Nurses in hospitals across the country are facing the dilemma of deciding whether to continue working or not as they are either unable to get the personal protective equipment (PPE) such as surgical masks and gloves, or the gear provided to them is of a lower quality than that given to doctors. This makes them more vulnerable to catching infections especially when they come in contact with patients already infected with the novel coronavirus.
“On March 20, two suspected cases and two positive cases of COVID-19 were brought to Wockhardt Hospital from Kasturba Hospital,” said Ayush Messa*, a relative of a nurse who works at Wockhardt. “The two positive cases were kept in the COVID-19 ward. The patients who were suspected of being infected were kept in the general ICU ward where non-COVID-19 patients were also being provided care. The nurses who attended the suspected cases were not provided with surgical or N95 masks, leading to their direct exposure. The suspected cases were tested and their results came in positive for COVID-19.” However, by this time, staff members and other patients in the Intensive Care Unit had already been exposed to the infection.
A 70-year-old heart patient, who had developed symptoms of COVID-19 at Wockhardt by March 31, had been admitted to the same general ICU ward where the suspected cases were provided care. On March 28, two nurses working in the same general ICU ward tested positive for COVID-19, and many other nurses began showing symptoms, confirmed Messa said. “Eight more nurses were tested positive in the following days, and 14 more are suspected to have the virus. They are currently in quarantine at the hospital,” said Messa, whose relative Bhanumati Hingorani* is also under quarantine with the other nurses in the hospital’s hostel premises.
A nurse who works for P.D. Hinduja Hospital in Mahim, on the condition of anonymity, said that she was contemplating taking a long leave because she feared she would soon catch the infection if she wasn’t given suitable protective gear that would protect her against the virus. Even as the medical, paramedical and nursing staff fight valiantly day and night across public and private hospitals at a time when the pandemic scare is at its height, they also fear for their own safety, security and life.
As of Friday, in the state of Maharashtra, there are 76,292 N95 masks, 18,17,482 three-layer masks and 7,774 PPE available. However, this is still in short supply because the total number of doctors in the state is 10,855 and nurses is 18,458. This shows that the availability of PPE is far below the requirement.
As per Messa’s account, nurses in the general ICU ward at Wockhardt, where the suspected patients were admitted, were not provided PPE or even surgical masks. “They were discouraged from wearing a mask in the non-COVID section of the hospital to avoid spreading fear and panic among general patients. Surgical masks were made available on March 25 onwards, but the availability was still short. All the nurses did not receive it every day,” said Messa.
Hingorani added that the hospital asked staff members, who showed symptoms, to be on duty instead of quarantining them. “One nurse, who was directly exposed to a COVID-19 positive case, was on duty till the morning of April 1. Another nurse, who had developed symptoms for few days, had to remain on duty till she fell very sick. All the nurses who were attending to a patient, who was first suspected and later turned out to be COVID-19 positive, were not quarantined or tested. Only two of the nurses were tested, and their results returned positive. More nurses began showing symptoms in the following days,” she said.
On April 1 when the Brihanmumbai Municipal Corporation (BMC) conducted an inspection at Wockhardt Hospital on nurses, who identified themselves as having been exposed to COVID-19 positive cases, were reprimanded by senior hospital staff and management, says Messa. At present, all the nurses have the quarantine seal from BMC on their hands, and the swabs of the nurses staying at the hostel have been taken for tests on April 2. The provision of PPE is graded by the medical staff.
“Lot of focus has been on making the PPE available for doctors but the paramedical staff is not really getting its hands on it. We need to put in place stronger infection control mechanisms to separate those who are suspected or positive with other general patients,” says Inayat Singh Kakar, public health researcher and activist.
Jibin T.C., president of the United Nurses Association, feels that most nurses are considered to be “below the professional doctor’s circle” and, hence, are being ignored and neglected when it comes to equipping them with the PPE kits.
“The nurses fear the management, and so we have not received a written complaint from those at Wockhardt Hospital. On March 20, the first patient turned out to be COVID-19 positive and on March 31, Hingorani who tended to the patient got infected, too. As of now, there are around 200 nurses in the hospital out of which 65 have been quarantined. Fifteen nurses are confirmed to have the virus. As of now, some of the nurses are being shifted from the hostel to the hospital wards for medical attention.” Jibin adds that the shortage of PPE is acutely felt across district hospitals in Maharashtra than in the cities of Mumbai and Pune.
“In Jalna district hospital and Kamla Nehru hospital, nurses are not even provided the N95 masks while those are available for the doctors,” he said.
Wockhardt Hospital was unavailable for comment.
*Names changed to protect identity in line with their request for anonymity
