Covid-19 warriors find succour

Hospitals have set up helplines and counselling centres to help healthcare workers tide over fear and depression. 

Doctors, nurses and hospital staff attending to pandemic patients are battling a host of problems: fear of contracting the virus, depression over not being able to meet their families, and the looming threat of salary cuts and job losses.

Dr Suhas Chandran, assistant professor, department of psychiatry, St John’s National Academy of Health Sciences, has been in the forefront of helping them cope.

“Each day the healthcare workers return home, it is with the fear of being infected, or worse, infecting near and dear ones. They go through this repeatedly, each time they step out for duty,” he says.

Some doctors and nurses are shunned by their neighbourhoods. “This leads to stress, worry, sleep disturbances because of frequent shift changes.”

A majority of professionals forego sleep, skip meals and forget personal commitments to ensure patient care.

“Many have quarantined themselves and quarantine has been associated with acute stress reaction, depression, insomnia, suicidal thoughts and post-traumatic stress reactions. Doctors are human too, and the fear of death is very real. Several doctors are drafting wills and even making goodbye videos for their family,” he reveals.

Donning PPE

Donning personal protection equipment (PPE) is not easy. Most doctors say they are uncomfortable being in it.

Rajiv Gandhi Institute of Chest Diseases, which has a dedicated Covid isolation ward, has at least 10 doctors on duty at any time.

Dr C Nagaraj, director, has donned PPE. “One has to wear it for a minimum of four hours and a maximum of six hours. It is suffocating and you can’t drink water, eat, or even use the washroom,” he says.

Keeping these restrictions in mind, PPEs are usually given to healthcare professionals below 40. The hospital has dealt with viruses before, with H1N1, SARS and patients being treated here and healthcare professionals are given adequate training on how to don and doff (take off) PPE, he says.

 “To start with, we ensure we get the best quality of PPE. This is the first step toward instilling confidence in healthcare staff,” explains Dr Nagaraj. He adds that care is also taken to carefully dispose of PPE in conformity with ICMR guidelines.   

Committee at work

The government-run Victoria Hospital has a wing to deal with Covid-19 patients. Dr C R Jayanthi, director and dean, Bangalore Medical College and Research Institute, has instituted a PPE committee for staff working at the hospital.

“We buy the PPE only after the committee has certified it is of good quality,” says Dr Jayanthi.

She hasn’t received any such complaints about the discomfort. “But I have heard some professionals have had to wear diapers under the PPE because they aren’t allowed to use the washroom for six hours,” she says.

The hospital has a psychiatric and counselling centre to address their concerns.

Dr Swetha Sridhar, dermatology and second year resident at MVJ Medical College, who is on Covid duty at Victoria, says, “Being in a PPE is uncomfortable because you have to wear three layers and keep changing the gloves. You can’t use the washroom, eat or drink water when you are wearing the suit.” 

She says she has experienced fear. “But if you are taking adequate precautions, there’s no need to fear. Duty comes first,” she says.

Economic stress

Dr Sanjiv Lewin, chief of medical services, and Dr George D’Souza, dean, St John’s Medical College and Hospital, says an additional worry among medical staff is salary cuts and job losses.

That is because hospitals are also under financial stress, with no revenue coming for a month from OPD services and surgeries.

“We need to protect everyone in the health care systems, government and private, especially those in the lower rungs. You could increase or advance salaries of these categories across the board, and go forward in a phased manner,” says Dr Lewin.

Dr D’Souza suggests revenue generation through paid tele-consultation, home delivery of medication and home laboratory sampling.

Don’t ignore stress

Dr Roshan Jain, senior psychiatrist and deaddiction specialist, Apollo, says stress affects healthcare workers’ enthusiasm to provide care for others. He thinks it important for professionals to acknowledge and accept their emotional reactions. “Denial and avoidance of these emotions will only make it worse. Having good quality communication (with peers and seniors) can allay individual and collective concerns at the workplace,” he says.

Tips for healthcare professionals

Your safety comes first: Make sure you are wearing all protective equipment before dealing with any suspected cases.

Take care of your basic needs: Ensure adequate rest and sleep, and keep yourself hydrated. Take a short walk from time to time, especially after a very challenging or distressing hospital shift.

Stay connected: Keep in touch with your significant other, family and friends. 

Peer support is important: Look after each other. Your peers and colleagues are your family away from home. Have regular debrief meetings, and just talking to each other helps.

Get help: Avoid self-medication. Contact a helpline if you would like to talk to a mental health professional. 

Help at hand

The Indian Medical Association (IMA) is running a helpline for doctors, nurses and others in healthcare. The helpline is available from 9 am to 9 pm. The numbers are 9999116375/76.

Green Oak initiative has also started a helpline for medical staff that works from 8 to 10 am and 5 to 8 pm. The number is +916366447484.