A Corona Warrior’s Tale of Woe

This is a guest post

Day 75 of lockdown:
More than 2 months of lockdown have passed by in a haze.

On 21st March, our PM declared a nationwide lockdown. The next 10 days resident doctors spent in a limbo wherein we wondered about the upsurge of cases, what measures would be taken to contain them, and when would the public healthcare system be hit. What we didn’t anticipate is how badly it would be hit and how fast it would crumble.

I’m an exam going resident who got relieved of my duties as a resident on 1st February of this year. I was expected to give my International Council of Ophthalmology examination on 20th April and my M.S. Ophthalmology theory exam on 15th of May. By June end I was supposed to be a free bird.

Cut to 1st April, all exam going residents who were neck deep in exam prep were recalled back for duties. Specifically covid duties. All exam leaves were declared cancelled until further notice. ICO flashed status of our exam as postponed to 3 months later. Shit was about to hit the fan.

Those of us who were in the same city rejoined immediately, others from different cities and states scrambled to find transport to rejoin as the lockdown was in full swing and all trains and flights and cabs were suspended. We were given circulars saying legal action would be taken against anyone who didnt rejoin work. Our degrees were already at stake. A friend of mine spent 25000 and hired a car to come from Bangalore to Mumbai. There would be no mercy shown to those who couldn’t show up.

I work at Sion Hospital, one of the busiest in Mumbai. There was buzz that Nair hospital would soon be converted into a COVID designated hospital. Sion was referring positives to Seven Hills, Kasturbha. We were managing the workload quite efficiently.

The first danger started when Dharavi got its first COVID positive case. Dharavi, last recorded population of over 8 lakhs, is situated exactly behind Sion Hospital, and its residents form a major chunk of our patient load. When cases started emerging from Dharavi, initially in single digits, then rapidly in double and triple digits, we knew Sion Hospital was about to go under the COVID wave.

It was days before the State Government finally accepted that community spread had occurred in Mumbai. Community spread is spread basically which cannot be contact traced, direct contacts are already traced and tested; it’s very difficult to contain a disease once community spread occurs. By the time the government declared community spread, Sion hospital was already receiving enough COVID cases that it could no longer refer to any other hospital. We had become a covid and non covid hospital now fighting to strike a work balance. Residents were shunted from departments to work in COVID wards in shifts. The Category A residents of specialties like Chest Medicine, General Medicine, Anesthesia would lead the fight; specialties like Obstetrics and Gynecology, Radiology, ENT and Ophthalmology were to struggle alongside.

Ophthalmology as a specialty doesnt equip us to deal with either respiratory distress or cardiac arrest. Systemically unstable patients are encountered by an ophthalmic surgeon as frequently as chilly weather is encountered in Mumbai. Once in a blue moon. I was petrified of what I would even do in such a scenario. I hadn’t declared a single death in three years of residency. More precisely, none of my patients had died in three years because systemically unstable patients are always stabilised before we operate on them.

Thrust into an unending vortex of community screening, ward duty which was putting angiocatheters, catheterizations, blood collections, vital monitoring, paperwork with alternate managing of department duties- casualties, OPD and OT it started looking like residency would never really be over. Exams or no exams, this was war and everyone had to participate.

Everyday we would get some new protocol from the authorities; some change in the period of quarantine we would be offered- which decreased from 7 day work and 7 day quarantine to 5 day work and 2 day quarantine to 9 days of work and 6 days of quarantine to 14 days of work and 9 days of quarantine and so on. Apex institutions disagreed with the Municipal Corporation which disagreed with institutes which disagreed with departments. The result? Residents were testing positive by the dozens.

Within a couple of weeks, 61 residents at Sion Hospital had tested positive, some were critical, all were stressed and overburdened. Meanwhile Nair was declared COVID only and referrals of non covid patients to Sion had of course increased substantially. Sion was crumbling under the weight but apparently nobody except residents could see the cracks.

One afternoon a video from Sion became viral. It was shot by the relative of one of the COVID positive patients and showed body bags on beds next to living patients. It didnt take long for everyone from civilians to the media to the government to raise questions about how Sion hospital was being managed so badly. They questioned the humanity of the doctors and the delay in transportation of dead bodies. What they didnt question was the reason behind it. They didn’t question the lack of goverment investment in public healthcare since decades. They didn’t question why noone bothered to rectify this when shortage of beds and manpower has been an issue way before this pandemic. And they definitely didn’t question whether the government had let doctors down by sending them to battle ill equipped and underprepared.

Residents were being made to work inhumane hours but noone had the energy to really speak against it because things were getting worse by the day. We lay in wait for the new resident batch to join so that we could get some respite. New circulars kept popping every day – “Residents will receive COVID work benefits of rupees 300 per say”, “residents will receive a pay hike”. Meanwhile our salaries were credited late, with a 10% tax cut, no COVID benefit and definitely no stipend hike.

A stay order on the state merit list of new incoming resident batch was finally lifted a week ago, which gave us some hope. Hope that was immediately squashed by the administration which issued a circular saying no matter when the new residents joined, we would not be relieved of our duties till 31st July at the earliest. No word about our exams or if we would get a preparatory leave period.

Meanwhile residents were thrust to the forefront while everyone else cowered conveniently behind us. We were being called “corona warriors” but we felt nothing more than a scapegoat. There is no glory in working a PPE suit so impervious your sweat forms puddles around your feet or taking swabs going from house to house in 40 degrees in a PPE suit.

I wont even get into how worried our families were during this ordeal. My mother lives in Nagpur and with every phone call she was becoming increasingly worried and upset and I was becoming increasingly quiet. She asked me to leave everything and just come home. Nothing is more important than staying healthy, she said. Of course, I didn’t listen to her. Though none of us had signed up for this, this was a price we would all have to pay, whether we liked it or not.

What was awful to watch was not the fact that we all were being coerced into work, but the fact that not only were the people of Mumbai doing nothing to abide by the lockdown, but our administration wasn’t supporting us with a well formulated protocol either. There was complete chaos in the way the pandemic was managed, right from availability of PPE and masks, to overlapping duty schedules, lack of facilities to isolate positive asymptomatic resident doctors and symptomatic ones, lack of facilities to keep asymptomatic positive patients and lack of tests. The government was refusing to let us test anyone asymptomatic, even those who had known contact with someone who had turned positive. Because of this, asymptomatic carriers were running rampant, and there was no way to identify who would be positive next until a 60+ person landed in respiratory distress in the emergency services.

Instead of focusing on things like getting adequate PPE for residents, making sure they got salaries and other covid benefits for their services, their food needs were taken care of; airplanes were busy showering petals from the sky.

Policeman had by this time given up on checking ID cards. Essential and non essential people were out on the streets. We were getting the usual trauma like assault when everyone was supposed to be maintaining social distancing and staying indoors. Some routine complaints like watering of eyes and refractive error were resurfacing. Clearly the pandemic seriousness had not permeated to all sections of the society, and even if it had, not even was being done to mitigate it.

Amidst the chaos, the fear and frequent blasts of depressing bulletins, residents were waging a war against the virus that had left life as they knew it in shreds. Managing to treat patients to the best of their abilities, bringing smiles to cured patients, delivering babies, operating tumors and saving lives. All while praying they wouldn’t contract the illness, praying they would be able to survive this pandemic with only emotional scars and nothing more.

Now here we are, still exam going, still very much working, still frustrated, overburdened and exhausted. With no end of the pandemic in sight (the peak is yet to come) and monsoon around the corner, which itself brings a tidal wave of dengue, malaria and leptospirosis and no manpower nor hospital facilities to deal with the upcoming doom.