By Sushil Kutty
Did you know that most Covid-19 deaths take place in the hours between midnight and dawn, extending up to when a new workday begins with a change of doctors and nurses and other hospital staff? Late in the night hospitals and patients are left to the care of junior doctors, including PG students, who have little or no powers to take critical decisions required to save the lives of the critically ill at their life’s end. Hence the relatively more deaths in the hours after midnight, the “doldrums of the day.”
The hours after midnight – the witching hours, so to speak – span a time-period when almost nobody has reason to be out working his a## out. In the Covid-care hospital, where an ounce of oxygen can make the difference between life and death, not having someone of rank high enough to enforce orders is when the Grim Reaper gets access to floundering souls.
Hospitals, especially those attached to medical colleges, are known to turn from efficient to inefficient when the heads of departments have all gone home. and if the fellow with the keys to oxygen cylinders loses his temper and turns gruff, it can spell doom for some poor soul.
Also, the hours after midnight are when exhaustion sets in. Contrary to common belief, doctors are neither god nor superhuman, and not everybody who has taken the Hippocratic Oath is a “corona/frontline warrior”, not after deaths have become commonplace in the Covid-hit and only the weakest in the chain-link loses sleep over them.
The Internet is strewn with videos of Covid-19 patients left to die in private nursing homes by doctors and nurses who had fled the establishment. It’s a simple theory: Who knows better of the rickety healthcare infrastructure in their healthcare facilities than the doctors and nurses who run them? In fact, hospitals all over India are strung for healthcare professionals. And the entire healthcare system of the country is bending over under the sheer weight of inadequacies, and expectations.
Dr. Devi Prasad Shetty, paediatric cardiologist and Chairman, Narayana Health, has warned about the critical shortage of healthcare professionals that hospitals are facing even as a third Covid-19 wave threatens. He says unless “young doctors” – most of whom are opting to sit out the pandemic at home to “prepare for ‘NEET” – are incentivized, it’ll be impossible to get out of the woods. By “incentivize”, he’s not talking of incomes, by incentivizing, he’s speaking “grace marks in Neet” and other career-enhancing sops, those which will pull young doctors to step out of cubby holes and into the vacuum created by Covid-19.
As a matter of fact, upwards of a 1000 doctors have so far lent themselves to be sacrificed to Covid-19, and there’s a genuine fear of death by Covid-19 in them. Both doctors and nurses in the frontline are wary of the “Covid-ICU.” Dr. Shetty says it’s getting harder and harder to persuade doctors and nurses to do duty in Covid-ICUs. If and when a third Covid wave hits India, there would be an acute need for Covid-ICUs and doctors and nurses willing to work in these intensive care units, which is not a safe environment. Therefore, the need to vaccinate parents in the age-group 18-45 ASAP, says Dr. Shetty. For, when the children get hit by Covid, it will be a different situation in the Covid-ICU. At least one parent each child will have to be stationed in the children’s Covid-ICU to take care of each child. That’s because managing a Covid-19 child will not be easy for nurses.
The bottom-line is India will have it entirely uphill if and when the dreaded third wave strikes and children start getting counted in the toll. Worst of all, the Modi Government has with its acts of omission and commission not done enough to enhance confidence. Right now, all that the Centre can do is salvage credibility, which is very scarce these days of the ‘2nd Covid wave’.
But, the odd black sheep apart, including those who have fled their own healthcare establishments out of sheer Covid-fright, the majority of healthcare professionals cannot be blamed for the tens of thousands of Covid-19 deaths. There are states with fairly stout healthcare infrastructure and there are states with rickety systems. Government hospitals and ‘sarkari’ primary healthcare centres in the countryside are ill-equipped and severely understaffed.
There are reports of Covid-hit dying at the doors of primary healthcare centres in Bihar and UP, and tragic “human interest” stories have become the norm; of triggered people quarantining villages in Bihar and Uttar Pradesh, allowing entry to known faces only. This is apart from the tales of floating bodies and burials on the banks of the Ganga linking Varanasi in Uttar Pradesh to Buxar in Bihar.
That said, both the Modi Government and state governments are tightening the screws on Covid-19, and there’s a marked effect on “Covid positivity rates”. The numbers of dead, however, continue to spell despair. May 2021 was the deadliest month for the national capital region of Delhi, and Maharashtra reported 17,779 deaths for the first 22 days of May.
That being said, every death is one too many, but there are some that hurt just that bit more, like that of a single mother who was allegedly “allowed to die” after she complained of being raped by three hospital employees in the Covid-ICU of a Patna hospital. Her single-daughter sat in protest with the body of her mother and #shutdownParashospital trended on Twitter, but the Nitish Government of Bihar chose #SavingPrivateHospitalParas instead. (IPA Service)
