How the pandemic alters the lives of Doctors & Health workers

With the mindset that this is the time the nation needs us, and it makes us strong enough to put our lives at risk to save others. `Dr. Zahra Jaan

In this time of perplexity, when a sense of foreboding is prevailing everywhere around the globe, it is not an easy task to step ahead and works as the frontline fighters. Amid this coronavirus pandemic, healthcare professionals are serving humanity at the expense of their own lives.

Pakistan, with no exception, is also facing the same crisis, with less than minimal resources and an underfunded healthcare system. Amid the chaos, the ones leading from the front are our caregivers, our national heroes. This not only demands to risk your own life but also the life of your loved ones in honor of the commitment they made to their profession, undeniably this requires huge sacrifices and courage.

With more than 1000 health professionals tested positive for corona, these doctors still are doing extraordinary service even without the protective gear and the essentials needed to minimize their exposure to the virus. With our health care system being extremely fragile, sloppy and not able to resist havoc like this- having less than 15000 ventilators in total, and not enough space to accommodate the patients, these warriors not only make themselves vulnerable to the virus by stepping out but also make tough calls deciding who gets a chance to live and who will be left to die; taking a toll on their mental health.

Dr. Zahra Jaan, is one of our white cap heroes, serving in Hayatabad medical complex in the Gynae department. Peshawar being the epicenter of this pandemic outbreak in KPK, Dr. Zahra, has volunteered in the combat team for COVID-19 too. In this dire situation, being responsible for not one but two lives demands an exceptional level of vigilance; we cannot overlook her tremendous courage to take this burden on her shoulders and stand steadfast in the face of this calamity.

Doctors
Dr. Zahra Jan is a trainee in gynae and obstetrics, Hayatabad Medical complex

To get an insight into the actual situation in KPK, we had a candid conversation with Dr. Zahra Jaan, a qualified doctor and a brave lady. She is serving her people with no fear amid coronavirus breakdown. Here are some excerpts of the conversation:

Sabeeka: During this pandemic, where everyone is freaking out being caged in the houses and gazing empty streets from their windows. Take us into what it is like for a frontline warrior who is potentially putting his life as well as of his loved ones at stake in this fight to combat the disease? 

Dr. Zahra: Everyone is scared, and it’s quite natural. But for us being at the frontline, this is our job to be in hospitals. Initially, when the cases were not spiked up, we did not have an absolute idea of how things will unfold, but since I am married, I was scared for my family too. After my first duty, I was in quarantine for 14 days, I could not meet my family, and I did not even see my husband for 21 days. They sent us to the hostel near the hospital, so we didn’t use to come home. So yeah, we miss our family, we are scared and fearful.

But even then, this strength comes from within us when we see people suffering in pain, and we realize that we are the only ones after Allah who can relieve them, pacify their pain. It also reminds us of our oath, the commitment to our profession. With the mindset that this is the time the nation needs us, and it makes us strong enough to put our lives at risk to save others. And after they recover, the blessings they give you, that feeling is something out of this world, totally unmatched, jubilant is a small word for that, but that makes you give your all to your profession. Having said that, inevitably, it is a difficult task to step out as a warrior in this whole fiasco full of risks.

Sabeeka: During this hour of crisis, how is your typical day now different from the one before? Do you have to perform “out of hour” service to meet the demands with the increasing number of patients?

Dr. Zahra: Initially, during the pandemic, our elective surgeries and OPD- everything was open, but when the cases increased, only the batch that got duty on a particular day used to come. We used to go for two days a week to limit our exposure. But to meet the needs with the increasing number of patients, they needed volunteers from every ward for the combat team; that condition was entirely different. We have ordered to stay in the hostel for seven days. During this week, we had consecutive duties of 6 hours at different timings-early morning or evening, depending on the schedule. They sent us buses for pick and drop, and then we were self-isolated in those rooms in the hostel, we were not even allowed to meet our colleagues.

After this week-long duty, we were allowed to go homes, where we were in quarantine for 14 days. After that, my regular duty started in the gynecology department. Still, when we return home from our regular duty, we are supposed to remove our shoes, overalls, or any extra thing we have at our gates. Even the essentials we have like stethoscope and phones; we sanitize them regularly with the alcohol swabs, take a shower, and then meet our families. And we don’t take any extra accessories to the hospitals, including our purses. 

Sabeeka: As a leading health expert, how do you see the COVID-19 different from other viruses like Ebola, Zika, HIV, and SARS? And what makes an individual vulnerable to the virus, and how can one generally catch the virus?

Dr. Zahra: The significant difference is that it’s very contagious, as we speak of HIV, it is transmitted through body fluids, though it is more fatal than COVID-19. Similarly, when we look at the transmission of influenza, it is one to one. The problem with COVID-19, it is extremely contagious, another distinct feature is its viral load, the one getting infected will have the same viral load as that of the transmitter. It only depends on your immune system, whether it is capable of fighting the provided viral load or not. And the primary means of its transmission are droplets though it’s not an airborne disease, if you sneeze, cough, or even breathe closer to a potential carrier of the virus, you are likely to get it.

Sabeeka: Being a trainee in the gynae department, you are aware of the vulnerability of pregnant women to this virus. What extra precautions is your department taking in this regard?

Dr. Zahra: We make sure that every patient we deal with is wearing a mask and taking all the precautionary measures. On our end, we neither allow more than one attendant with the patient nor do we check more than two patients simultaneously. We have minimized the use of a stethoscope, we monitor fetal heart through machines. Other than that, we prioritize patients if it seems that a patient has come for an antenatal checkup, and there is not anything serious. We can keep them from entering the ward and recommend them home treatment. 

But, when it comes to the labor room, we can’t do much as everyone out there is in a critical condition, and there is havoc, but we have tried to distance the beds and everyone in the staff wears PPE when they enter there. The most we can do right now is to ensure their safety and this is what we are doing.

Sabeeka: We have witnessed that the doctors compelled to compromise their safety. With your hospital, are you in the same predicament? How well are you people equipped with the PPE?

Dr. Zahra: With our hospital, our seniors made sure that everyone got their PPE. Although PPEs are not disposable, we have to wash them daily, yet this is the most they can do for us with limited resources. Our buses for pick and drop and our hostels where we used to live were decontaminated regularly, and everything is government-funded. But I don’t think the conditions are as favorable as our hospital in the surrounding hospitals.

Sabeeka: What is the potential protocol for testing the patients? Any vital signs? Have you witnessed any asymptomatic patient?

Dr. Zahra: Initially, we didn’t have our PCR machine here in the hospital. We got our PCR last week, but obviously, we can’t test all of the patients. Our first priority is any faculty member who develops symptoms- we treat them as the suspect of COVID-19, and the next priority is the patients who are vitally unstable with high respiratory rate and shallow oxygen saturation rate like below 96. 

Initially, we used to consider their travel history too, but now as the cases in the community are increasing, travel history is not that important. Instead, we test the elderly having any other comorbidities or underlying illnesses. The ones with mild symptoms or no apparent signs having a travel history are registered and recommended to a private hospital for the test, later, the reports are checked. In the case of mild symptoms, we only recommend them to self-isolate in their homes.

Dr. Zahra screening the suspected patient of covid19

Sabeeka: What would you suggest to the potential COVID-19 patients with mild symptoms at-home treatment?

Dr. Zahra: They can take Steam inhalations, Panadol for fever, cough syrup, or spray for throat soreness and incorporate colored vegetables in their food and fruits with a high content of vitamin C like oranges and do exercise to boost their immunity.

Sabeeka: How many tests are you guys conducting per day at HMC Peshawar? Is the government satisfying the needs of the hospital concerning testing kits?

Dr.Zahra: Here at HMC, we used to conduct almost 30-60 tests per day. The testing rate is slower in KPK, which is one of the main reasons that the fatality rate of COVID-19 is higher enough in KPK. 

Sabeeka: Are you worried that it is a matter of time that the hospitals will run out of the equipment, masks, ventilators, PPE? Are you seeing the coming days leading us to a catastrophe and the trajectory only going straight uphill? What is your opinion regarding the idea of a partial lockdown?

Dr. Zahra: People have no idea how delicate the situation is, if they keep on with their non-serious, irresponsible behavior, we will no longer be able to control the situation. Talking of our health care system, we have 3-4 ventilators in a hospital. Even in times of normalcy, we don’t have a free bed in ICU in case of an emergency, and we have converted 2 wards into intensive care units already. Where all hale health care units have come down to their knees, what will we do with meager resources and ill-equipped system?

Due to ease in lockdown, we are all set to open our gates to a more severe catastrophe. With the stroke of the curve going upward every day, the coming 15 days will be crucial for us, and unfortunately, people are not dealing it the right way. At the moment, we don’t even know the exact number of potential COVID-19 patients and not even the precise mechanism of this virus- nothing is definite. And unfortunately, we don’t see the trajectory getting flattered anytime soon. 

Sabeeka: Many conflicting ideas go viral about the portion of the population this virus is targeting. In your opinion, and from what you see, are the elderly or those with some sort of sickness more prone to the disease?

Dr. Zahra: The coronavirus doesn’t spare anyone irrespective of age, we have even seen cases of newborns infected with the virus. Nothing is going to protect you regardless of your age. You may get mild or no symptoms if you are young and contract the disease, but you will infect the elders in your home who may lose their lives. Yes, you can say that if you are young and you don’t have any underlying illness, you have high chances of recovery as the fatality rate is meager in such cases. 

Sabeeka: Several things are being exchanged on social media regarding dugs and treatment to cure coronavirus without any authenticity. What will you say about this self-medication people are practicing and the threats it can pose?

Dr. Zahra: I cannot emphasize enough how dangerous this self-medication can be. People are taking a high dosage of antimalarial drugs for COVID-19 without knowing the side effects they can have like Hydroxychloroquine disturbs heart rhythm. You can have a heart attack while the excessive dosage of Panadol can cause kidney failure. You do not have an idea about any underlying disease or allergy you may have, and any of the ingredients in the medicine you are taking can cause a shock or trigger a reaction in your body. 

Sabeeka: Is there any message for the people on civil responsibility they should show to curb the spread of this disease?

Dr. Zahra: Social distancing is the only way to curtail the spread of coronavirus. If you don’t go outside to get the virus, it’s highly unlikely to reach you in your home, so please stay at home. Especially for the young lot, if you won’t practice social distancing, you may not be affected this much, but your elders won’t be able to survive if they contract it. Our health system has already started to cripple, doctors in our fraternity have started getting affected- we are at the cusps of an unmanageable crisis. Take it seriously and follow the precautionary measures. Don’t hide your history, be honest with your health care providers, and don’t hoard as there is an apocalypse waiting for you out there. To take care of others, start taking care of yourself.

Also, Read: Be the change you want to see

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