‘Who will treat patients?’: Staff shortages loom as Omicron infects doctors and hospital workers

Dr Anuj Aggarwal, a resident radiologist in Delhi’s Vardhman Mahavir Medical College and Safdarjung Hospital, woke up on Wednesday morning to a string of WhatsApp messages. Seven of his fellow doctors at the hospital had started experiencing Covid-19-like symptoms overnight.

Aggarwal himself is in isolation with similar symptoms and is awaiting his test report. So is his colleague, who along with him and a third doctor, perform the colour doppler ultrasound procedure at the Central government-run hospital, one of the largest health facilities in the capital. “Currently, there is only one doctor instead of three,” he said. “This is putting undue burden on him.”

It was only a matter of time, Aggarwal prophesied grimly, that his other colleague, too, would have to self-isolate. “Every second doctor is currently symptomatic,” he said. “Fifty plus doctors at Safdarjung are infected as of yesterday. Then there are nurses and paramedical staff at the hospital.”

According to Joshy Mathew, the president of the United Nurses Association in Delhi, around 100 nurses in the city have tested positive for the virus in less than a week.

While hospitals in Delhi have not yet given out any official numbers of infected staff members, The Indian Express on Tuesday reported that over 100 doctors had been infected in just four government hospitals in the city: All India Institute of Medical Sciences, Safdarjung, Ram Manohar Lohia and Hindu Rao hospital.

If Covid-19 infections are surging at an unprecedented speed in India, courtesy the highly transmissible Omicron variant, they are spreading like wildfire in hospital settings, infecting doctors and other staff by the dozen.

Most healthcare workers are vaccinated and, therefore, seem to be experiencing only mild symptoms. But the need to self-isolate means they are no longer able to report to work. The result: hospitals in many parts of the country are starting to experience a crunch of healthcare staff.

Kolkata and Patna struggle

In Kolkata, Dr Manas Gumta, who works at a tertiary hospital in the city, said the situation was “very very bad”. “Doctors, junior doctors, other support staff, everyone is down,” said Gumta, who is the general secretary of an association of the government doctors in the state. “Who will do the treatment? Even if Covid hospitalisations are low, who will take care of the others?” he asked, referring to patients admitted to hospitals for medical emergencies and other treatments.

Like many of his colleagues, Gumta, too, is down with the virus.

The state’s director of health services Ajay Chakraborty, however, insisted that the situation was not as dire. “There are sporadic infections with clusters in some hospitals – 10, 15, 20, like that,” he said. “We are managing the situation.”

Chakraborty said he was not in a position to provide specific information on the total number of healthcare workers who had been infected.

News reports from the weekend, however, said the size of the infection clusters in hospitals were much bigger and at least 200 doctors have been infected in Kolkata alone.

With over 15,600 cases, the state capital is the epicentre of the outbreak in the state. Every one in five people tested in the state is turning out to be positive.

According to Gumta, “30-40% of doctors in each and every hospital [in Kolkata] are positive” currently.

Government hospitals in Bihar’s capital Patna seem to be in crisis too. At the centre of the turmoil is the city’s Nalanda Medical College and Hospital where over 150 doctors are reportedly down with the virus.

It began with a breakout in an undergraduate students’ hostel on January 1, which has briskly spread since. “With postgraduate resident doctors also starting to get infected, there are fewer hands in emergency and OPD [outpatients’ department] wards now,” said Dr Sachin Sinha, a resident doctor at the hospital.

The Patna Medical College and Hospital has seen fewer infections among its staff, but the situation there isn’t rosy either. Dr Manish Mishra, a senior resident in the department of medicine, said OPDs in some units were having to do with less manpower because many postgraduate students, junior residents as they are called, were infected. “They are the real workforce, whether in Covid or non-Covid wards,” said Mishra.

Mishra recounted that he received an SOS call earlier in the week with a request to fill in at an OPD unit as three of the four junior residents were in self-isolation. “But I am myself positive and in isolation,” he said.

Mumbai blues

Things aren’t very different in Mumbai. Across the three major civic hospitals in the city, King Edward Memorial, Sion and Nair, at least 210 resident doctors, interns, and medical students have tested positive for Covid-19 since January 1, according to the Maharashtra Association of Resident Doctors.

Here, the sudden surge in infection amongst healthcare workers has led to paucity of not just healthcare providers but even isolation facilities for them.

Dr Sachin Pattiwar, a resident doctor who is currently admitted in King Edward Memorial hospital with mild Covid symptoms, said they have requested the Brihanmumbai Municipal Corporation create isolation facilities in lodges and hotels for health workers.

“A lot of us are asymptomatic or have mild infection and don’t need hospitalisation. But we can’t isolate in hostel rooms because we share one room with several others,” said Pattiwar. “The cases amongst hospital staffers have shot up in the last few days and some arrangement to isolate them must be made.”

According to officials in the civic body, it has already reserved two floors of the Seven Hills hospital, another BMC-run tertiary care facility, for infected health care workers. Seven Hills’ authorities, however, said one of the two floors was already occupied.

Private hospitals haven’t been immune to the surge. TC Jibin of the United Nursing Association said many staffers in private hospitals had also tested testing positive. “In some cases private hospitals are asking asymptomatic staffers to resume work even if they are infected,” Jibin alleged.

In at least three private hospitals in Mumbai – Breach Candy, Bombay Hospital and Global Hospital – multiple nurses had tested positive, nursing association members told Scroll.in.

Jibin said the situation had compelled healthy nurses to work overtime.

The government seems to be aware of the crisis. Last week, the Maharashtra government issued a circular to all districts to consider reducing the isolation period for asymptomatic health workers to five days. Dr Pradeep Vyas, Maharashtra’s additional chief secretary, said the intention was to ensure hospitals didn’t fall short of healthcare workers as Covid-19 cases surged. “In the USA, the Center for Disease Control too has shortened the isolation period to five days,” he said.

Mumbai’s additional municipal commissioner Suresh Kakani said the civic body had initiated a recruitment process to hire doctors on a temporary basis. “We are also trying to create more isolation facilities for health workers,” he said.

Shortage likely to worsen

The low rate of Covid-19 related hospitalisations in most cities is a source of relief at the moment, but there are fears that things may worsen soon. Early trends suggest the peak of the Omicron wave may be significantly higher and come in quicker time than the previous ones. Even with low hospitalisation rates, that could mean thousands of patients requiring critical care at the same time.

If hospitals are understaffed, the surge could be difficult to manage, warn doctors. “As patients are increasing, the need for doctors will increase,” said Suvrankar Datta, a junior resident radiologist at AIIMS in Delhi. “But with more and more doctors turning sick, availability is decreasing. We are still holding up, but when cases reach the peak, I am not very sure.”

As Aggarwal pointed out, the wild transmissibility of the virus makes the situation peculiarly tricky. “Other kinds of illness, like migraine, or even common cold, we are accustomed to handle our work after taking medicine,” he said. “But here you are helpless, because you can’t risk infecting others.”

This reporting was supported by a grant from the Thakur Family Foundation. Thakur Family Foundation has not exercised any editorial control over the contents of this article.