My duty days in the corona isolation center – A war we will win
It was time for me to enter the warfront on April 9, 2020, in the war against the coronavirus. There were eight of us doctors, from different specialties, on duty, in the corona isolation center in Kannur, a district in Kerala, where the highest number of coronavirus disease (COVID)-19-positive cases had been reported at that time [Figure 1]. Initially, I was slightly skeptical in dealing with such a big crisis, but I had to keep my apprehensions to myself, as this war was for all of humanity, for each and every one of us… If I could heal one person, break one chain, I could be saving thousands from getting infected.
The suspected patients were being brought to the OP triage in the “108 service” ambulances. In some individuals infected with COVID 19, only mild infection may be seen, which may go unnoticed, leading to danger. We had to take around 20–30 nasal and throat swabs per day, and during this procedure, the patients were likely to cough or sneeze which could lead to a highly infective environment. Any patient testing positive was placed in a single isolation room with an attached bathroom. The rooms were well ventilated so that they received fresh air.
Most of the COVID-19-positive patients were returnees from the Gulf. During the night duty, we often saw patients who could not sleep due to anxiety and stress, but we always managed to reassure them. Many of them were moody and irritable. They were given counseling by psychiatrists. Some of the people I saw in the isolation wards were petrified as though they had lost all hope in life. We had to pacify them. Some of them even asked me, whether they would die from this disease. I assured them we would not let the disease get the better of them and that they should have courage at this point of time. Maybe they did not realize that I too was facing the same risk…
The patients were being given a nutritious diet and also books and magazines to read so that they could feel comfortable. The geriatric and pediatric patients were given special care. We made sure that they found a second family in us.
As getting information regarding the individuals they had come in contact with, was important. We talked to each of them patiently, to get them to reveal each and every one of their contacts, the places they had gone to, and the people they had interacted within the preceding days. This was painstaking work and would take hours, but we could not afford to miss even one link as such an omission could pose a grave threat to the society. All the contacts of the COVID-positive patients were so traced. Their movements were tracked using a mobile GPS tracker by the authorities. After this, their route map was built up so that anyone who had been in the same place at the same time, or had been in contact with the infected patients, could be alerted. Such persons could contact the health department and be home quarantined for a minimum of 2 weeks. If the symptoms were to appear before this prescribed period, they had to attend the OP triage for further screening.
All the screening and management of the affected were done by us wearing the personal protective equipment (PPE), sometimes for up to 5 h, which really took a toll on us. Putting on the PPE alone took around 20–30 min as we had to be careful not to expose any part of the body. No air conditioners or fans were allowed in the facility. In this scorching April month, the outside temperature was around 34°C, and we were drenched in sweat and our protective eyewear was getting fogged. We could not quench our thirst, have any food, or even go to the restroom. In spite of these exhausting conditions, we had no option but to stay strong and dutiful. Removing the PPE was the riskiest of all, as we had to remove it carefully so that no part of the body came in contact with the exposed material as we knew that there had been reports of doctors getting infected despite the protective gear. Hence, donning and doffing, the PPE properly was by itself a challenge.
Then came Vishu, a festival widely celebrated in Kerala, where everyone spends time with their family, and here, I was, at a place I had least expected to be, especially since it also happened to be my birthday. My duty started at 8 am and went on up to 2 pm. Some of the patients had got their final results as “negative” and were to be discharged on that day. They thanked us and some of the elderly blessed us in gratitude. I thought that this was the best birthday gift I could ever have. We waved them goodbye and wished them the best of health. They were dropped back home as “happy faces” by the “108 ambulance service,” following which they would be under a 2-week quarantine period at home.
My family had called me, but being in PPE kit, we could not use our mobile phones. I returned the call after my duty was over. Everyone wished me on my birthday, I felt that they really missed me or maybe I missed them more... My family, including my parents and wife who is an endodontist, has been very encouraging and supportive of me to this day.
In this war, all my cowarriors – my colleagues, staff nurses, nursing assistants, cleaning staff, and IMAGE (biomedical waste treatment and disposal facility established by Indian medical association) staff – have all done an exceptional job. The Health Ministry of Kerala deserves an applause, for the immense support, they gave to each one of us. By aggressive testing, contact tracing, and by isolation of the patients, we have tried to combat this disease. No stone has been left unturned in this endeavor. The high literacy rate of the state was a huge advantage in favor of Kerala, in the fight against COVID. The “Break the chain” campaign of the Health Ministry which advocates frequent washing of hands and social distancing has also played a major role in preventing the mass spread of the disease.
Today, I have finished my duty of 14 days, and I am now in my quarantine period of 2 weeks. We have been given a good accommodation by the government, in keeping with the spirit of the “break the chain” campaign so that we do not end up as carriers of infection to our family. I shall be getting my tests done after a few days and I am hoping the results will be negative so that I can prepare myself to come back to the warfront again.
Till a few months back, being a doctor felt like a thankless job.., but now, I think it will change.. So will this situation... Let’s stay positive….