Being the first contact, resident doctors face high risk

Health Department received plaints that specialists, senior faculty rarely attend to COVID-19 patients

When an 82-year-old patient was wheeled into the Chigateri District Hospital in Davangere in a critical condition on a hot afternoon earlier this month, his first point of contact was a postgraduate resident doctor on duty at the ICU.

The 27-year-old final year anesthesiology student, who was on duty that day, intubated the patient who had gone into respiratory distress and started treating him. The patient was a suspected COVID-19 case and was admitted in the suspect zone of the ICU. Though the patient later tested negative, there is no denying the risk factor in such cases.

Close contact

Resident doctors such as the anesthesiology student are often the first point of contact in many such cases. “We are under risk while intubating as the patient can fight against the insertion by gagging or other reflexes. Initially, we were doing it only wearing masks but now we have been provided face shields,” the doctor told The Hindu. “I was posted in the ICU that has both suspected and positive zones. I am now under quarantine after a week’s duty,” said the doctor.

A resident doctor from Bangalore Medical College and Research Institute who finished his COVID-19 ward duty at the Emergency and Trauma Care Centre has a wound on his nose at the point where the N95 mask sticks. “As resident doctors we are used to working in long shifts spanning 36 to 48 hours normally. But, it is suffocating to wear the personal protection equipment (PPE) continuously for six hours. This gets stretched to seven hours if we include the time spent on donning and doffing and bathing after duty. By the time we finish our shift, we are drenched in sweat. As we cannot drink water or use the washroom during our shift, most of us are experiencing dehydration, hypoxia due to decreased supply of oxygen, headache, dizziness, and fatigue due to carbon dioxide retention as well as skin rashes,” said the doctor.

Resident doctors are the backbone of most medical institutions, more so during the pandemic. The Health Department has received several complaints that specialists and other senior faculties are not attending to COVID-19 patients and pass on instructions to resident doctors. Following this, the department recently issued a circular asking the medical superintendents and district surgeons to prepare a roster and ensure that specialists attend to COVID-19 patients in wards. These frontline workers are also worried over the Health Department’s recent guidelines that has done away with the 14-day institutional quarantine for healthcare workers who have worn complete PPE without any breach while treating COVID-19 patients.

Quarantine worries

“We are working in COVID-19 wards risking our lives. A nurse in Victoria Hospital recently tested positive despite wearing complete protection. With most infected patients being asymptomatic, there are chances we may remain asymptomatic despite being exposed to the virus. Now we are sent to quarantine only if we show symptoms. Since we now go home directly after COVID-19 duty, there is a possibility of spreading the infection to others,” said another doctor.

Healthcare workers, who now feel this rule may discourage doctors from taking up COVID-19 ward duties, had appealed to the department to withdraw the circular. However, Jawaid Akhtar, Additional Chief Secretary (Health and Family Welfare and Medical Education), said that the circular was based on the World Health Organization and government of India guidelines. He argued that a similar system was being followed in other States as well, and would be essential if the case load increased.

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