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Monday, June 14, 2021

Karnataka hospital staff sound alarm: Families at risk, vaccinate

The insurance of vaccination has resulted in the doing away of the mandatory quarantine for Covid workers in many places — especially in short-staffed government hospitals, say health workers.

Written by Johnson T A | Bengaluru |
Updated: May 21, 2021 7:13:37 am
A health worker after receiving a shot of Covaxin, that has been in short supply, at a centre in Mumbai, Thursday. (AP)

Over the last two months, Naveen Raj, the head nurse at a government hospital in Bengaluru, has been at work every day — managing patients, nurses and staff, and also handing over bodies to families.

At the hospital, his day begins at 7 am and goes on late into the night with the 36-year-old flitting through the emergency, ICU and general wards in the over 150-bed Covid hospital, sometimes in a PPE kit or with just a mask.

At home, he says, he stays in his room and does not interact with others in his family, including siblings, because while he has the protection of a double vaccination, other members of his family do not.

Raj’s dilemma carries an echo across India where vaccinations have shielded doctors and healthcare workers to a large extent in the second Covid wave, but their family members remain unprotected amid a slowdown in vaccination.

The Centre has told states that they do not have the discretion to add categories of beneficaries from the doses it procures and allocates to them for vaccinating three priority groups free of cost: healthcare workers, frontline workers and those above the age of 45.

However, states can make provisions for other categories from doses directly procured by them from the open market under the 50-50 formula unveiled on May 1.

On Wednesday, Odisha was among the first off the block by including families of healthcare workers in its priority group for vaccination from the doses it procures independently.

“I have got young doctors and nurses who are working eight-12 hour shifts. I am averaging around 10-12 healthcare workers who test positive every day,” said Dr Sanjiv Lewin, head of medical services at St John’s Medical College and Hospital, a 1,000-bed Covid hospital.

“Most have moderate or mild symptoms, most of us have been vaccinated. They are, however, returning home to people who may not be vaccinated. I have come back after 10 days of isolation because my wife tested positive. She is a doctor. We have elderly parents at home. We locked up the entire family for 10 days to deal with this crisis,” he said.

“This is the first time we have felt it hitting all our families. By not vaccinating our families, we are tying up the hands of healthcare workers again,” Lewin said.

Unlike the first wave last year, when doctors, nurses and hospital staff could take a week off in quarantine after a week of working shifts, the insurance of vaccination has resulted in the doing away of the mandatory quarantine for Covid workers in many places — especially in short-staffed government hospitals, say health workers.

“Nearly 99 per cent of deaths are among those who have not been vaccinated. Those who have been vaccinated are safe,” said Dr Shivakumar, head of the emergency unit at the 550-bed Victoria Hospital, the main government Covid facility in Bengaluru.

A related challenge that big hospitals are facing is to find replacement workers when regular staff fall ill. While medical college hospitals like Victoria and St Johns can fall back on interns, PG students and doctors from other departments, stand-alone government hospitals do not have that luxury.

“Though we have not been in clinical practice for over 20 years, we have been asked to fill in for regular doctors who fall sick on Covid duty. Since most of us are vaccinated we do not hesitate but going home to our families is a concern,” said a forensic medicine doctor at a large government hospital for Covid in Bengaluru.

“Vaccines guarantee protection against severe disease and death. But no vaccine can prevent infection,” said Professor V Ravi, the former head of the department of virology at the National Institute of Mental Health and Neurosciences. Ravi is part of the Karnataka government’s Covid technical advisory committee.

The Karnataka chapter of the Indian Medical Association reported 36 deaths of doctors during June, July and August of 2020 when the first wave peaked in the state. “There have been around eight deaths of doctors this year but it is not clear if they were vaccinated or not,” said Dr M Venkatachalapathy, president of the IMA in Karnataka.

When the vaccination drive was launched for priority groups in January, there had been reluctance among many health workers due to lack of clarity over efficacy and safety. “But now, I see them seeking out vaccination. The vaccinated are protected. There may be only one or two staff members who have been infected. Those who have got infected have also had only mild infections,” said a senior nurse at a government hospital.

The Karnataka government was forced to stop vaccinations for the 18-44 age group on May 14 due to the availability of only 11.24 lakh doses for nearly 19.97 lakh persons above 45 who are due for second doses. Last week, there were a total of nearly 65 lakh people awaiting second doses in the state.

Karnataka, which saw over 45,000 cases in early May, has seen a dip to the 40,000 range in the last week and below 30,000 in recent days. While nearly 500 deaths were being recorded per day at the start of May, they are now in the 250 range.

In Bengaluru, however, 3,702 deaths were recorded in the last 19 days, which is the highest for a single month in the second wave and exceeds the peak of 971 in September 2020. In April, the official Covid death count was 1,907 in Bengaluru.

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