For healthcare professionals, 2021 may have little relief to offer

Covid-19 fatigue notwithstanding, the healthcare industry witnessed loss of livelihood and salary cuts too

As the New Year arrives sans customary fanfare, amidst the wait for the vaccine and the entry of a new Covid-19 mutant, there is little to rejoice for many, especially the country's healthcare personnel.

For the sector which saw the normal being rewritten each day, the battle in 2021 is likely to be an uphill one. Thirty-six-year-old Prerna (name changed) -- a nursing officer and a mother of two -- has been working for six months at a Covid ward in a government hospital in Delhi. “I have been working in the Covid ward for the last six months without any replacement. Staff shortage has been a huge problem and still continues,” she said.

Her husband and elder daughter had tested positive for Covid-19. “It was such a difficult time and I didn’t get leave. During Diwali, the situation was worse,” she said.

Frontline warriors like Prerna have been braving a whole new world of issues ever since the pandemic broke out. They now brace for the onslaught of additional challenges the new Covid 19-mutant may bring in.

There are concerns among the health workers that the burden of 2020 may be carried over to the new year. On whether the hospitals are prepared for the challenges posed by the new mutant in India, Dr S Venkatesh, a lead interventional cardiologist from Bengaluru said: "The lessons learnt by the healthcare professionals during the first wave of Covid-19, and the preparedness in terms of facilities should ideally make it easy for a second wave, if any, to be handled easily," he said.

“But there is a caveat to this: just as the first wave is receding, healthcare professionals are about to recover from Covid fatigue, induced by a large number of cases, sick patients, and deaths, hospitals have suffered from huge losses due to the dramatic reduction in non-Covid elective operations and routine patient visits,” he added.

He said that many state governments that leveraged private hospitals for treating Covid patients on their behalf haven't kept their promise of paying for the services and therefore most hospitals are reeling under huge losses.

“In such a scenario, a return of the virus in the form of a second wave is like to have devastating consequences to the health and morale of healthcare professionals as well as financial status of most hospitals,” he said.

Uncertainty has been the hallmark of the past year and healthcare workers, among other frontline warriors, have been bearing the brunt of it. The virus has taken a toll on their professional and personal lives.

Reflecting on how tough it has been for the healthcare professionals after the pandemic struck, Venkatesh said that the doctors have been at the forefront of the war against Covid-19 on the healthcare delivery front." He explained that they have also "had to cope with pressures on their personal front just like every other citizen".

“Right in the beginning, barring those who are vulnerable, most doctors were called upon to care for patients, by their own volition, their organisations or the respective city or the district administration,” he said.

Loss of livelihood, shortage of resident doctors

Covid-19 fatigue notwithstanding, the healthcare industry too witnessed loss of livelihood and salary cuts, which added to the economic hardships of many personnel. “Due to lockdown and subsequent reduction in people's movement, like all other businesses, healthcare facilities saw a drastic reduction in footfalls of patients,” Venkatesh said. He added that individual doctors had difficulty maintaining their practices and hospitals cut salaries of employees in some cases up to 50%.

“Many healthcare professionals lost jobs and livelihoods. Hospitals were also hit by their own staff being affected by Covid-19 and shortage of resident doctors, especially in the emergency and intensive care units, affected the efficient care of sick patients,” he said.

Asked what she’s looking forward to in the New Year, Dr Mansi Khanderia, a Bengaluru-based medical oncologist, said it’s indeed 'the vaccine'. “The pandemic has drained us in every possible way,” she said.

“It’s been nine months and most of us have been wearing N-95 masks with visors for eight hours a day every single day; wearing a cloth mask after work feels like a breeze. It’s heartbreaking to see people being so selfish and lazy to pull up a mask even for a few minutes or hours once in a while when they step out.”

“From a time when people stigmatised and ostracised healthcare workers from the community in the fear of catching the infection, we are now in a stage when healthcare workers are acquiring Covid 19 infection from their neighbours and family in the community. This proves a simple point that masks work. We only wish everyone masked up responsibly,” Khanderia said.

Covid-19 denial and the refusal to follow the protocols by the public have heightened the challenges for healthcare professionals across the world.

“Wilful non-adherence to wearing masks because of a false notion that Covid is not a dangerous illness and that masks are a conspiracy to curb individual liberty (anti-maskers) is a movement that is more in vogue in the West, especially the USA. Luckily, such extreme denial is not common in India,” Venkatesh said.

“But, not following protocols of masks and social distancing due to ignorance or sheer negligence has become common of late, as the first wave of the pandemic tapered.”

“This is a chance for the virus to raise its head in the community as a second wave. Also, with the apparent return to normalcy, as more non-Covid patients go to hospitals, this behaviour obviously puts healthcare professionals at risk,” he said.

Challenges of 2020 were many, varied

The virus unleashed challenges never before fathomed. “While doctors and other HCPs were prepared to provide care for Covid-19 patients, another challenge was patients of Covid who presented with symptoms unlike typical infection," Venkatesh said. “Many patients had affliction of the heart, strokes, clotting in the blood vessels, etc, and if HCPs were not vigilant in treating these patients with due precautions, there was a heightened risk of contracting Covid-19.”

“At the peak of the pandemic in Bangalore, when bed availability became a problem another phenomenon was noted. Some patients with Covid infection masked their symptoms by taking over the counter medicines and misreported their symptoms to gain entry/admission into hospitals. While this was obviously a desperate measure by patients fearing for their lives, such action potentially put unknowing healthcare professionals in danger,” he added.

As 2021 arrived, Prerna, like other healthcare professionals, is back to taking care of their patients.

“I love looking after patients and talking to them. They are concerned about my health as well. I only hope in the New Year, the staff shortage is addressed and they can find a replacement for me after six months of work in the Covid-19 ward,” she said.