Hyderabad: Despite the daily rise in the number of Covid-19 cases across the country, health care workers especially senior doctors attending to Covid positive patients directly are now able to manage the disease properly, which played a major role in reduction of fatalities due to the virus in India, says Managing Director of Star Hospitals, Dr Gopichand Mannam.
The renowned cardiothoracic surgeon and Padma Shri awardee, who has done more than 25,000 heart surgeries, while interacting with ‘Telangana Today’ points out that better management protocols for Covid-19 patients are enabling doctors across Telangana to save lives of even critical patients with severe Covid-19 symptoms.
On disease pathology
A vast majority of the health care facilities in Telangana are now able to save the lives of Covid positive patients. There will be a bit of struggle with Covid-19 positive patients who have delayed their treatment and have serious comorbid conditions like diabetes, hypertension, heart ailments or other pre-existing medical conditions.
Rest of the patients, despite having symptoms and even suffering a bit of damage to the lungs, are recovering in Telangana, which is a great positive development for all of us. The number of cases might be going-up across the country but we are now able to manage the disease well and are able to bring back sick patients to normal and reduce the number deaths.
At the beginning in March and mid-April during the lockdown, there were no established protocols to deal with Covid-19. Lot of people were dying with the disease in countries like Spain and Italy and the pandemic was starting to get intensive in the United States.
Not many medications were available at that time and steroids were not fully studied. Even the pathology of the disease like what is the cause of the illness was not known. Today, despite rapid spread of the disease, we have more understanding of the disease and what is the cause for serious illness? We know it very well and that’s helping all of us.
What Star Hospitals did?
We first started focussing on acquiring knowledge about the disease. Our 13-member ICU team was led by pulmonologist and intensivist Dr Chandana Reddy.
The team essentially comprised senior pulmonologists and physicians who started to get themselves educated and study the disease. As more information related to Covid-19 came through various sources including personal contacts, published and unpublished study papers from China, South Korea and Singapore initially and later from western countries, our understanding of the diseases started to improve.
On establishing a Covid block
Luckily, we have two blocks and we had the intention to make the B Block of Star Hospitals as an exclusive Covid block and also develop a Covid-19 laboratory. We already had an RT-PCR and one of our laboratories is accredited by the National Accreditation Board for Testing and Calibration Laboratories (NABL), which made it possible for us to get Covid testing permission from Indian Council of Medical Research (ICMR).
By the end of April, we were ready to take patients and do testing also. Almost all our facilities including laboratory, critical care ICU team and hospital administrative team were ready by April. To ensure safety of our health care workers, we stocked-up quality PPEs.
By May, when Covid-19 cases started to rise and patients started to come-in, we had managed to create enough infrastructure for about 60 Covid patients in the B Block. The team of physicians for Covid-19 were relocated to B Block while other routine work in that block was shifted.
On home quarantine and tough cases
At present, each physician in our hospital is handling anywhere between 30 and 40 Covid-19 patients who are in home isolation. We monitor their development very closely and on a daily basis. Apart from our doctor consultation, nurses also provide video counselling to patients at least two to three times per day. In case they develop complications, such patients are immediately shifted to our ER. Due to these set-protocols, our results in treating Covid patients have been very good.
While treating Covid patients, we come across many critical cases. We helped a morbidly obese person who had weighed 130 kg and had undergone weight loss surgery but had regained weight. We did a tracheostomy procedure and had to put him on a ventilator but were successful in helping the patient to recover and get discharged. Our preparedness, before we started receiving the patients, helped us.
Behavioural changes that are needed
Unfortunately, a lot of panic has set-in among the general public, which is natural because there is no medicine and vaccine for Covid-19. A mere cough or a sneeze from an infected person is enough to spread the virus. Moreover, there is a lot of interaction about the disease in the social media, which has added to the panic.
We created a lot of publicity material stressing that there is no need to panic. Yes, it is a dangerous disease but you can control it. I personally did two large webinars on Covid-19 disease and went on live television channels to talk about the disease. Even my colleagues also went on to television channels to explain to the public that hand hygiene and mask everywhere will prevent this.
During the initial days of the pandemic, the acceptance among people towards masks was very little. Even convincing people to wear masks in hospitals was a challenge. However, there are signs of change and I personally feel that in the last two to three weeks, there has been change and more people now are using masks.
In our hospitals, we have made it mandatory for all to wear masks and have put-up signs and posters, hand rubs and sanitisers. All these measures went a long way in helping to prevent exposure within the hospital. Now, we are exclusively testing all the non-Covid patients who are getting admitted to our hospital, so that we can prevent people getting infected within the hospital.
Where are we heading with Covid-19?
There is no doubt in my mind that we are going to end this pandemic. It’s just a matter of getting a proper vaccine because the treatment has already been established. Despite not having specific medicine to kill the SARS-CoV-2 virus, today we have enough medicines to neutralise the effect of the virus.
Only problem now is that positive patients are arriving late. If people develop fever or any other Covid related symptom, instead of consulting a doctor, they are indulging in self-medication and preferring to stay at home and wait for the symptoms to subside. They reach hospitals after three to four days, when there is significant damage to the organs, especially the lungs. Otherwise, there are clearly established treatment protocols to counter the impact of the virus on the human body.
First of all prevention including social distancing, using masks and hand hygiene are very important. Then, in case they develop any kind of symptoms, they should get tested and then through home or hospital management, patients can be treated.
Need to understand initial symptoms
We come across many instances of Covid-19 positive persons being moved from one hospital to another in search of beds. Such unfortunate instances are occurring because people are not taking the initial signs and symptoms seriously. There are very few unfortunate people who die within a few hours but the vast majority of the positive patients, may be out of sheer ignorance or negligence, tend to overlook their symptoms. Today, there is no excuse for people with symptoms to avoid going to a hospital and get tested. Majority of the positive cases can be managed at home through video or phone calls and medicines.
Those who are sick can be shifted to hospitals.
Mental health issues and morale boosting
Health care workers in hospitals, during the ongoing Covid-19 pandemic end-up working for months together without taking any significant break. They work in situations of heightened anxiety and during such time, vulnerable people go into depression. The hospital administration has to identify them and constantly speak to them. I directly talk to groups of nurses often and encourage them. We must make them understand that they are doing a wonderful job, despite the heavy stress during the pandemic.
Message to public
Do not panic but be vigilant and be responsible in terms of preventing the disease. Today you are either a vector or a victim. If an individual is a vector then by taking preventive measures like using masks, hand hygiene and physical distancing, they will not infect others. If individuals follow all the preventive measures, then they will not become a victim. In case they become victims, they should not panic because there is a treatment. But, you need to approach medical professionals early.
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