Challenges of delivering medical care amidst a global pandemic

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On National Doctor’s Day, Dr Tarun Sahni, Senior Consultant Internal Medicine, Indraprastha Apollo Hospitals, New Delhi, explains the challenges faced by doctors while providing the best medical care to their patients during COVID-19

With an unexpected and ongoing pandemic over the past 18 months, the medical fraternity has faced major challenges. From empowering the hospitals to managing complex patients in a segregated area, to training the medical and paramedical staff while continuing to deliver care, the healthcare infrastructure has been stretched at the seams of all services. Starting from the treatment of COVID-19 to managing non-COVID patients amidst the pandemic, it has been a journey of prioritising the best-available patient care, research, accommodation and augmenting technology to equip the system better.

With the global lockdowns, travel restrictions and the new set of required precautions, telemedicine came to be a great support. Whether it was in the form of WhatsApp calls, or online apps, telemedicine could connect a patient and doctor virtually. However, in cases of emergency care, the in-person availability of both the patient and the doctor was an unsaid necessity. It was only through the innovative and devoted minds at work that we were able to manage non-COVID patients, along with COVID patients. This required maintaining the highest of safety measures and all the necessary precautions while delivering medical care. It required hard work, long duty hours, absence from family in PPE gear and devotion from all the doctors and allied health staff across the world to be able to prioritise the patient care amidst these challenges. The changing knowledge and protocols required regular updates and sharing of knowledge by the global, national and local leaders to ensure the best practices.

The anger against the disease, its mortality and morbidity was often directed with anger towards doctors and healthcare workers. This needed immense maturity and resilience of the administration to continue to support the medical teams to deliver care.

The MOHFW and National Sample Survey Office (NSSO) data even before the pandemic clearly indicate that demand for allied health care workers is significantly higher than supply. This disparity is observed in all categories of allied health care workforce across the states. Assuming the demand for allied health care worker per 1,000 people to be consistent, India would need 60,00,000-70,00,000 AHP by the year 2024. Hence, it is imperative to augment our healthcare workforce and their training methodologies to be able to prepare them for such challenging situations in the future.

The current scenario can count to be a great example of how doctors with their available knowledge and technical know-how are managing procedures and care to carry out organ transplantation, bariatrics and robotic surgeries, interventional cardiology, obstetrics and gynaecology, oncology and renal transplantation amidst this pandemic.

The patients were also exposed to uncertainty on where to get appropriate treatment, get blood test and acquire medications amidst this lockdown and while being in quarantine. The online and local suppliers came forward to support the community during these uncertain times. With the fear of catching the virus and travel restrictions due to lockdown, patients who required a regular and continuous medical intervention couldn’t continue their treatments. As a reason, various patients who were on dialysis, chemotherapy and other continuous treatments, reported increased problems. We have also seen cases where organ transplantation was the only possible procedure to salvage patients unable to get their regular dialysis and due to a delayed treatment.

Organ transplantation in times of the pandemic required an extra set of precautions both by the patient, its family and the doctors. For conducting a transplantation procedure, not only a different ward but different buildings were also used to maintain an extra set of precautions. As a part of the precaution drill, the team performing the procedure undergoes regular COVID tests and the patient is administered treatment under a supremely available precautionary environment. Doctors involved in providing the maternity care too take the best possible precautions for conducting the surgical and non-surgical procedures with utmost care.

The impending third wave makes it important to plan for proving a smooth medical care. Patients and even health people are advised to not delay their ongoing treatment and preventive health checks, despite travel restrictions. A timely diagnosis can ensure appropriate and timely medical intervention with better outcomes.

The worst may be over but we cannot let our guard down. We must be ready if the next wave attacks us. Get vaccinated, observe COVID protocols and support the healthcare industry to help you out of this quagmire. We have seen many a young lives lost and many moving around with long COVID. Let us not let our guard down.

COVID-19 doctorsCOVID-19 healthcare workersCOVID-19 pandemicNational Doctor's Day
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