are made in bulk, some pieces may end up damaged. “One or two from a pack of 100 PPEs could have been damaged but how can we stop accepting kits because of that? The need of the hour is to protect our front-line workers, who are risking their life and safety to fight this pandemic,” Jain said while speaking to reporters.
The shortage of PPE also forces doctors and nurses to spend their entire day in one overall, which means they need to avoid bathroom breaks and are forced to wear adult diapers. “We cannot remove our PPEs once we wear it, because there are not enough suits to change into. This means that we cannot even drink water during duty,” said a 38-year-old nurse at east Delhi’s Rajiv Gandhi Super Speciality Hospital, asking not to be named.
“It is very hard. There have been days when I have spent my entire after-duty time drinking water because I am so dehydrated,” she said, adding that shifts usually stretch into 14 hours and the diapers are often at the verge of leaking.
She said the meals offered to them are also insufficient and of poor quality. On Monday, she said, her only meal consisted of a bun with butter, a bottle of cold coffee and one bar of chocolate. “The food in the initial days was good and the portion size was enough to get you through the day. How do they expect people to keep working without proper food and water? In such a situation, if we fall ill no one will be there to even look after us,” she said.
Mini Joseph, joint secretary, Joint Federation of Nurses, said: “If there are four nurses on duty, only one or two get PPEs, while the rest have to manage with only masks and gloves. Everyone from sanitation workers, to lab technicians and even nurses are risking their lives but not everyone is getting proper protection. Who gets to decide who gets safety gear and who doesn’t?”