The COVID 19 has taken a heavy toll oN the health care workers in our country. Doctors, nurses and other paramedics who form the backbone of our fight against the ravages of the pandemic are invaluable weapons in this war. Losing them is akin to getting the fighting machine depleted to the aggressor, which in this case is a deadly virus. As per the WHO director 1,18,000 health care workers have so far succumbed while carrying out their duties since 2020.
We have till date lost 1167 doctors in this country since the beginning of the pandemic last year out of which 420 succumbed to the second wave which is continuing. The stories of senior doctors like Dr K K Aggarwal and Dr Himthani from New Delhi are fresh in our minds. We also remember Dr Vivek Rai who committed suicide finding him helpless in the casualty of Max Hospital, New Delhi to handle very sick patients who could not be admitted because of no beds being available. Highest deaths have been reported from Delhi with 100 casualties, followed by Bihar (96), Uttar Pradesh (41), Gujarat (31), Andhra Pradesh (26), and Telangana (20). Jammu and Kashmir has reported 9 unfortunate deaths so far. Sadly only 3% of the 420 doctors lost this year after the availability of the vaccine had been vaccinated.
These numbers are far in excess as compared to any other country including European states, USA and UK. The total deaths reported from these countries had been 278 in May 2020 when COVID had peaked its mortality. Italy had 122 casualties followed by Iran with 44 doctors dying. The numbers in USA and UK were much smaller 15 each. Compare our numbers of 747 doctors dying in the year 2020. No death of doctors from these countries has been reported during the 2nd wave of COVID. More than half the doctors who lost their lives in our country were general physicians. Specialists of different disciplines, including pulmonology had a much lower mortality. The alarming numbers from our country are despite the fact that total number of cases in USA since the start of the pandemic has been much more than in India (3.31 crores vs 2.67 crores) with higher mortalities (5.89 lacks vs 3.04 lacks)
Death while performing duty is the doctor’s ultimate sacrifice. This is further compounded when physicians unknowingly infect their families. General public may not comprehend the importance of self-isolation measures to contain the COVID-19 pandemic until a physician dies fighting the virus. Physician deaths from COVID-19 may vary between countries due to different public health resources, governmental policies and controls to enforce quarantine and Covid appropriate behaviour. Countries like Singapore, South Korea and Taiwan exercised decisive early actions and had hardly any deaths of physicians.
Health care workers endure considerable mental and physical stress caring for patients with COVID-19. There have been reports of physicians of the older age groups dying of exhaustion and cardiac decompensation. It is important for the hospitals to provide mandatory rest, meal breaks and organize shifts to prevent exhaustion, dehydration and malnutrition. Senior doctors with co-morbidities should be given consideration and not kept on the front line and be kept for duties other than managing the patients who are still positive for COVID test. In the initial periods of the COVID pandemic in 2020 inadequate personal protective equipment’s (PPE) were commonly cited a reason for deaths but there is no such shortage now, yet we continue to see these unfortunate happenings. Proper donning and doffing techniques are necessary. In fact, in hospitals and larger setups a safety monitor and a trained examiner is needed to ensure that proper safety measures are being taken to avoid inadvertent contamination.
In these troubled times the government and NGOs need to come forward and help physicians and other health workers to take care of their families by providing essential things during the lock downs and keep an empathetic attitude to keep their morale’s up. Giving them significant monetary allowances is also a right step in this direction and has been done by many state governments.
The most important reason of the striking reduction in the mortality of the general population and also the health care workers in Europe and USA is the very aggressive and sustained vaccination program in the current year. In USA the new Biden government has set the target of achieving 70%, 2nd dose vaccinations by July 4th 2021. A number of incentives in the form of lotteries etc are also being offered. In some states like California masks are no longer necessary because new infections have become rare. Europe is planning to open their resorts for tourists because of the numbers becoming very small. A certificate of having both vaccinations done is however mandatory.
We need to accelerate our vaccine programs. For health care workers it needs to become mandatory. In spite of the covid vaccine being available since January this year and health care workers being on top priority the vaccination rates are far from being optimal. The overall rate for the country for single dose is 89% according to the official communication of 22nd May. In Delhi the percentage is only 78%. The maximum rate reported is 99 % in Chhattisgarh followed by Madhya Pradesh 93% and Rajasthan 91%. For Jammu and Kashmir, the single dose administration has been done in 81% and for 2 doses only 47%. Shortage of the vaccine is one of the issues but reluctance on the part of doctors continues to be a problem. We need to strengthen this force as much as possible and make 2 doses of vaccination mandatory for them.
It is a full-fledged war and doctors are the most important weaponry we have. It is a shame that we have already lost 1167 of them while fighting for the life of COVID victims. Country cannot afford it and it needs to be halted at all costs.
Prof Upendra Kaul is a reputed Cardiologist, Founder Director Gauri Kaul Foundation. He is a Recipient of Dr B C Roy Award and Padma Shri