Professor Jagat Ram, Director, PGI, Chandigarh, in conversation with The Indian Express on how the coronavirus posed new challenges, paved the way for many changes at the premier institute and the road map ahead.
COVID-19 has created new challenges in every sphere of life, with the large onus on the medical fraternity to cope with the crisis. What were the odds that PGIMER faced, as it catered to patients from across the region?
Tough times teach us so many valuable lessons and for us at PGIMER, the first and foremost thought that guided all our actions and responsibilities was that we are responsible for our patients, no matter what the odds are. As we geared for a brand-new way of working, many things were required on an emergency basis – PPE kits, N-95 and surgical masks for both the staff and patients, hand sanitizers, ventilators; digital temperature equipment…the list is long. We closed the physical OPDs in March- end, and prepared 200 beds at the Nehru Hospital Extension and added 100 more beds in August and 100 more in September, with oxygen facilities for beds. Many innovations were done to ease the process of coping with a large number of patients, including employing automated trolleys, drone to carry samples, ensuring facilities for testing for across the region, with more than one lakh tests done, as the virology department worked round-the-clock to cope with the increasing pressure. We trained 52 institutes of north India in RT-PCR testing and did validation of kits sent by ICMR. All along, our emergency services continued, as we treated COVID positive patients. There were many logistic requirements, separate entrances for patients, preparing quarantine facilities for hospital staff, ensuring testing, isolation and treatment. In September, there was a drastic rise in cases and the positivity rate, with more than 100 patients admitted to the COVID wards. It is team PGI which has done outstanding work, with each member of the Institute giving more than 100 per cent and that led to the success of PGIMER dealing with such a physically, emotionally and medically trying time. We know our strengths and weaknesses and that helps us improve.
In terms of treatment for COVID-19, what are the findings?
Steroids are very helpful in treatment, but it is essential that there is no self-medication. Remdesivir was found very helpful in reducing the viral load, but the WHO says it is not very useful in the treatment of COVID and is now used very selectively. In the initial stages of the pandemic, we were using Hydrochloroquine, but not anymore, with the antivirals overall not too effective. The response of plasma therapy is different in patients with or without co-morbidities and both plasma and Remdesivir are used very selectively, with patients responding to drugs in a different way, with extra care required for older people and people with co-morbidities. Early detection is very valuable in treating COVID-19 and now new research and study is being done across the world for effective treatment. In my opinion, we need to prevent the spread of infection, and that can be done with only following COVID-appropriate behaviour.
PGIMER is an ICMR-approved site for conducting the concurrent Phase 2 and Phase 3 clinical trials of the Oxford Covid-19 vaccine. What have been the findings so far?
We have received an overwhelming response from volunteers from all age groups and it is a matter of pride that PGIMER is part of the process of the vaccine search. So far, as many as 197 people have been screened with the first dose administered to as many as 149 volunteers and the second dose to 99 people. The results have been promising, with no major side effects noted so far, as we will over time see the antibody formation pattern, which will extend to over a period of six months. Personally, I am very optimistic about the safety and efficacy of the vaccine.
The physical OPDs have now restarted at PGIMER, and the city is also seeing a rise in COVID positive cases.
In these months, telemedicine has emerged as a wonderful new way of reaching out to patients, with our doctors and people adapting to the system brilliantly. The need of the hour is to develop it further, to save patients a lot of effort and also reduce the load on a tertiary care institute like PGIMER, though we were attending to all emergency patients throughout. As for restarting the physical OPDs, it was important, as many patients require physical examination for diagnosis and further treatment. As you know, we have changed the entire system of OPDs, with a limited number coming to the hospital, and various safety measures in place to ensure physical distancing, with not more than one attendant allowed. More screening and testing are paramount, and we will increase the number of patients over time, for our primary aim is to stop infection spread. We have done a lot of work to control COVID-19, and now the onus is on the people to check a second wave. With the festival season, people were outdoors, and are not following safety measures, of maintaining distance, wearing masks and washing hands. As a result, cases are increasing in the city and around, and there is an urgent need to be safe.
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