“We have turned doctors into gods and worship their deity by offering up our bodies and our souls — not to mention our worldly goods. And yet paradoxically, they are the most vulnerable of human beings,” wrote Erich Segal, in his 1988 novel Doctors. It is these words that come to mind as I speak to 22-year-old Shravan*, an intern at a government medical college in Hyderabad. For 15 days, the young student-doctor had been posted at the Fever Hospital in the city, overseeing the coronavirus isolation ward.
For a little over two weeks, Shravan was one of several interns, fresh out of their final year of MBBS, taking turns at the hospital. They had to handle individuals who tested positive for COVID-19. The interns were given personal protective equipment (PPE), including N95 masks, gloves and oversuits, and sent to staff different wards of the hospital.
“People who are suspected to have contracted the disease are admitted to the isolation wards. Their samples are taken and sent for testing to confirm if they are positive for COVID-19 or not,” he explains, adding, “There is no way of knowing if someone is positive for the virus until after test results come back.”
Across the world, as doctors suit up to tackle those affected by the coronavirus pandemic, a plethora of younger doctors have been called upon to aid in medical efforts. While the United States has relaxed several of its regulations pertaining to foreign graduate doctors (those who have studied medicine outside of the country), young medicos have found innovative ways to help out. Medical students, whose classes have temporarily been halted, have been staffing call centers, sourcing PPEs and even babysitting for consultants who are on-call.
For medicos like Shravan, who are just beginning their careers, the pandemic has proven to be a real litmus test, with many questioning how this would shape the rest of their lives.
“There are doctors who are very senior to us who don’t know much about this disease or its progression. It really makes you look at the knowledge you’ve acquired over these past few years and you are able to realize how little you know,” he says.
While doctors like Shravan have been forced to face the fire as part of their medical studies, for others, like one young doctor from Chennai, the pandemic came at a time when she was considering leaving medical practice in the country.
“It was unbelievably hectic. I would have never imagined myself in this position a few months ago when I joined work,” states 25-year-old Dr Swathi*, a junior resident at a private hospital in the city. Just before the outbreak scaled up to a global pandemic, she had been considering moving to Singapore to pursue her postgraduate studies. Her travel plans were postponed due to COVID-19 and she opted to continue working for the time being.
Swathi has been working in the emergency room of the hospital for the past week, posted there to triage individuals who may have been infected with the novel coronavirus (SARS-CoV-2).
When a suspected COVID-19 affected individual is brought to the hospital, they are taken to the separate casualty ward demarcated for such cases. Here is where Swathi steps in and assesses them.
“Every patient has to be viewed as though they are positive for the virus. We have to do this so that there is less chance of the infection being transmitted to us. Of course, we are still at risk of being exposed to the disease,” she points out.
After a week-long shift, she has been told to self-quarantine for one week. She has also been started on hydroxychloroquine as a precautionary measure.
“I had to get an electrocardiogram done and then had to sit with another physician who told me how to start on the HCQ. He also advised me about the side effects I needed to be aware of. This is not a drug that should be taken unless advised,” she emphasises.
It is not just patients that doctors have to view under the lens of this disease, but also anyone they come in contact with is put at risk by association.
“As part of my profession, I am exposed to hundreds of people everyday who may potentially be carrying the virus, whether it has been detected or not. That not only puts me at risk, but even the people I meet outside of the hospital at risk too,” explains Dr Srinivas, a junior resident in nephrology at a private hospital in Hyderabad. He too has been doing shifts in a COVID-19 isolation ward.
He and others take extensive precautions when entering the hospital at the start of the day and before leaving after their shift, to ensure that there is as little contamination as possible. After reaching home, he has to take extra care to avoid contact with his family.
“We have heard so many stories of doctors and nurses and other healthcare workers not just getting sick themselves, but also having gotten their loved ones sick. It’s a risk and it’s one thing that we are faced with on a daily basis,” he adds.
Despite stringent safety precautions, medical personnel on the frontlines of the emergency continue to put themselves at risk of exposing themselves and their loved ones to the disease.
“But what happens to us when we aren’t given the most basic of protective gear?” questions one postgraduate student from Eluru’s Alluri Sitarama Raju Academy of Medical Sciences (ASRAMS). At the medical college in Andhra Pradesh, students have alleged that safety precautions are not being taken and that adequate gear is not being provided.
Doctors who speak out openly about PPE shortage have been suspended or threatened with suspension. On Wednesday, news of the suspension of Dr Sudhakar Rao, an anesthesiologist from Andhra Pradesh, caused outrage. He was suspended by the Health Department for “spreading false news” that there was a lack of PPE and masks in the hospital.
The situation is similar not only across the country, but globally as well. Even as doctors, nurses and other healthcare workers are fighting the battle against the disease at great personal risk, many are hopeful.
“There are some things that we, as teachers, cannot teach our students. There is no course which can prepare them for what they face now. Almost suddenly, they have had a lot of responsibilities thrust upon them. No amount of teaching in a classroom can provide them with the vital lessons they are learning now,” states general physician Dr MKS of a branch of the Indian Medical Association (IMA) in Tamil Nadu.