Battling coronavirus: Why medicos in Telangana are seething

“We, the medical professionals, are being hailed as frontline COVID-19 warriors. But, we are being put to risk at hospitals in Telangana. This in turn increases the risk to the patients we treat, our families, and our immediate contacts. All of this can be prevented.”

This first person account of an anonymous doctor, published in a local daily in Hyderabad, sums up the mood among the healthcare professionals who are increasingly falling prey to the coronavirus infection.

Nearly 50 doctors, postgraduate medicos, and other paramedical staff in the city have tested positive for the coronavirus in the past few days. Of them, 18 are PG medical students from Osmania Medical College (OMC). Five doctors from the Nizam’s Institute of Medical Sciences (NIMS), two other senior doctors from the Gandhi Medical College (GMC), and two professors and three associate professors at a Maternity Hospital were among those who have tested positive.

All these institutions are run by the state government.

Demand for more testing

“Our demand is very simple. We want the government to conduct mass screening of frontline medical staff because we are exposed to highest risk,” a PG medico, who is on duty at a COVID-19 ward at the state-owned Gandhi General Hospital, told The Federal.

However, Telangana government has been drawing all round flak for its poor testing. It has the lowest testing rate in the South. It has conducted 652 tests per million population, compared to the national average of around 1,600.

“The government hospitals are in serious risk of becoming hotspots and sources of further spread of the infection. The protocols demand sanitising and cleaning of operation theatres, X–ray labs, and all other places. But, we are told that this is not being done due to budget constraints,” the medico said.

Related news: Telangana’s COVID-19 strategy trips on low tests, weak infrastructure

After the rapid spread of the coronavirus among the medical community evoked public outrage, the government finally issued orders for quarantine of the affected PG doctors.

However, senior doctors say this is not enough. “Testing or screening of patients coming for elective surgeries have to be carried out rigorously so that the risk to doctors treating is minimised,” a doctor working at NIMS said.

“I started showing coronavirus symptoms two days after I had performed duty at the operation theatre, assisting in a C-Section for a suspected COVID-19 patient. Despite that, we were told to come to work. It was only when the whole group of PG medicos showed symptoms that our cases were taken seriously. Tests were conducted and those exposed to the pregnant women were first identified. After that, those who came in contact with us were tested. I am now COVID-19 positive and in home quarantine,” wrote the anonymous doctor, who was on duty at the government-run Maternity Hospital.

With the government hospitals emerging as the new hotspots, the anger is growing among medical professionals over poor screening, lack of personal protective equipment (PPEs), and other facilities.

The patient load has been increasing at Gandhi Hospital, an exclusive facility to treat the COVID-19 patients. At present, there are over 800 patients and 100 Severe Acute Respiratory Illness (SARI) patients undergoing treatment.

The coronavirus death toll in the state has reached 113, with eight more cases of fatalities, the highest single-day spike, being reported on Friday (June 5). A total of 3,290 positive cases have been reported in the state so far.

Snub from high court

The Telangana High Court on Friday (June 5) pulled up the government over the issue and asked it to explain why there has been a spurt in the number of positive cases among healthcare workers in the state if the government was providing them enough PPE kits.

Hearing a batch of Public Interest Litigations (PILs), a bench, comprising Chief Justice RS Chauhan and Justice B Vijaysen Reddy, asked Advocate General BS Prasad to explain how so many healthcare workers were testing positive for the coronavirus.

The petitioners claimed that there was a ‘mismatch’ between the government’s statements to the court and the reality on the ground and many doctors did not have adequate safety gear.

The counsel for the petitioners also pointed out that testing in the state was inadequate, and this could be another reason for a delay in COVID-19 cases coming to light.

Related news: COVID-19 situation under control in Telangana, says Tamilisai

After hearing the arguments, the court asked the Advocate General to furnish a detailed report with the state government’s response to the claims, by June 8.

Earlier last month, the court had directed the government to conduct tests for COVID-19 on dead bodies before they are released from hospitals.

The government was also asked to provide data on tests conducted on returning guest workers.

“You cannot hide behind the fig leaf of financial constraints as human life is most important for good governance. The State does not have the discretionary power to form its own opinion on conducting of tests by putting the health of the people at stake,” the court had observed.

It also directed the government to inform the court of the number of guest workers who have returned to the state, how many of them had been tested and the outcome.

The court sought data on whether the positive cases had been sent to quarantine. It asked for the number of secondary contacts tested, what the situation was in the villages once the guest workers reached there.

The court gave these directions based on five PILs filed by retired Osmania University professor P.L. Vishveshwar Rao, Dr K.P. Rajender, retired district medical and health officer, and others.

“Rather than congratulating ourselves for having fewer coronavirus cases, the state should rather take up more tests. Ignoring the presence of coronavirus by not testing a large number of people is almost like inviting the Trojan horse,” Chief Justice Chauhan said.

“When a country like the USA, which is financially stable and equipped with the best medical infrastructure, could fall prey to coronavirus, a country like India and Telangana state should never sit back and relax but start strengthening ourselves to deal with this menace by going for more tests,” he said.

Following the norms

The State Medical and Health Minister E Rajender, however, defended his government’s strategy on testing, saying it was being done on symptomatic and high-risk categories of people, as per the ICMR guidelines.

The minister also urged the activists to approach the government with suggestions and queries before approaching the High Court.

Dismissing allegations over inadequate PPE kits, he claimed that over 10 lakh PPE kits and over 11 lakh N-95 masks were available in the state.

Related news: Casual approach to pandemic blunts COVID-19 fight in Telugu states

“There is no shortage of gloves and surgical masks,” Rajender said.

“We have nearly 225 ventilators along with sufficient number of beds at Gandhi Hospital. However, not all of them are being used for patients. Enough infrastructure support is available to provide invasive ventilation through C-PAP, BiPAP and traditional ventilators,” the superintendent of Gandhi Hospital Dr Raja Rao said.

“We are doing our best not to allow the condition of our patients to become critical. We have enough infrastructure related to invasive ventilation like C-PAP and traditional ventilators,” he said.