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Coronavirus: In the line of duty, till the last patient is cured
Covid-19 crisis: In the second week of March, the hospital’s administrators knew that it was only a matter of time before the hospital was asked to handle Covid-19 cases. They started discussing work plans with the doctors and other health care workers.
At 8am on Monday, March 16, a group of 47 health care workers reported for duty at the Rajiv Gandhi Super Speciality hospital in Delhi’s Tahirpur, aware that they would not see their families for at least the foreseeable future.
In the second week of March, the hospital’s administrators knew that it was only a matter of time before the hospital was asked to handle Covid-19 cases. They started discussing work plans with the doctors and other health care workers.
On March 16, just around the time everyone was waking up to the crisis, they implemented this plan, which involved everyone in the hospital working 14 days at a stretch, and then spending the next 14 days at government allotted accommodation — on campus, or at the nearby Hotel Leela — in a sort of quarantine to ensure they did not carry the infections back to their families and neighbourhoods.
Two 14-day cycles are almost over; the second cycle will end over the weekend. And the first batch of workers — nurses, doctors, technicians, housekeeping and security staff — that worked between March 16 and 30 will be back again.
“We came here mentally prepared. We knew that we would not be able to see our families for months. Now we will go home only when we have no Covid-19 patients left in our ward,” said Dr Ajeet Jain, who has been coordinating with authorities from across agencies – officials from the integrated disease surveillance programme, the testing centres, the district magistrates, and ambulance operators who bring in patients.
He has also been on call with agencies providing food, arranging transport for those who are discharged, and with the anxious families of the patients admitted to the hospital.
“My phone does not stop ringing. I get at least two or three calls every minute,” said Dr Jain, a cardiac surgeon by training and the nodal officer for Covid-19 efforts at the hospital. Between all the calls, he manages a two-hour nap, usually between 3 and 5 am.
His wife is a doctor in a mohalla (neighbourhood) clinic in the city, and he has been sharing tips with her on staying safe after reports of mohalla clinic doctors being infected started coming in.
“I learnt about all infection control measures and told her everything over video call. At least at her clinic, the staff uses N-95 masks, and all the patients follow social distancing to ensure that no one gets the infection,” said Dr Jain.
With at least 172 suspected and confirmed cases of Covid-19, Rajiv Gandhi Super Speciality hospital houses the second highest number of patients after the Lok Nayak Hospital near Delhi Gate. It is located right in the middle of one of the 23 hot spots for the infection that have emerged in the city.
All patients coming to the hospital are referred by state health department or district officials who call in ahead. An ambulance is sent to get them.
“A separate corridor and lift have been kept for patients coming in. The hospital staff come in from a separate entry,” said Dr BL Sherwal, director, Rajiv Gandhi Super Speciality Hospital, which also serves as a screening and sample collection centre.
A sample collection kiosk has been created away from the main building, where people can walk in, get screened and, if needed, give swab samples for the test. The hospital is also in the process of upgrading its microbiology laboratory to start doing the RT-PCR {Reverse Transcriptase Polymerase Chain Reaction} test for Covid-19. Currently, it sends the samples to four testing centres in the city.
The hospital has 200 operational beds, with 45 in the intensive care unit.
On Wednesday, there were five patients in the ICU. In the unit, doctors and nurses work in a 6-hour shift without a break.
“They all hydrate and visit the washroom before donning Personal Protective Equipment, and usually stay inside for the entire duration of the shift. It can be very taxing,” said Dr Jain.
Here’s what is involved: In the donning area, doctors change into hospital scrubs and slippers. They remove all accessories and wash their hands thoroughly. They then put on the shoe covers, the first set of gloves and the full body suit. Then, the N-95 masks are put on, followed by the goggles or face shield. Then comes the head cover and a second pair of gloves.
To keep lines of communication open, the doctors and nurses are allowed to carry their cell-phones inside but it has to be without any case and in a plastic bag.
“The nurses or junior residents on duty can communicate with senior doctors outside, so they are allowed to carry the phones inside. However, when they step out they have to sanitise the plastic bag, and then the cell phone before taking off their PPE,” said Dr Jain.
For those working in the general wards, the shift lasts for 12 hours with only two breaks – one for lunch or dinner and another for tea.
At the end of the day, all health care workers at the hospital have to change out of their duty clothes and take a bath before heading home. Which is actually not home. Even at the accommodation, they are asked to stay inside their rooms.
“They cannot go out. The food is delivered outside their door. All they have are their phones to communicate with their families and may be watch something. The next morning, they again wake up by 6 and after breakfast report to duty at 8am,” Dr Jain said.
Like Dr Jain, Dr Sherwal is on his phone constantly.
“There is always some or the other problem that comes up. Yesterday, we received the test report for a patient at midnight; (it was negative) she was with her two children (their tests too were negative). I decided to discharge her immediately. So, I had to coordinate with my team on arranging a vehicle for her,” he said.
After she left for home with her children, he complimented his team on the WhatsApp group before going to bed at 1am.
He is one of the few who gets to go home in Dwarka, 20km from the hospital. “When I reach home, I ask my wife to open the door and head straight to the shower,” he said.
