Firstpost Podcast: How does a hospital prepare for coronavirus; an expert explains

How are hospitals dealing with the numerous patients who walk in with coronavirus symptoms? With the number of COVID-19 cases rising by the day, how are healthcare professionals and hospitals in India readying up for the storm that is to come?

In this episode, Dr Aiswarya speaks to Dr Uma Devi, professor of Medicine at Stanley Medical College in Chennai, who is currently in the front line of the coronavirus taskforce in Tamil Nadu. Dr Uma Devi explains what is being done to ensure strict hygiene practices in hospitals while taking us through the journey a patient goes through in a coronavirus virus ward. You can listen to the full episode here. Here is the full transcript of the interview.

***

This is Day 1 of the national lockdown for dealing with the coronavirus crisis in India. The front line healthcare workers have put the interests of their patients with COVID-19 infection ahead of their personal interests and that of their families. That’s the commitment shown by these professionals. Our appreciation for them goes beyond words.

I am Dr Aiswarya Rao, a paediatrician, and a public health consultant, and today, I talk to Dr Uma Devi, professor of Medicine at the Government Stanley Medical College and Hospital in Chennai. She has been working round the clock in the coronavirus clinic and ward set up by the Tamil Nadu Health Department.

***

Uma: Hello!
Aiswarya: Hi Dr Uma!

U: Yes, hello, Aiswarya!

A: How are you?

U: Yeah, I am… going on. Life is going on.

A: You are a front line medical professional, especially in this current coronavirus crisis. So I just wanted to talk to you and understand from you, how it is, being at such close proximity to this crisis that all of us are very unsure of.

U: Yeah.

A: I have a couple of questions for you and I will be very happy if you can very briefly explain to us, and I believe your answers and everything that you tell us will be very…erm…it will help us understand what the government is doing for us, and what it is doing for the people who will come down with the COVID-19 disease.

U: Sure..sure

A: I just want to understand how the Government Stanley Medical College in Chennai is gearing up to manage people who will be positive for coronavirus when they come to your hospital for hospitalisation.

U: So now, whenever a patient comes to us with a travel history, fever, cough, sore throat… so each day now the criteria is evolving. So as on that day, the Ministry of Health and Family Welfare is issuing a notification. So based on that day, we also evolve. So, it’s an evolving process. So, as of now, what the Ministry has told is, that people with a sore throat, fever, dry cough, if they come with a travel history from a corona-affected region, first, or if they come only with a contact, we divide them into whether they have symptoms or they don’t have symptoms. If the patient does not have the symptoms and comes from these affected areas, we advise them home quarantine. 14 days plus 14 days. A total of 28 days. They should be symptom-free. That is the strict advice that we give them. Now, in case they have mild symptoms, like cough, sore throat, mild breathlessness, we do two tests. One, we do a complete blood count and we take an X-Ray. Now all this is done in an isolated area. We are not sure of those patients.

A: Can you describe the facilities in your hospital? Did you have to create new wards, or, were existing wards turned into…?

U: No. We turned available wards… because this was a very acute need, and we cannot go for new spaces, whatever was available we used the resources and turned into an isolation OP — a COVID OP and restroom; the injection OP was shifted outside and those rooms were converted into rooms where services were required.

 

A: In your hospital how many beds are earmarked for this COVID

U: As of now, 31 beds are ready

A: And can you describe the entire personnel involved in this corona care?

U: So, the personnel involved is, of course, the frontline – the doctors part that is a post-graduate or a junior resident, then there is an assistant professor and a professor who oversees all that. Now in the OP, we have three shifts of… this is about the doctors. Staff nurses also, dedicated staff nurses are there. So, we divided the OP and isolation ward. So, for OP there is one batch going on and for the ward, there is one set of personnel… they are doctors, staff nurses and, of course, the workers who do the cleaning part, every three hours, surface spraying, mopping all that. So, that is the personnel involved.

A: And, are you working round the clock? How are the shifts, and how have you organised that?

U: Round the clock, it’s going round the clock.

A: And are you having enough personal protection equipment? Enough masks, and hand sanitisers?

U: Yes, yes. All that is adequate. The government has adequately provided.

A: Alright! Has there been any training or orientation, we know that there are guidelines and advisories issued by the MOHFW, but this is a new disease and how are you updating yourself on the scientific knowledge and management part?

U: So, they have given us the website of the MOHFW and all of us are already physicians, and so… they asked us to go through it and update ourselves. And as and when we get our handovers from the government, our Dean sees to it that it is conveyed to us.

A: Ok, so, we heard all that is going on in your hospital and asking you personally. Describe your feelings to me as you are involved in this work and as you are right there, how do you feel?

U: So, definitely there is a feeling of fear. Initially, we had that panic reaction among our junior residents and all, so our senior colleagues sat and counselled them out and now they do the work, but the component of fear is always there.

A: Always there, right! And how does your family, and your children feel about it? What are they telling you?

U: Uh… they are like…, of course, they are worried. But I think they are keeping a brave face. Because we have to face it. So, I think I have good support. All of us medical professionals are receiving good support from our families.

A: Describe the mood in your hospital. Last night we saw the tweets from the health minister of Tamil Nadu. He visited the hospital in the middle of the night and he was all praise for your professionalism and for your team. But just describe the mood in the ward and in the clinic for us, Uma.

U: All health professionals and teams are now ready to work… the mood now, with all the motivation that has been coming in, is everybody is ready to do their best.

A: Wow! These are very early days. The days ahead are going to be very challenging and we really thank you for your service, Uma. It has been lovely talking to you, bye.

U: Thank you.

***

So, if you are feeling scared and isolated, know that the doctors and other frontline healthcare workers and their families are scared too. But they are making the best of a bad situation by putting the interests of their patients forward. On Day One of this lockdown, if you are thinking of maybe, just maybe going outside for an errand, just because you are bored, think of those on the frontline and do a WhatsApp video conference with your friends and family instead. Stay at home. Do it for our healthcare workers.

I am Dr Aiswarya Rao, and I will be back soon with my next podcast. Thanks for listening.