Doctors, nurses, and medical staff have tested positive for COVID-19 in two private hospitals in Mumbai raising questions about the safety of medical professionals. Medical professionals have to use Personal Protective Equipment (PPE) while tending to COVID-19 positive patients. But the unions representing these professionals have expressed fear that a shortage of PPEs in India is putting them at risk of getting exposed to the virus and contracting it. Various hospitals and associations have appealed to state authorities to look into this issue as it leaves the medical fraternity at risk of getting infected by the virus.
Wockhardt hospital, one of the two private hospitals has reported around 52 positive cases, making it one of the hotspots in Mumbai that has reported over 600 cases. Another prominent private hospital in Mumbai, Jaslok Hospital also reported nurses testing positive for the virus. The staff of both the hospitals were exposed to the virus as two patients who were earlier asymptomatic later tested positive for the virus.
The issue of medical staff being at risk has been highlighted even in New York as the US state has over 1.5 lakh positive cases and the number of medical staff testing positive for the virus have been increasing. New York also reported the death of two nurses who contracted the virus while on duty which has led to an increase in panic among the medical fraternity.
But unlike the US, India has not yet entered the mass transmission phase. Hence the worry about major prominent hospitals going out of action and the impact it will have incase the city sees a major spike in cases in the coming weeks.
Three doctors, 17 nursing officers and one sanitation officer have also tested positive for the virus at Delhi State Cancer Institute in the capital.
Medical Staff Affected In Mumbai
Two patients with pre-existing health morbidities got admitted to the non-isolation wards of the two hospitals for treatment. They developed symptoms a few days after their respective surgeries and were immediately tested. Since the patients were asymptomatic at first, they were not kept in the containment zones.
At Jaslok hospital, a patient who had come for treatment for bladder cancer and who further required a dialysis developed symptoms later. Jaslok also reported a COVID-19 death. The nurses and doctor tending to the patients were tested and one of the nurses tested positive. Over a few days, other nurses and a ward boy tested positive for the virus.
At Wockhardt, a heart patient was admitted with a cardiac emergency and was asymptomatic at first but later developed symptoms and was shifted to the isolation ward at the hospital. Nurses, medical staff, and doctors who came in contact with the patient tested positive and have been shifted to the government's isolation wards at Seven Hills. Over 52 medical staff tested positive for the virus. Wockhardt Hospital also reported a death due to the virus.
Both the hospitals have been identified as containment zones by the Municipal Corporation in Mumbai and have temporarily suspended outpatient services. Employee unions have accused the hospitals of being negligent in the process. BOOM contacted both the hospitals and has heard from Jaslok.
The officials at Jaslok stated that they have taken all the precautionary measures since COVID-19 cases emerged in the hospital. They also maintained that the first patient was asymptomatic and thus the hospital was treating the patient under the guidelines of regular delivery of services. The staff has been isolated and quarantined.
While Wockhardt did not respond to BOOM's queries, in an interview with Economic Times, Habil Khorakiwala, the chairman of the Wockhardt Group stated that the cases emerged from the non-isolation wards and they were not negligent but not anticipating a case either. The hospital coordinated with the officials and immediately informed them about the patient testing positive. However, the late onset of symptoms in the patient and the exposure of the hospital staff to the patient for the first 7-8 days led to the spread of the disease.
What Does The BMC Say?
BOOM contacted Dr. Daksha Shah, Deputy Executive Health Officer and the head of the COVID-19 response, Brihanmumbai Municipal Corporation to understand how the municipal body is going about tackling the increasing cases of COVID-19 among the medical staff.
"The BMC hospitals have had no cases in the medical staff but even we had a few suspects who came in contact with patients and were immediately quarantined. Nobody has tested positive for the virus. We have COVID-19 designated hospitals and wards where the staff has been given protective gear", Dr Shah stated on the preparedness of the Municipal body.
When asked about the private hospitals, Dr. Shah said that it was unfortunate and unanticipated. "At both these hospitals, the cases were earlier asymptomatic. They informed us immediately as they exhibited symptoms. The hospitals did what they could and they had no means to control the asymptomatic patient from developing symptoms."
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Nurses' Association Raise Alarm
Since most of the nurses in the city are from Kerala, the state CM Pinarayi Vijayan has also written a letter to Maharashtra CM Uddhav Thackeray, highlighting the status of the medical staff in the hospitals.
Furthermore, Jan Swasthya Abhiyaan, a health collective along with the United Nurses Association Maharashtra chapter and the Nurses and Paramedical Staff Association, Mumbai wrote a detailed letter to the Mumbai Municipal commissioner as well as the Chief Minister's office regarding the plight of the nurses and the steps that they could take in order to ensure the safety of nurses.
One of the most important demands was the provision of PPE kits to the nurses as they are the first point of contact for most of the patients and are tending to the patients far longer than the doctors.
BOOM received a copy of the letter that states that the nurses are at risk due to the inadequate facilities being provided in terms of less rest, no food, and having to travel home putting their families at risk.
The letter demands for PPE, proper infection control trials, training, appropriate working hours, not allowing students of nursing or nurses who are pregnant closer or with other co-morbidities near COVID patients, mental health services, accommodation, protection of salaries, and inclusion in decisive bodies and committees.
Maharashtra Health Minister Rajesh Tope has requested the Centre for 3 lakh PPE kits, 9 lakh N 95 masks and 99 lakh triple layer masks for the state. Currently Maharashtra has 35,000 PPE kits, 3 lakh N95 mask, 20 lakh triple layer masks, and 1300 ventilators.
BOOM's founder Govindraj Ethiraj even spoke to Jibin, United Nurses Association- head of Maharashtra chapter who emphasised the need for provision of personal protective kits.
BOOM also spoke to Ranjana Athavale from the Nursing and Paramedical Staff Union, Mumbai and Brinelle D'souza, one of the conveners of the Mumbai chapter of Jan Swasthya Abhiyaan and Professor at Tata Institute of Social Sciences, Mumbai to understand the reasons for writing this letter.
Athavale stated that it was necessary for nurses to speak about their safety as there was a shortage of protective gears. Furthermore, she stated that this issue was being highlighted and being taken to court by other associations.
"Nobody in the BMC has tested positive so far, we need to ensure that the government follows these orders soon", Athavale stated.
D'souza emphasised how nurses who are frontline workers and a very integral part of the health system are finally coming together to raise their voices. Jan Swasthya Abhiyaan as a health collective encourages health professionals to speak about their rights in such times.
"Before this, no advocacy groups spoke about nurses as much as they are doing now. We are dealing with a virus that is rapidly infectious and leaves the medical professionals susceptible if certain steps are not followed", D'souza opined.
They have received an acknowledgment from the CM's office but are yet to hear from the Municipal Commissioner.
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