It has been six months into the global COVID-19 pandemic and four months into the lockdown in the country, yet the central government-run ESIC Hospital in Okhla still hasn’t managed to get COVID-19 protocols in place. The hospital has no proper isolation and triaging area for patients and the ICU staff are not given proper personal protection equipment. ESIC Hospitals are a part of ESI Corporation under the Union Labour ministry.
Recently, a 20-year-old patient who had tested negative on June 27 while in the isolation ward was moved to the ICU. In the isolation ward, the patient was kept along with COVID-19 positive patients. The patient tested positive for COVID-19 on July 7 and died due to respiratory complications on July 11. The ICU is now sealed for three days for sanitisation. Two other ICU patients who had come in contact with the 20-year-old patient have been moved to isolation wards.
After the patient tested positive, the ICU staff were given permission to wear PPE. But, by then the damage had been done. Four ICU staffers have tested positive for COVID-19. Of the four ICU staffers, who tested positive, one is pregnant. After this fiasco, the hospital ordered 50 ICU staff, including doctors, nurses, technicians, nursing support staff, housekeeping staff and security guards to stay at home till Monday.
“All the ICU staff have been told to stay at home until Monday, after which they would be informed about the hospital’s procedures. The ICU will be closed till July 14,” explained a health worker from the hospital. The person did not want to be named.
In the ICU, the hospital was providing only N95 masks, face shield and gloves even though patients had to be intubated. According to guidelines released by the Ministry of Health and Family Welfare, those working in the ICU must be provided the ‘full complement of PPE as aerosol generating activities are performed’. A full PPE suit consists of goggles, face shield, masks, gloves, coveralls, head cover and shoe cover.
“The hospital has been violating guidelines for a long time. Several medical workers complained, but the administration did not want to listen. There is no COVID-19 testing facility either at the hospital They should look at adding that or find a lab from where they can get the swab results within a day. Currently there is a waiting period of more than 48 hours before the COVID-19 test results come. An RT-PCR test takes only 4 hours to be done. Why is there a delay,” asked another health worker at the hospital.
In hospitals, the PPE is supposed to be worn by doctors, nurses, ward support staff, house-keeping staff and security guards. It protects them from direct exposure to SARS-CoV-2 virus.
The staff have been complaining about the lack of PPE to especially the ICU staff. “We are not a COVID-19 hospital, but the patients who come may have or could test positive for the virus during their stay in the hospital. So, at least the ICU staff should have been provided with PPE kits from the beginning as the staff has to perform intubation of patients. This releases aerosols,” explained a health care worker.
However, the ESIC Hospital’s Medical Superintendent Dr Deepika Govil disagreed. “Our hospital is a non-COVID hospital. We are running a 20-bed isolation ward. We are not supposed to keep any COVID-19 positive patients in our hospital. According to that we are taking all precautions. All health workers are given protective equipment in the hospital. We are not denying any protective gear to especially ICU staff. They have all been given PPE kits for two-and-a-half months. Several staff have tested positive and now 4 ICU staff have also tested positive after June 8. Since ours is not a COVID-19 hospital, it is very difficult to say if they have got the infection from outside or from the hospital,” said Govil.
She said that the ICU was not sealed, but simply closed for disinfection. “We continually perform such disinfection measures regularly. We sanitise whenever there are no patients in the ICU,” underscored Govil.
According to an RTI response, a total of 102 PPE kits were provided to ICU staff for more than 3 months. There are at least 3 doctors, 20 nurses, 8 nursing staff, 5 technicians and three security guards. “This RTI response is also not correct. How could so many people have used only 102 PPE kits for three months? This means they are sharing PPEs. In reality, no one in the ICU were using PPE until July 7. After the patient tested positive, the staff were asked to borrow from the casualty department. The hospital is not giving out the truth,” explained a healthcare worker.