Frontline fatigue in third year of Covid

“We have seen people crying outside hospitals without oxygen. We have seen dead bodies lined up for cremation. We have seen all this. And it has a long-lasting effect, conscious or subconscious,” says Dr Harjit Singh Bhatti, recollecting the second wave of Covid-19 earlier this year.

No one wants it to happen again, he says, “to have to choose who to save, while another may die”.

It’s been a relentless two years for doctors, nurses, community healthcare workers and para-medical support staff on the frontlines of the Covid battle. And they are “exhausted”.

But the end is not in sight yet, as the pandemic enters the third year, with the highly transmissible Omicron variant adding a new level of uncertainty. The medical fraternity is left hoping for the best even as it prepares for the worst, as its members wear their courage and vulnerabilities on their sleeve.

“It is not easy when you have a ward full of very sick people, all requiring continuous attention, and the resources are limited. You lose a bit of yourself in looking after another in such conditions,” says Bhatti, National President, Progressive Medicos & Scientists Forum. Younger colleagues have nightmares and recurring memories of patients from the second wave; and personally, he says, there was the fear of taking the infection home to family, which included a parent with terminal illness.

Nurses have their gritty stories. “We continue to work at the same pace we always work,” says Anita Panwar, president, All India Government Nurses Federation. “The bulk of the corona load was handled by community healthcare workers at the primary health centres (PHC) and community health centres, but their effort was never acknowledged,” she says, pointing to homecare visits, among other things. The situation is similar across the country, she adds.

While over 1,500 doctors are said to have died during the pandemic, little information is available on the toll on nurses and other healthcare workers.

The country is better prepared with vaccines and knowledge to tackle Covid-19, says Dr Bhatti, but the need is for more hands. Doctors have been calling for NEET-PG counselling to add more doctors to the system, especially given the threat of a third wave. “There is fear (from past experience) and hope (that the third wave will not be as devastating),” he says, hoping that health administrators and people do the right thing, having seen the second wave up close.

“Almost everyone lost someone during the second wave,” says Dr Sourav Kumar, medical officer at a PHC in Nalanda district, Bihar. States and hospitals are better prepared now with facilities like oxygen, more than during the second wave. Having worked at Delhi’s RML Hospital during the first wave and in Bihar during the second wave, he says the challenge for doctors initially was to stay brave in front of patients, never mind the risk to their own lives. In the second wave, he says, people worsened a bad situation by hoarding and blackmarketing medicines and oxygen. He recounts how a doctor colleague had to pay ₹15,000 for an ambulance for a family member. Having been through this, he says, the medical administration is on the alert for any spike on the ground.

A medical student in Madurai during the first wave and now a PG resident at AIIMS (Patna), Dr Venkatesh Karthikeyan recounts how doctors, too, lost loved ones during the second wave, often unable to get beds or ambulances for themselves or their families. A price that remains invisible to the larger society.

“With Omicron, one is not sure what to expect,” says Dr Rahul Pandit, Director-Critical Care, Fortis Hospitals (Mumbai) and member, Maharashtra Covid-19 taskforce. “Hospitals are doing non-Covid work,” says Pandit, indicating that systems could come under pressure if hospitalisations increase due to Omicron.

Hospital space can be created and protocols activated, he says, but human resource cannot be increased overnight. “You need one cycle of education to be completed for new staff in the system,” he points out.

For the fraternity, the last couple of years have been “the most strenuous, mentally, emotionally and physically,” he says. A clear signal that 2022 would require Government and people to act responsibly, this time in the interest of the well-being of frontline workers.

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