Threat of super spread looms large over Thiruvananthapuram Medical College

There is a threat of a major virus spread in Thiruvananthapuram Medical College. Already 18 healthcare workers, including seven doctors (post graduates and house surgeons), have tested positive and over 150 staff in the premier hospital have been asked to undergo quarantine in the last five days.

That the spike in cases has happened in the non-COVID wards of the Medical College is a sign that many patients visiting the hospital for non-COVID treatment are silent virus carriers.

More than 30 staff, including doctors, of the Surgery ward had already been put in quarantine when four PG students, one house surgeon and a staff nurse in the surgery wards were tested positive on July 16. They had likely contracted the virus from two patients in the surgery ward who were found positive in the routine COVID test done before their surgery.

It looks like the spread is not confined to the surgery wing. A post graduate student in the Psychiatry wing has also tested positive. Further, a patient in the Orthopaedic wing (Ward 15) has also been declared positive.

These developments have fuelled the speculation that more doctors could be infected. The samples of all PG students staying in the PG Hostel and house surgeons will be taken today (July 19) afternoon. Therefore, more positive cases among doctors are expected to be revealed later in the day.

The non-COVID wings of the Medical College function with less precautions. "Positive cases are being detected only when routine pre-surgery tests are conducted on patients. Till then, patients in non-COVID wards are treated like other normal patients," a senior doctor in the Medical College said.

Unprotected health workers

While doctors and nurses and attenders in the COVID wing are decked up in PPE kits, those in non-COVID wings are in their usual uniform, a white overcoat for a doctor and nothing else. Even the doctors and nurses in what is informally called 'suspect wards', where patients with respiratory illnesses other than COVID-19 are treated, are not adequately protected.

"After the lockdown was lifted, it looks like there was a general loosening of the guard. Now it is increasingly likely that many patients who come daily to the non-COVID OPs and for other treatments are silent carriers," the doctor said.

Therefore, just about a month ago, as a matter of precaution, doctors in non-COVID wards were also asked to have some semblance of protection. Now, they have a gown and a face shield. But, after the sudden spurt in cases, it is evident that these are not enough.

There is also a sudden shortage of manpower in the Medical College. Final year PG students, because their practical examinations are on, have been asked to keep way from the hospital. As for the first and second year PG students and also house surgeons, the two groups of doctors who does the bulk of the patient care in the Medical College, they have been asked to keep themselves sparse after the situation showed signs of worsening.

While one half works for seven days at a stretch, the other half will stay at home. "Our fear is if more PG students and house surgeons test positive, they and their close contacts, which again would be PGs or house surgeons, will either have to be put under treatment or quarantined," the senior doctor said.

Are COVID wing docs safe?

As it is, the healthcare workers in the COVID wing of the Medical College have not been affected. Truth is, it is still not certain whether the protocols are properly followed in the COVID wing.

For instance, the 'donning and doffing' of the PPE kits have to be done at two ends and far away from the patients. There have been complaints from doctors themselves that there is not enough space in the COVID ICU to strictly observe such a protocol. "Doctors are sometimes forced to doff (remove) their PPE kits very near to a patient," a doctor on COVID duty said.

“Doctors in the COVID wing, after their duty is over and the PPE kits are removed, are bound to cross paths with patients visiting non-COVID wards in the hospital,” the doctor on COVID duty said.