New Delhi: The shortage of proper protective gear for doctors tending to Covid-19 patients, even suspected cases, has had doctors and medical staff around the country worried.
Doctors at AIIMS-Delhi have reportedly been using self-made masks, while medical personnel at a few of the capital’s mohalla clinics told ThePrint they’d been buying protective gear for themselves and their staff at personal expense.
At government hospitals in Baghpat, Uttar Pradesh and Patna, Bihar, doctors and medical staff have complained about being given protective kits meant to prevent HIV transmission, instead of those required for Covid-19.
They point to the different modes of transmission for the two infections — HIV is transferred through contact with blood and other bodily fluids, while Covid-19 is primarily transmitted through droplets sneezed out or coughed up by an infected person — to claim they are ill-equipped to tackle the pandemic.
The hospital authorities in Baghpat told ThePrint that the two kits served the same purpose, but experts disagreed, pointing out that HIV kits didn’t have the kind of masks that kept coronavirus at bay.
A protest in the hospital
According to guidelines published by the World Health Organization (WHO) as well as the central government, those on the frontlines of the battle against Covid-19 need to be equipped with a personal protective equipment (PPE) kit that contains coveralls, gloves, medical masks, goggles or a face shield, head and shoe covers, and, for specific procedures, respirators and aprons.
On 26 March, Baghpat recorded its first coronavirus case, a 32-year-old with travel history to Dubai.
Two days later, Saturday, nursing and paramedical staff in the district hospital of Baghpat staged a protest against the authorities for not providing them with the proper PPE kits. The protesters claimed the hospital was instead giving them protection gear worn while treating HIV infected patients, and said this was a sign the authorities didn’t take their safety seriously.
Similar grievances were raised by the staff at two government hospitals of Patna last week.
According to Nalanda Medical College Hospital’s (NMCH) Junior Doctors Association (JDA) president Dr Ravi Ranjan Kumar Raman, the HIV kit didn’t have the same quality of masks as the Covid-19 one is supposed to have.
“The HIV kit has a basic surgical mask and not an N95 mask. When we are in such close proximity to infected patients, we need an N95 mask,” Raman said.
Approached for comment, Baghpat chief medical officer (CMO) R.K. Tandon acknowledged that the staff was being given HIV kits, but insisted they were the same.
“The coronavirus PPE kit and the HIV kit are one and the same. The nursing staff who were protesting were only trying to evade their work and responsibility,” he said. “They wanted to avoid working in the coronavirus ward… We have launched an investigation against a couple of them. If they do this again, an FIR will also be registered against them. They shouldn’t be behaving this way in times of a crisis.”
While the Baghpat CMO said both HIV and PPE kits were the same, experts disagreed.
“HIV spreads via blood and bodily secretions. So while goggles, gloves and gown may be a part of the HIV kit, an N95 mask is not,” Dr Yogesh Jain, secretary of the Jan Swasthya Sahyog, an organisation engaged in rural health, said.
“What you require for health workers testing and treating coronavirus patients is an N95 mask — to prevent the virus from entering the mouth or nose of the worker. Coronavirus is much more contagious than HIV,” he added.
Jain said the staff’s concerns would be addressed to an extent if N95 masks were added to the HIV kits. “But there needs to be a conversation around that. The government needs to listen to the protesting staff,” he added. “If even a single doctor or nurse is relegated to the ventilator because of this negligence — we could be looking at healthcare givers deserting hospitals en masse. This would be a catastrophe.”
Malini Aisola, co-convenor of the All India Drug Action Network (AIDAN), a group of NGOs working to bolster healthcare access, said the mask shortage needed to be addressed immediately.
“We need to use the masks in line with the guidelines issued by the WHO, and the government needs to acknowledge that there is a shortage to begin with,” she added.
According to the experts, hospitals could just arrange N95 masks for those working in proximity to Covid-19 patients. “But here, we have politicians and bureaucrats and police personnel all wearing N95 masks, adding to the shortage,” Jain said.
Govt moves to address shortage
Having taken note of the shortage complaints, the Modi government, in a Twitter thread Monday, assured that the requisite protective gear was being arranged via local manufacturers, donations as well as foreign contracts.
3.34 lakh PPE coveralls are available with hospitals in the country. Another 3 lakh donated coveralls being received from abroad by 4th April.#IndiaFightsCorona @PMOIndia @NITIAayog @drharshvardhan @FordaIndia @nppa_india @AIIMSRDA @IMAIndiaOrg @Pharmadept
— Ministry of Health (@MoHFW_INDIA) March 30, 2020
According to a 28 March Reuters report quoting an internal government analysis, the country needs around 3.8 crore masks and 62 lakh pieces of PPE to tackle the Covid-19 pandemic.