#COVID19 Through an Indian Doctor's Eyes

On March 22nd, on the Prime Minister's decree, Indians across the world stood on their balconies and clapped & clanged pots to pay respect to the healthcare workers of India - "Corona warriors" - who were the front line in the battle of the dreaded #COVID19 pandemic. 

India had a total of 341 cases till March 22nd. 46 days later, we stand at 56,383 cases. 

Spare a moment from your altered lives to visualize India during these 46 days through the eyes of those healthcare workers.

Treating Covid-19 Patients requires every doctor and healthcare worker to have the best of facilities, medication and support at their disposal. Early on, despite government assurances, it became obviously clear at the ground level in hospitals that there were not enough protective gear (PPEs) for all staff. This is actually forgivable in this author's opinion since this is a scenario most countries face. What is not forgivable is the lack of clarity since. 

1. Gaslighting to Hide Inadequacies

As the weeks have gone by, the daily press conferences from the Ministry of Health and Niti-Aayog members have offered lesser and lesser answers, deflecting direct questions about kits, gear and medicines, resulting in a classic study of gaslighting, something most politicians indulge in but which is hardly appropriate in a pandemic where honest data matters. 

Did anyone seriously believe that the COVID19 spread would end by May 16, 2020?

 

Statements early on by government-related officials that doctors are getting the virus due to attending parties (in this time of a national lockdown!) and that we don't need trained specialists to look after corona patients were minor wounds compared to what was to come.

 

2. Threats and Intimidation

Senior doctors were intimidated by the police and taken in for questioning for pointing out actual lacunae while administrators of medical Whatsapp groups were told to officially report incidents of grumbling by doctors to law officials. 

Students who spoke about the lack of PPE and actually helped procure kits for hospitals directly from manufacturers using their own resources were actually terminated, receiving threats from government officials who accused them of robbery, no less, in addition to accusing them of bringing the hospital's name into disrepute. 

  

It took social media outrage to give him back his degree. 

3. Doctors Rendered Homeless

Within the first fortnight, there were videos online of residential complexes taking decisions not to allow doctors to return to their apartments since they 'could' be infected. For every video that emerged showing the public thanking a grateful health worker, there were two showing doctors and nurses distraught as they could not find a way back into their own residences. 

 

Some cities responded with extreme kindness, 5-star hotels actually putting up these doctors. For most though, the battle to find a place to stay remains today, with a few forced to stay within the hospitals themselves for extended periods. 

Others have become actual 'warriors without homes' now, begging for places to stay. Think of that - because one member of the house goes to work in a hospital, all the members are kicked out including the children and even pets. Still want to call them the Corona Warriors you love?

4. Violence - Whether Dead or Alive

Reports of doctors and nurses being spit upon, taunted and chased away emerged early on in this battle, the combination of ignorance and communal distrust ensuring these images would linger on for weeks in public memory. Soon, the reports of physical assaults arrived, something Indian doctors are all too familiar with. This also led to one of the few positives for doctors - a stricter law has finally been approved which makes assaulting a doctor a non-bailable offence.

Worse was to come, of course. In 3 cases, doctors who died of COVID19 were denied even a proper burial. Those who came with the body were assaulted, the ambulance damaged and the body of the doctor in Chennai shoved around as though it were a bag of trash. 

 

In the end, with tears in his eyes, his junior colleague buried him in the dark of midnight alone in the graveyard digging the Earth with his own hands, aided by a lone policeman. The doctor who died was no 'no low-level flunky', mind you - he was a senior neurosurgeon who was also the medical director of a hospital. Think of that for a moment.

5. Legally Bound

For those still alive, the rules of the land have been equally ignominious. As more hospitals suffer losses, doctors in the frontline - the exalted Corona warriors of March 22nd - were now forced to work with make-shift protective gear (including wearing garbage bags over their heads and torsos) while also taking huge salary cuts. Limited test kits at the start of this battle resulted in delayed or no testing in many cases with staff becoming infected even before they realized they were dealing with a COVID case.

Of the limited kits, the standard was so poor that they offered only 5 % accuracy.

 

Cases were filed against doctors who ended up being COVID19 positive after treating patients 'for becoming carriers' of the disease. Cases have been filed against doctors for charging money for tele-medicine consultations (which is insane. Tele-medicine is still a medical consultation and a fee must definitely be charged.) 

Show cause notices have been sent to doctors when patients escaped from their quarantine wards, blaming the doctor!

 

Private doctors in Maharashtra across all specialties have received notices 'requesting them' to report for COVID19 duty for 15 continuous days, failing which their decade-long hard-earned degree could be taken away from them. 

I mean, why kind of a 'request' is this? Does it not sound more like the saccharine ultimatum given by a villain to a hero before he kills the hero's girlfriend in a Bollywood movie? Why pretend with requests like this? Why not just kidnap the children of these doctors and threaten them to work at gunpoint?

 

6. The Numbers Game Just Got Worse

Despite what you might imagine when you hear the word 'doctors', not every medical professional is trained to battle against COVID19. Only a few specialties are trained for the worst complications - not the meager 10 lakh odd doctors you may imagine but barely 20,000 at an optimistic rate. Think of that number - 20,000 doctors across India are all you truly have. Tragically, as hospitals demand that they need revenue to keep running, all other specialties (the remaining 9.6 lakh doctors) have to pitch in doing their regular work, thus risking becoming infected themselves. 

All this while watching innocent people suffer and die in ICUs and distraught family members break down as they lose their loved ones. Again, something not all doctors are trained to do or emotionally equipped to handle, a fact becoming evident as more online social media posts come from doctors themselves. 

This is where the doctors of India stand today in the battle against COVID19.

1. Forced to work in the most riskiest condition possible 
2. absolutely understaffed 
3. with no fixed action plan
4. after taking a salary cut with 
5. the knowledge that they don't have adequate protective gear to wear, 
6. don't have adequate test kits to test every potential carrier who comes to them, 
7. cannot guarantee the accuracy of the test kit 
8. and not having enough beds in the hospital should a COVID outbreak start in their community, the latter almost an eventuality in the coming days since the lockdown has eased.
9. Doctors are threatened (at both the hospital and government level) for pointing out the lacunae in facilities and gear. 
10. They have cases filed against them for working during quarantine in some cities and 
11. threats of having their degrees taken away in other cities for not working, even if they have no expertise in ICU management. 
12. Interns who have completed their residency have been denied their medical degrees & told to continue working as interns with no stipend for an extended period for the coming months. 
13. We are kicked out of apartment complexes for being 'possible carriers' and have nowhere to stay when we come back from work.
14. Threats of applying the Essential Services Maintenance Act (ESMA) to force doctors to work irrespective of the lacunae of essentially everything necessary 'to work' are already there.
15. If we die, even our bodies are desecrated and denied both burials & cremations. 

The truth is seeing how healthcare workers are being treated across India, we do not feel like beloved warriors. We feel very much like the bonded labourers being held at virtual gunpoint across various states in India right now, our rights stripped away from us with no guarantee of even a dignified death. Quite a heady fall it has been since the overwhelming gratitude shown on March 22nd, when the whole country released videos of themselves clapping and saluting the doctors of India. Unfortunately, through all that noise, most of us Indian doctors always knew this was coming. 

It still hurts that you proved us right once more. 

Author's note:

Some of what is happening is understandable. Being overwhelmed by the number of cases in highly infected red zone areas and shortage of equipments, I get. Violence and a reduced salary was almost inevitable. But others - filing cases, threatening to cancel degrees, suppressing voices of protest, kicking out of homes, not allowing the dead to find a place to rest - reeks of a nature that is less about poor governance and more about sheer dominance, brutality and the need to be an oppressor. 

We, the doctors of India, are fighting for you, risking not just our lives anymore but those of everyone we hold dear. We need you to respond humanely... to fight for us when you see an act of violence or intimidation... now more than ever.