‘We Are Gearing Up For an Influx of Patients’: TN Docs On COVID-19

Tamil Nadu government doctors tell how we should brace ourselves for an influx of COVID-19 cases.

Though doctors and nurses are on the forefront of fighting the COVID-19 pandemic, a section of them are facing discrimination from house owners and neighbours. Representative image only.

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“Now because of the curfew people are not coming until their symptoms are severe. And also it has just entered the state so wait for 15 more days, and the cases will start coming. This 21-day lockdown is very necessary but this is not going to be over soon. We can soon expect an influx of patients.”

Tamil Nadu has come to a standstill just like the rest of the country amidst a lockdown. The state's doctors are working on a war-footing to help those who have been diagnosed with COVID-19.

The Quint spoke to a few doctors in a leading government hospital in Chennai to find out whether adequate resources are available, whether we can expect an influx of patients soon and whether the state is prepared to handle this pandemic.

‘Now Only Elite Are Coming to Get Checked’

Dr Rakesh* (name changed), who works in the COVID-19 ward in a government hospital in Chennai, explained that as per the guidelines by the Director of Medical Education, the doctors working in any hospital in this specific ward have been divided into three teams. At any time only two teams of doctors will be working on shifts and the third team needs to rest for a week in quarantine. And the cycle repeats.

“This is to ensure that even if a few doctors are exposed to the virus, there is a backup team to attend to the patients. Technically, medical professionals need to be in quarantine for at least two weeks, but I believe that doesn’t seem possible,” said Dr Nirvin* (name changed), who also works in a government hospital in Chennai.

Dr Rakesh who has been working in the coronavirus special ward for weeks now, said, “Right now only the elite and the most aware people are coming to get themselves checked. One lady came from Bahrain, a country which has only a few cases, and she had only subjective symptoms. But if a person is traveling from countries where COVID-19 cases have been detected, then even if they don’t have a fever and just a dry cough, it is the rule that we test them.”

The Quint spoke to a few doctors who said that earlier the directive was to do tests only on those with significant travel history, contact history or high-risk people like medical professionals who would’ve been exposed to the virus. However, now the guidelines have been revised and anyone with respiratory distress and sore throat should be checked and tested, they said.

‘All We Ask For Is Better Protective Gear’

Chief Minister Edappadi K Palaniswami announced at the Assembly on Tuesday that doctors, nurses, paramedics and sanitary workers involved in treating COVID-19 patients in isolation at government hospitals will get a special payout of a month's salary.

When The Quint asked doctors in the state what their view was, Dr Rakesh* said,

“The one month extra pay is very good and we are glad, but all we ask for is extra masks and better protective gear.”

The doctors reiterated that the state is doing its best but they are ‘falling short’ in this aspect which is highly concerning.

“The protection is good but doesn’t protect from aerosol. It is supposed to be two layers which isn’t and doesn’t cover from the knee below.”

Dr Rakesh* (name changed)

Many doctors also told that since they’ve been in close contact with infected persons, they do not plan to return to their homes in the next 2-3 months.

A group of twenty doctors, nurses and medical professionals from the government hospital were tested after they were exposed to the virus. The results came as negative.

‘Brace Yourselves for the Influx of Cases’

As of 26 March 2019, the total number of COVID-19 cases in the state has gone up to 29, including one patient who died and two persons who have recovered. The state has tested 1,039 samples in all, screened 2,09,284 passengers, placed 15,788 people under home quarantine and 284 under hospital isolation. One of the doctors pointed out that it is only now after lockdown that middle-class and the marginalised have become aware of the pandemic, its symptoms and how the virus can spread.

“Now because of the curfew, people are not coming until their symptoms are severe. And also it has just entered the state so wait for 15 more days, and the cases will start coming. This 21-day lockdown is very necessary but this is not going to be over soon. We can soon expect an influx of patients.”

Dr Rakesh* (name changed)

Is TN Ready for the Influx?

While the country is on a war-footing to deal with this virus, a doctor pointed out that we need to keep in mind that people are suffering from several other illnesses as well, and need treatment for the same.

Dr Nirvin* (name changed) said that already there is a shortage of protective gear like masks and gloves in the other wards like casualty.

“As of now we have enough for COVID-19 care but I am not sure if we are stocked up for any calamity that comes our way,” he said.

“This will affect the number of beds for regular patients, the personnel like doctors, nurses and other medical professionals attending to regular cases will be reduced and so will resources like ventilators. Now this will impact the healthcare system. Everything is fine now but we should look out for this.”

Dr Nirvin* (name changed)

Another doctor said that the wise solution would be to arrange for hospitals with a number of beds that can serve as isolation wards for COVID-19 patients.

On Thursday, the Tamil Nadu Health Minsiter Vijayabaskar stated that an exclusive 350-bedded hospital with isolation ward, step down ward, ventilators and an efficient medical team is ready at Omandurar, Chennai. A doctor said a similar facility was being readied in Villupuram as well.

Testing, Recovery & Other Misconceptions

A doubt raised by a many people was if Tamil Nadu was right in declaring a patient ‘recovered’ less than two weeks after he was tested positive.

Tamil Nadu confirmed its first case of COVID-19 on 7 March when a 45-year-old man, who recently visited Oman, was tested positive. He was discharged on 17 March, and he, along with his contacts, are under quarantine for 28 days. Results of his two consecutive samples taken 24 hours apart tested negative.

Meanwhile in Kerala, the the first set of patients were declared as ‘recovered’ nearly 20 days after their admission.

So was Tamil Nadu hasty in declaring a patient ‘virus-free?’ Absolutely not, said doctors in the state.

Explaining, Dr Rakesh* told that if a patient is exhibiting symptoms visibly and is struggling to breathe, then he will require oxygen cylinders and ventilators. “But if the patients are asymptomatic, we can put a patient to test even in a week after observation. When it turns out negative, we can repeat the second test in 24 hours. So it is a case to case basis,” he said.

Dr Nirvin* added that symptoms can vary from person to person. “For some it can be just a fever, sore throat and cough or can be respiratory infections like severe breathlessness with a lot of sputum collection and blood in the sputum or can even lead to respiratory failure which means the patient will need to be incubated and put on a ventilator and yes, there’s death too. This is the broad spectrum of the infection,” he said.

He went on to say that these ‘swab tests’ are only 70%-80% accurate. “It is possible that a person can still harbour the virus in one’s body. Technically we should do the test to determine if a person is infected or not before ruling out anybody, but in India, we don’t have as many resources,” he said.

The doctors have only one message for you: Stay indoors and help stop the spread of the contagion. This can go a long way in saving so many people.