(Editor's note: This piece was written after talking to a doctor at the COVID-19 clinic of the Government Medical College Hospital Kannur where scores of persons – both confirmed and symptomatic – from Kannur and Kasaragod districts are being treated. We have changed the doctor's name for privacy reasons. She is currently on a 14-day quarantine. This piece will help you understand the travails of our front line healthcare workers fighting the pandemic.)
It has been more than a month since Dr Celine (not actual name) began working at the COVID-19 clinic of the Government Medical College Kannur in Pariyaram.
Scores of people flock the hospital every day for diagnosis and treatment of COVID-19, the diseases caused by a coronavirus. The steady flow, which started in the second week of March, continues unabated even today because the hospital caters mainly to people in Kannur and Kasaragod districts, the two major COVID-19 hotspots that together account for 75 per cent of the positive cases in Kerala.
This puts a lot of pressure on health workers in the hospital's COVID clinic.
Celine says her life has undergone a sea change after she started working in the clinic. It had a different setting than the work environment she was familiar with. She said she had struggled to put on the personal protection equipment (PPE), the essential gear for health workers in the COVID ward.
In the early stage, she was reluctant to treat a COVID-suspect person for fear of contracting the disease. She was pained to listen to the death of a patient but overjoyed to receive a baby born to a woman cured of COVID.
Here, Celine describes her experiences.
An overview of the clinic
The isolation wards for COVID patients at the Government Medical College Hospital in Kannur are in the seventh and eighth floors. My team has six doctors and we have to take care of the patients in isolation wards, collect swabs of both in and out patients, and monitor the intensive care unit (ICU) beds.
Doctors at the COVID clinic work for 12 continuous hours.
After reaching the clinic, the first task is to collect details of each patient in the isolation wards from the doctors in the previous shift. This is followed by the ward visit, putting on the personal protective equipment.
We have two types of wards. The COVID confirmed patients are on one floor while the suspected cases are on the other floor. The PPE used on one floor should not be used on the other floor. This means I have to change the PPE twice in two hours.
Swab collection is a tedious task. I have to wear PPE before collecting each sample. If a person (whose sample has to be collected) comes late, I have to continue inside the outfit, coping with the unbearable heat. ICU duty drains me of all my energy.
My first COVID patient
I attended the first COVID suspect patient on March 4. The five-year-old boy had come from Dubai with his parents, who were also present in the isolation ward.
Fear gripped me when I was heading to the isolation ward. I was worried about my personal safety and the chances of contracting the disease.
Nonetheless, I mustered some energy to put on the PPE. I consoled myself that nothing would happen. After checking the boy and taking his swabs, I carefully removed the PPE and ran to the bathroom. I took a quick bath and washed my clothes. I couldn't overcome the fear of the virus.
I went to check on the boy the next day. I stood by his side for some time. My fear slowly started subsiding. I treated him for five days. By that time, I was fully equipped to deal with coronavirus.
I felt really happy when the boy was tested negative for the virus on March 9.
I started attending to COVID patients as well as persons with COVID symptoms. I never missed to wear PPE whenever I met them.
Getting into PPE is a huge task
PPE guards health workers in their battle against coronavirus. But I must admit that it is a pain to don and doff the 'weighty' stuff. It takes 10 minutes to literally 'enter' into the gear that comprises three pairs of gloves, one coverall, shoes, goggles and headgear.
The heat inside the PPE is unbearable. I sweat profusely even if I am in an air-conditioned facility. It dehydrates the body.
Doffing the PPE is a major task. I have to exercise so much caution. There is a major possibility of contracting the virus if it is not done properly. Doffing takes a minimum of 15 minutes. The funny part is that swab collection will be over in two minutes, but donning and doffing the PPE will take 25 minutes.
The day I worried most
I realised the importance of PPE on April 9 when a five month-old-baby boy, suspected to have contracted the disease, was brought to the hospital. His condition was bad and I had to put him on a ventilator.
I wore the PPE with headcover. But I couldn't see the boy properly because of fogging of the glass. I had no option but to remove the headcover to connect the ventilator. I realised my mistake only after getting out of the ward. I was nervous until the baby's test result returned negative a few days later.
Saddest day in COVID clinic
I was on ICU duty on April 10 to look after a critically ill patient from Mahe (he died on April 11). He was brought from a private hospital in Kannur. He was brought with ventilator support.
My colleagues had briefed me about his critical condition the previous day. They told me that he would survive if he could hold on for one more day. I was optimistic because he was on the same medicines that rescued a British patient at Ernakulam Medical College (Lopinavir and Ritonavir).
But I saw his condition deteriorating since my duty began. It was quite depressing to watch a hapless person struggling even to cough. I continued praying for him. He was alive until I finished my duty. He died the next day. I felt really sad as we couldn't revive him despite best efforts.
The pall of gloom, however, was lifted the same day with the arrival of a baby boy.
Red letter day
I will always remember April 11 as the happiest day in my professional career. It was the day I received a newborn baby of a young woman, who was cured of COVID-19.
The hospital's expert team of gynaecologists set a history of sorts by performing the first Ceasearian-section on a woman cured of COVID-19 in Kerala. It was the third such instance in India. I was over the moon when the gynaecologist handed me the baby for examination.
I could not take out my eyes from the baby. His arrival lit up my thoughts and helped me forget, at least for a moment, the havoc created by COVID-19 across the world.
My hydroxychloroquine dose
This drug needs no introduction. US President Donald Trump had put pressure on India to get this antimalarial drug, believed to be effective against coronavirus.
For health workers, it is a preventive drug. Quite naturally, I am also taking this as I hope it would keep the virus away from me. The first day, I swallowed two 400mg tablets in the morning and at night. It was followed by one tablet in a week, for seven weeks. I will complete the course next Monday. The tablet gives me extra protection, but taking it is not as difficult as putting on the PPE.
Long working hours
The 12-hour shift is quite tiring. I feel exhausted and dehydrated when I finish my duty. I will take a quick bath after reaching my accommodation and hit the sack quickly.
Home sickness
I am badly missing my family, especially my daughter, these days. The last time I met them was more than a month ago. I hope to meet them soon.
Quarantine plans
After two weeks' duty, I started my two-week quarantine yesterday (April 17). (Starting this month, all those who served COVID clinic for two weeks have been asked to be under quarantine for two weeks).
I am planning to read books during this 14-day break, so that I can resume my COVID duty afresh on May 2.
