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View | COVID-19 3rd wave: India's biggest challenge is going to be acute shortage of medical staff

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View | COVID-19 3rd wave: India's biggest challenge is going to be acute shortage of medical staff

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High exposure to the daily rising patient population, mostly asymptomatic, at hospital OPs, general wards and ICUs makes health workers vulnerable to contract with a super transmissible variant of the virus

View | COVID-19 3rd wave: India's biggest challenge is going to be acute shortage of medical staff
If a severe shortage of hospital beds and dried-up medical oxygen supply were the biggest challenges that India would recall about the first and second waves of the COVID-19 pandemic, the worst challenge that the country will see during the third wave is an acute shortage of healthcare staff. As the third wave of the pandemic, driven by the super spreader Omicron variant, catches momentum, Indian hospitals are already overcrowded with panic patients. However, the hospitals are also equally panicked with a severe shortage of staff to attend to the patients.
A large number of medical staff, including doctors, nurses, paramedics and housekeeping staff, are also down with the viral infection and are either hospitalised or under home quarantine or in self-isolation. A total of more than 8,000 healthcare workers at various hospitals, including premium medical institutions, government-run general hospitals and private healthcare facilities, from across the country have already been tested positive for COVID-19, and the number is increasing every day.
"Currently, there is a shortfall of at least 20 percent in the personnel strength on an average in most hospitals across the country. Two key contributors to this worst situation, at a time when the third wave is peaking, are rising Covid infection cases among healthcare workers and doctors, and the delay in the admission of postgraduate students– the resident doctors– who are the backbone of routine operations of a hospital,” says Dr J A Jayalal, National President, Indian Medical Association, the largest body of medical professionals in India.
The increasing number of positive cases among healthcare workers is mainly due to the alarmingly rising breakthrough infections by the highly transmissible virus variant – Omicron –, as their (hospital staff) close exposure to the ever-increasing patient crowd, mostly asymptomatic with no proper mask and hand sanitisation, visiting the hospitals and medical facilities in the last three to four weeks.
Close to 400 resident doctors are currently Covid positive in the state of Maharashtra alone. Maharashtra, the most affected by the Omicron-driven third wave of the pandemic, has seen an average daily surge of about 16,000 new Covid-19 cases in the last week.
"All major hospitals in Maharashtra were already under pressure as they have been working with just 60 percent of their staff strength as resident doctors for the new batch of post-graduate courses are yet to join. However, the situation is even worse now with a total of at least 380 doctors in key hospitals from across the state are on leave due to COVID-19," said Dr Shivkumar Utture, former President, Indian Medical Association, Maharashtra State chapter, and a senior member at the State COVID Task Force.
While all leading hospitals in Mumbai, including KEM Hospital, Sion Hospital, PD Hinduja Hospital, JJ Group of Hospitals, among others, have reported a suddenly fallen number of medical personnel due to coronavirus infection, the situation in Delhi is also not different. Over 700 healthcare workers and doctors in Delhi and the National Capital Region, including at least 400 from the premium medical institution –All India Institute of Medical Sciences (AIIMS) – have tested positive. At 96, Delhi’s Ram Manohar Lohia Hospital also has a significant number of COVID-19 positive cases among its staff, while other leading hospitals such as Safdarjung and Shri Ganga Ram Hospital have reported almost similar numbers of COVID infection within its workforce.
Similar situations are reported from other states, including Uttar Pradesh, Bihar, Punjab and West Bengal. Most hospitals, which are reeling under the worst situation of short-staff, including AIIMS, have now suspended some of the routine inpatient admissions and non-emergency surgeries. AIIMS has also shut its specialty clinics and partially restricted out-patient visits, to adjust the staff shortage and to meet the rising demand at the COVID counters. The Institute has also asked some of its faculty members to cut their winter vacation to resume for duty.
“The decision to suspend some of the routine services was to minimise the spread of COVID infection among other patients and also to utilise the available manpower to meet the rising demand of treating COVID-19 in-patients,” said a senior official at AIIMS, requesting not to be identified.
While the key factor that led to the sudden increase in COVID infection is the higher transmissibility of the virus, which is now being proved airborne, the other reason is non-adherence to COVID appropriate behaviours on both sides as well as non-availability of proper personal protection equipment like proper masks, hand sanitisation, and foolproof body covers to the medical staff in most hospitals, says Dr Utture.
Adding fuel to fire, the delay in the NEET PG counseling too led to a shortage in resident doctors, who typically attend to the routine crowd of the out-patients as well as admission cases on a day-to-day basis.
“Anticipating the third wave and this crisis, we had cautioned the Health Ministry with several reminders in the last three months requesting booster shots of vaccines for healthcare workers as well as the hiring of more doctors, who are aplenty waiting outside to join government service. But instead, the ministry just sat on it and is now trying to adjust the manpower shortage by cutting short of the quarantine and resting time for the sick,” says the IMA president Dr Jayalal.
The government also wasted at least four months to complete PG counselling. The joining of those junior doctors was also delayed, he added.
Although the health infrastructure and material supply seem to be adequate this time to meet the third wave challange, healthcare experts are now concerned about the worst scenario after the big election gatherings in Uttar Pradesh and Punjab. An acute manpower problem is going to play major havoc in the coming days as the COVID patient footfall in all hospitals across the country is bound to increase multifold, while more healthcare workers fall sick due to their increased exposure to the virus carriers.
Covid positive data among healthcare workers in top hospitals as on January 8:
Delhi
AIIMS Delhi– 400
Ram Manohar Lohia–96
Safdarjung Hospital –17
Shri Ganga Ram Hospital- 19
Rest of Delhi hospitals–460
Mumbai
KEM Hospital – 157
Sion Hospital – 32
JJ Group of hospitals – 67
Rest of Maharashtra hospitals – 570
Kolkata
Calcutta Medical College Hospital – 182
NRS Medical College Hospital – 63
Patna
Nalanda Medical College and Hospital – 76
Hospitals in rest of Bihar –  162
Lucknow
Medanta Hospital – 40
Hospitals in rest of UP – 136
Patiala
Rajinder Hospital and Medical College – 91
Hospitals in rest of Punjab –
CH Unnikrishnan is Founder & Editor at Future Medicine India. Views expressed are personal.
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