Why do most COVID deaths occur in the hours after midnight?

Most hospitals have a skeleton staff to see through the night. Young healthcare professionals do not have enough incentives either and a third wave will be more devastating, as Dr Devi Shetty warned

Representative Image
Representative Image

Sushil Kutty

Did you know that most Covid-19 deaths take place in the hours between midnight and dawn, extending up to when a new workday begins with a change of doctors and nurses and other hospital staff? Late in the night hospitals and patients are left to the care of relatively junior doctors who may find its difficult to take critical decisions. This has been cited as one plausible reason for relatively more deaths in the hours after midnight.

The hours after midnight – the witching hours, so to speak – span a time-period when almost nobody has reason to be working. In Covid-care hospitals, where an ounce of oxygen can make the difference between life and death, not having someone of rank high enough to enforce orders is when the Grim Reaper gets access to floundering souls.

Also, hours after midnight are when exhaustion also sets in. Contrary to common belief, doctors are neither god nor superhuman, and not everybody who has taken the Hippocratic Oath is a “corona/frontline warrior”, not after deaths have become commonplace in the Covid-hit and only the weakest in the chain-link loses sleep over them.

The Internet is strewn with videos of Covid-19 patients left to fend for themselves in hospitals facing an acute shortage of doctors and nurses. In fact, hospitals all over India are facing shortage of healthcare professionals. And the entire healthcare system of the country is bending over under the sheer weight of inadequacies, and expectations.

Dr. Devi Prasad Shetty, Cardiologist and Chairman, Narayana Health, has warned about the critical shortage of healthcare professionals that hospitals are facing even as a third Covid-19 wave threatens. He says unless “young doctors” – most of whom are opting to sit out the pandemic at home to “prepare for ‘NEET” – are incentivized, it’ll be impossible to get out of the woods. By "incentivize”, he’s not talking of income; by incentivizing, he’s speaking of “grace marks in Neet" and other career-enhancing sops, those which will pull young doctors to step out of cubby holes and into the vacuum created by Covid-19.

As a matter of fact, upwards of a 1000 doctors have so far died of Covid and there’s a genuine fear of death among healthcare workers. Both doctors and nurses in the frontline are wary of the “Covid-ICU.” Dr. Shetty says it’s getting harder and harder to persuade doctors and nurses to do duty in Covid-ICUs.

If and when a third Covid wave hits India, there would be an acute need for Covid-ICUs and doctors and nurses willing to work in these intensive care units, which is not a safe environment. Therefore, the need to vaccinate people in the age-group 18-45 ASAP, says Dr. Shetty. For, when the children get hit by Covid, it will be a different situation in the Covid-ICU. At least one parent of each child will have to be stationed in the children’s Covid-ICU to take care of each child. That’s because managing a Covid-19 child will not be easy for nurses.

The bottom-line is India will have it entirely uphill if and when the dreaded third wave strikes and children start getting counted in the toll. Worst of all, the Modi Government has with its acts of omission and commission not done enough to enhance confidence. Right now, all that the Centre can do is salvage credibility, which is very scarce these days of the ‘2nd Covid wave’.

There are reports of Covid-hit dying at the doors of primary healthcare centres in Bihar and UP, and tragic “human interest” stories have become the norm; of people quarantining entire villages in Bihar and Uttar Pradesh, allowing entry to known faces only. This is apart from the tales of floating bodies and burials on the banks of the Ganga linking Varanasi in Uttar Pradesh to Buxar in Bihar.

Every death is one too many, but there are some that hurt just that bit more, like that of a single mother who was allegedly “allowed to die” after she complained of being raped by three hospital employees in the Covid-ICU of a Patna hospital. Her single-daughter sat in protest with the body of her mother and #shutdownParashospital trended on Twitter, but the Nitish Government of Bihar chose #SavingPrivateHospitalParas instead.

(IPA Service)

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