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Thursday, August 06, 2020

Inside Bhagalpur’s Covid ICU: Staff crunch, fearful families, stressed doctors

Bhagalpur battling a case spike, lack of manpower and complaints of negligence, the 800-bed hospital in Mayaganj, one of Bihar’s four dedicated Covid facilities covering several eastern districts, is under severe strain.

Written by Dipankar Ghose | Bhagalpur | Updated: July 20, 2020 11:34:46 am
Bhagalpur unlockdown, Bhagalpur coronavirus cases, Bihar covid cases, covid icu, Bhagalpur news, Bihar news, indian express news A toilet in the ICU of the Jawaharlal Nehru Medical College and Hospital in Bhagalpur. (Express photo)

Over a month ago, Dr Hemshankar Sharma, who is in charge of the Covid isolation ward and ICU of the Jawaharlal Nehru Medical College and Hospital in Bhagalpur, was confident. The district had seen 245 cases and one death till June 8. And Sharma was able to follow guidelines that a doctor of his age was not to enter the ICU, and instead handle management and coordination.

But now, with Bhagalpur battling a case spike, lack of manpower and complaints of negligence, the 800-bed hospital in Mayaganj, one of Bihar’s four dedicated Covid facilities covering several eastern districts, is under severe strain. “I am 65, hypertensive, and still working in the ICU. We are doing all we can with what we have,” Sharma said.

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Today, Bhagalpur is second in Bihar’s Covid tally with 1,601 cases, and 16 deaths, after Patna’s 3,696. The district has also been left rudderless, with several senior officials testing positive, including the District Magistrate and the officer appointed in his place.

Bhagalpur unlockdown, Bhagalpur coronavirus cases, Bihar covid cases, covid icu, Bhagalpur news, Bihar news, indian express news Condtion of toilet in the ICU of the Jawaharlal Nehru Medical College and Hospital in Bhagalpur. (Express photo)

Said the son of a 60-year-old who was admitted four days ago in the isolation ward: “They just lock and leave, there is no monitoring. There were relatives of patients sleeping on the floor. We got him shifted to the ICU, but there is very little care. The toilet is so unsanitary and barely cleaned. I saw a woman tell nurses that there was a need for an oxygen cylinder. There was no response. Even if patients survive, this is taking a heavy mental and emotional toll.”

Read | As cases rise in Bhagalpur, hospitals under pressure, oxygen a concern

The son of a 55-year-old patient said his father was tested on July 12 and got the report the same evening because they “knew some people”. Others had to “wait for up to 12 hours” to even get tested and “many were turned away”. He said his father was admitted to the Medicine Ward on July 15, which was “neat and clean” but had one key element missing — a compounder to administer injections. “We then shifted him to the ICU,” he said.

Bhagalpur unlockdown, Bhagalpur coronavirus cases, Bihar covid cases, covid icu, Bhagalpur news, Bihar news, indian express news A toilet in the ICU of hospital in Bhagalpur. (Express photo)

Both the sons enter the ICU every day, despite being negative. “I don’t want to come, but I am afraid my father will get no care,” said one of them.

There’s also a video purportedly shot inside the ICU by the son of another elderly patient, which shows his father gasping for breath. “There has been no check for four days… The system has collapsed. My father now wants to die,” the son says in the clip.

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On Saturday morning, Dr Sharma spoke to The Indian Express on a video call from inside the ICU, wearing a face shield, mask and PPE suit. “I want to show you how hard we are trying, the work we are doing,” he said. He walked the halls, showing nurses in masks and doctors, including several heads of department, in the ICU. “We are working day and night, and people are still complaining and making videos. Everybody here is risking everything,” he said.

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But yes, there is a manpower problem, he admitted. “What I need are junior doctors…at least 50-60 dedicated to this crisis. The junior doctors are not reporting for duty properly. Action should be taken, they should be warned,” he said.

Since the COVID crisis began, as many as 14 junior residents have quit, with four others resigning after their duty roster was “tightened”. “Their duty is only three days a week. They were asking for one day,” Sharma said.

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On June 18, Dr Hemant Kumar Sinha, the principal of the medical college, issued a show cause notice to five more junior doctors on their absence in the ICU without prior consent, and warning of action under sections of the Epidemic Diseases Act 1897 and the Bihar Epidemic Diseases, Covid-19 Regulation 2020.

“The junior doctors either say they are unwell or complain about PPE kits. We say this is the same kit that is being supplied all over the state. This is the kit that AIIMS-Patna is working with. On OPD duty, what do you need? Two gloves, one set inside and elbow gloves. Two masks, surgical and N 95, and a face shield. And a head cover. These are provided. Moving into the ICU is a different issue, but how many per cent are in the ICU? Ten per cent,” Sharma said.

Bhagalpur unlockdown, Bhagalpur coronavirus cases, Bihar covid cases, covid icu, Bhagalpur news, Bihar news, indian express news “The toilet is so unsanitary and barely cleaned.” (Express photo)

Asked about the violation of norms that prohibit doctors above 60 and with comorbidities from entering high-infection zones, Sharma said: “What can I do? We have to be cautious, but mentally you are tortured when you want to do something and others do not support.”

The senior doctor, however, acknowledged that there was fear among patients and their relatives whose presence inside the isolation ward and ICU was “a problem”. “We are trying to convince them to leave. We tell them that they will be carriers. But they are fighting with us, harassing the guards,” Sharma said.

Presently, there were 130 beds fitted with oxygen in the isolation wing, of which 80-90 are being used. What’s needed now, say doctors, is “public awareness to report symptoms early”. “We have treated 1,200 to 1,300 patients and our total casualty rate is not high. A majority of the patients who died had comorbidities. The patients come here at Stage 4, with oxygen saturation of 60 to 70 per cent, and expect magic from us,” Sharma said.

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