‘No matter the effort, we are unable to make them survive’

- April 20, 2021
| By : Sashikala VP |

Patriot speaks to nurses, who reveal how symptoms of the new Covid strain are worse this time – with hospitals in the Capital city short staffed, and many contracting the virus A couple of days earlier a video showing two Covid-19 patients sharing a bed at Delhi’s Lok Nayak Jai Prakash Narayan (LNJP) hospital bore […]

Patriot speaks to nurses, who reveal how symptoms of the new Covid strain are worse this time – with hospitals in the Capital city short staffed, and many contracting the virus

A couple of days earlier a video showing two Covid-19 patients sharing a bed at Delhi’s Lok Nayak Jai Prakash Narayan (LNJP) hospital bore witness to the overwhelming strain on the city’s healthcare system. The hospital’s 350 covid ICU beds are full and so are its normal 1,500 Covid beds, according to the Delhi government’s Corona dashboard.

We spoke with Eldho Elias, a nurse at the hospital’s Covid ward who says they are inundated with patients. He candidly spoke about how “scary” the situation has become, with patients dying despite all the effort that has been put in to save lives. “No matter what the effort, we are unable to make them survive. The outcome is just negative…every day we are seeing 2-5 deaths in each ward. In my ward (of 36 beds) we had a death this morning,” he says, sharing how difficult it is to witness the constant loss of life, something he adds, they try to overcome, “I just pray for strength.”

“I always wonder when I see families losing someone, about grief. Recently one family lost two members to Covid. These things really make you think, and I feel sad”. 

Patriot asked him before his evening shift began, if counselling was being given to them, he nervously laughed and said “there’s no time for that. We speak amongst each other, all of us, doctors, nurses, sanitation workers work as a team.”

Sometimes, there’s no time to drink water, forget going to the toilet — he says — in their official six-hour shift which extends to a couple more hours as they hand over their patients. Last year too, with LNJP becoming a Covid hospital he was in the frontline, and since April this year, he says, the fight has begun yet again.

Since last year he has also been away from his wife, who was pregnant at the time Covid pandemic started its influx in India. She had their baby in December, and staying away seems to be the less stressful of choices, Elias says.

For many frontline workers it may be so, as the wave of positive cases and deaths that Delhi is facing is incredibly worrying. In the last 24 hours it saw 23,686 new positive cases and 240 deaths. Speaking to someone like Elias, who is working to fight this pandemic, gives us a sense of just how bad things are.

Last year Delhi may have faced its first wave, but Elias, and other nurses Patriot spoke with say this time around it’s worse. “This time, respiratory problems are high. While normal oxygen saturation level is 95, there are many whose oxygen saturation is dipping to 60-70 and they are all requiring high flow of oxygen, of about 15 litres and up and along with that medicines have to be administered. But patients are collapsing”.

He points to many dying from blood clots. While there is a lot of discussion surrounding AstraZeneca vaccine causing blood clots, a study published in the journal EClinical Medicine by the Lancet found blood clots led to an increased risk of death by 74 per cent in Covid patients.

The study, led by Mahmoud Malas, MD, division chief of Vascular and Endovascular Surgery at UC San Diego Health, noted that overall, 20 percent of the Covid-19 patients were found to have blood clots in the veins. This gets increased for patients who are admitted to the intensive care unit to 31 percent.

The authors of the study explained that blood clots in the vein can reach the lungs and develop into a pulmonary embolism, resulting in a higher risk of death. Furthermore, blood clots in the arteries may lead to limb amputation if not treated surgically in time.

 High infection zone

We spoke with other nurses working in different wards of Delhi’s government hospitals to get the Covid scenario from their work sphere. They all mention high infection rate in staff members, high oxygen demand and a stressful time which never seems to end.

Delhi’s Chief Minister Arvind Kejriwal had pointed out that the city is facing an “acute shortage of oxygen” calling it an “emergency”. He tweeted that “In view of sharply increasing cases, Delhi needs much more than normal supply. Rather than increasing supply, our normal supply has been sharply reduced and Delhi’s quota has been diverted to other states”.

He also wrote letters to the Prime Minister Narendra Modi and Union minister Piyush Goyal. The latter instead has said that States should “keep demand under control”. Placing the onus on state governments he went on to say, “The demand-side management is as important as the supply-side management. Containing Covid-19 spread is the responsibility of state governments and they should fulfil this responsibility.”

But Delhi’s scenario is going worse, Kejriwal while imposing a week-long lockdown on April 19 said the healthcare infrastructure has reached its limits. Going by our report on the acute shortage of ICU beds, it is certain that hospitals at the current stage will be unable to help any more critical patients.

With most patients coming in requiring oxygen support, having a scenario with none to administer cannot be an option. Those working in AIIMS Trauma centre, dedicated for Covid patients have said that many are requiring oxygen. With a limited number of oxygen points, a nurse tells us, the slots become full and many are lined up. On top of that there is a huge shortfall of staff with many having themselves been infected with the virus.

In the second week of April, reports cited over 30 staff members of AIIMS, including doctors and nurses, had been found positive for Coronavirus.

Philomina Reggie, a nurse in AIIMS, had her first day in the Covid ward in this second wave on April 20. She says this time around the symptoms of patients is much more severe than before, “this time it’s worse”.

Philomina Reggie

And while the healthcare workers have to brave it out to help the infected, what is concerning, Reggie says, is the government cutting back on their allowances. “Last year we did not receive our dearness allowance, the Centre has even withdrawn insurance cover for health care workers who succumbed in the line of duty.”

A Rs 50 lakh insurance scheme was set up last year by the Central government for health care workers, but Pradhan Mantri Garib Kalyan Package (PMGKP) ended on March 24 leaving healthcare workers bare in the time when many are getting infected in this new wave.

What also does not sit right, Reggie says, is that there are no provisions being made for hotel or hostel facilities, an option which would be welcomed by many healthcare staff worried about infecting their family members.

Ajo Jose, who works in the emergency ward of RML hospital tells us he lives with his parents, his mother a retired nurse. “When I reach home, I go directly to the bathroom, take a shower wash my clothes and then step out. Even those who have taken vaccination are getting Covid, and many healthcare workers are turning positive.”

Ajo Jose

His last ICU duty was in the Covid ward in December, and before that in September in the normal Covid ward with 15 days of duty and 15 days free for quarantine. What is easy this time around is that they know exactly what protocols to follow, Jose points out. “Last year we would get new SOPs, protocols constantly.”

But in his ward the problem is that people who are undetected to be Covid positive are next to the negative patients. “Patients will come in with symptoms of high BP, Tuberculosis, stroke… they don’t know they have Covid, only when we test them, we find out. By then they would have ended up infecting others, and this is the problem we are facing and it’s happening because we have low beds.”

By the second week of March, he says RML started witnessing a slight spike of Covid cases but most didn’t require hospitalisation. But by the fourth week the people started requiring beds which he calls was an “exponential influx of patients”.

RML Nurses Union secretary Santha Sivarajan told Patriot that a total of 120 nursing staff have become positive, in the last month. “But there are no beds for the doctors, nor the nurses. 90% are in home isolation, and only when their health situation is really bad, they come for hospitalisation. But even then they cannot accommodate the staff.”

Sivarajan also says that even though there are family members of the staff turning positive, many have to come to work. “There is an acute shortage of staff. Many people are tired but have to come. And this is happening despite the fact that there are almost 300 nursing staff sanctioned, but not being inducted into duty. We have raised this but nothing has happened. Nurses are really suffering”. 

The shortage of staff scenario seems to be the case in all the hospitals whose nurses we spoke with. Even at Lady Hardinge Medical College, where reports have claimed staff members have contracted the virus, Neha, a nurse here tells us the shortage pertains. “Many of the nurses are coming positive for the second time”, this coupled with the constant threat of being infected, Neha says, gives home to “mental stress” which she calls as “torture”.

These nurses paint a grim picture of what is happening in the healthcare infrastructure of Delhi. While the second wave looks even deadlier for all the city’s residents, they are exposed to even more threat as they work in the frontline — with no guarantee of their own safety.

(Cover:  Medical staff in PPE coveralls attend to patients housed in the Shehnai Banquet Hall Covid-19 care centre attached to LNJP Hospital on April 15, 2021 in New Delhi, India // Photo via Getty Images)