Epidemic exposed how little political establishment cares for safety and well-being of medical personnel

The huge toll from COVID of 5 lakh Indians, including 1200 doctors, 120 nurses and 150 ASHAs, has failed to make our political establishment re-evaluate its lopsided priorities

Epidemic exposed how little political establishment cares for safety and well-being of medical personnel
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Dr Siddhartth Taara

Aping countries which have superior health Infrastructure to contain an outbreak than ours, Union Ministry of Health and Family Welfare has decided to cut down isolation period from 7 to 5 days. Evidence against this policy is growing with some studies suggesting that a shorter isolation period can increase viral transmission.

An infected individual can be in acute phase of the disease till 5 days and continue to shed live virii well beyond the end of 5 days of isolation. This reduction also applies to health care workers like doctors and nurses who can’t work from home or maintain social distancing from their team and patients due to invasive nature of their work.

The risk of transmission in hospitals can have catastrophic consequences, as it's not just patients that can infect staff, but personnel prematurely returning to work after an inadequate period of isolation can infect team members and worse, the severely ill in-patients, the elderly and other various high-risk populations of patients with co-morbidities that they treat.

Mounting administrative pressure exerted on policy makers by the dearth of healthcare staff to take care of the patient load in hospitals seems to be basis of this decision rather than sound scientific evidence.

It will be dishonest for any observer to blame it all on COVID-19. This dire situation was many years in the making in the Indian scenario.

The systemic problem of chronic and deliberate understaffing has been exacerbated by the needless delay in NEET-PG 2021 counseling that has essentially halved number of resident doctors, who are the flesh and blood of tertiary health care and decompensated the already anemic infrastructure.

It's premature to assume that Omicron has replaced Delta as the dominant strain; still, healthcare workers are being made to work long hours in high viral load environment.


What is more problematic is that the inadequate provision of quarantine quarters for personnel deployed in COVID-19 ERs, wards, ICUs and OTs. Resident doctors and paramedical staff have no option but to return to their homes after their shift, placing their family members with co-morbidities at risk.

Designating a room with independent entrance for self-isolation at home is an easy advise to give but for most young doctors, a shared room with roommates is all they have to call home.

Most medical institutes still lack adequate numbers of hostel rooms with attached toilet bathrooms for resident doctors where isolation at individual level is simply not possible. And for those who do not live with their families and have moved from another city, the cost of renting a room near their hospitals far exceeds the housing allowance they are entitled to.

They find roommates who may not be medical professionals and pool money to rent apartments nearby. Roommates and landlords can turn hostile during an outbreak. COVID-19 duty comes with stigmatization and fear of eviction for many who benefited most from provision of quarantine quarters in hotels.

Had there been such residential quarters already in campuses or near it, a lot of public money spent on hotels could have been saved.

Lack of manpower can only explain cancelation of post-deployment quarantine; it doesn't explain outright denial of quarantine quarters during the period of COVID deployment itself.

It is hard to ignore the abrupt and suspicious timing of this decision that coincides with the nationwide doctors’ protests. Hospital-hotel quarantine model was always expensive, but it rapidly became unsustainable when the doctors started protesting. Dissent is always expensive.

This epidemic has laid bare the neglect of public health care by successive governments, their lack of respect for HCWs and utter disregard for their lives, whether they work in Anganwadis or in apex medical centres.

One would have hoped that desperation, despair and dead bodies of 5 lakh Indians, including those of 1200 doctors, 120 registered nurses and 150 ASHAs would make our political establishment re-evaluate its priorities, but alas, the lives of Indian citizens, including those whom we call lifesavers, continue to remain one of the cheapest in the free world.

Who needs Wuhan when we have Lutyens’? The point source of this endemic of indifference in India has been on since long before COVID-19.

May be after decades of malnutrition deaths, we're past those the point where 5 lakh dead Indians would been a matter of national security or where safety of the families of our COVID warriors would have been a national priority.

Quarantine rooms were our barracks and bunkers in this war. They not only protected our families from catching infection from us but also saved us from catching COVID from our family.

Maintaining a healthy working population of doctors and nurses is exactly what this policy is failing, leaving everyone vulnerable. It's a security failure.

Ours is a society in which quarters for our living heroes are deemed too expensive but palaces for dead gods aren't.

In a civilized society, no HCW should been denied provision of quarantine quarters for the duration of COVID deployment. It's more of a matter of basic decency and ethics than epidemiology. Non-COVID patient shouldn't catch COVID in hospitals.

In a rational society, the isolation period should be increased back to 7 days from 5. Medical personnel who have completed their seven days isolation should test negative for Antigen on two consecutive days. RAT tests before rejoining is the bare minimum to ensure safety of our patients.

Any solution to the current crisis has to take into account the biology of this contagious pathogen and safety of patients and the personnel who treat them. Policies should not be devoid of science and empathy. Families of young doctors shouldn't be punished. Choosing the life of a healer is their crime and their alone.

I hope when another virus brings another pandemic upon our unprepared Infrastructure, it's just another wave and not a tsunami like the one we witnessed in the summer of 2021.

(The writer is general secretary of Progressive Medicos and Scientists Forum. Views are personal)

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