Mr. Gautam Khanna, CEO, PD Hinduja Hospital
Dr. Gautam Khanna draws on the past pandemics such as The Spanish Flu which help us gain a better insight in order to deal with our current situation and the adverse effects it has on the mental health of those who are at the forefront.
How can hospitals and other medical facilities play a role in de-stressing the front-line workers? Are there any steps which your organization has taken and how effective it has been?
This crisis has stretched the frontline workers in many ways. They have had to come into a workspace where they were at risk of infection and then go back home to their loved ones, so yes this has proven to be extremely stressful for them.
At our organization, we tried to take their mind off these stressful things by conducting simple yet engaging activities such as singing competitions which helped them destress and thus work even more efficiently.
This helped this connect with each other. In addition, we established a 24/7 psychiatry helpline for people experiencing severe mental distress.
During the crisis, doctors and front-line workers have experienced the burden of not being able to save their patients. This often pushes them into a zone of shame and guilt. How do you suggest that people should deal and overcome such feelings and thoughts?
Both at a personal level, by being a fellow human and at a professional level by being a doctor I have encountered such feelings and so have my co-workers. Helpless feeling of not being able to save a life is extremely heart-breaking. But we should always remember that we have given our best. In addition, its also very important to remind ourselves of the positive things we have done and the people we have saved. Looking on the brighter side of things is always helpful in such situations.
The front-line workers have found themselves to be vulnerable to infection which also poses a risk of affecting their families. What measures can be put in place to reduce the risk of transmission?
At our organization we have identified different areas of hospital and colour coded them with the risk levels such as- green, red, yellow, orange zones. Each zone has their own requirement of PPE kits and protection protocols. In addition, we always advice our workers to be extra cautious and to overlook comfort and prioritize safety.
Compliance often comes when people understand why these measures need to be undertaken. Also, workers are relatively safe in the hospital, but what happens when they go home and other places? In order to tackle such situations, we have made efforts to explain masking and other safety protocols to our workers. For some workers, it may be difficult to isolate at home and hence we have arranged for separate isolation facility for our staff.
How can rural and remote areas control the spread of the virus with the limited resources they are equipped with?
Doctors and nurses need to be provided in such areas. Protocols which are prevalent in urban health care system need to percolate in rural areas. Companies have CSR funds which should be utilize in order to build infrastructure which would equip remote areas to deal with current and future health care issues.
Third wave and the uncertainty attached to it is now being frequently discussed. Could you shed some light on this?
Third wave is inevitable, as it is the nature of the virus to mutate and spread. We cannot predict what course this pandemic will take. What we can as a community is be prepared for whatever lies ahead. Hence, we need to abide by the Covid protocols strictly, even when the second wave dies down.
How can we adapt with the growing severity of the pandemic? In this regard, what additional training can be provided to our frontline workers?
Communication of the latest scientific information and evidence needs to be done. Feedback given by the patients to us also needs to be taken positively; especially with regards to the hospital staff. We need to understand that the patients are alone and the only people they interact with are the health care workers. Hence, empathy is extremely important. Being with patient-will help tremendously in recovery. Recognise the stress and find positive ways to deal with it and be ready for it
What challenges will be faced in future regarding the supply chain?
The best example for this is – remdesivir. The drug reduces hospital stay by a few days but it not an absolute cure and needs administered at appropriate time. Doctors prescribe it which expands the demand and then it seems like there is a shortage in supply. WhatsApp information often persuades the family pressurize the doctor into prescribing it. Control over market through agencies like FDA is extremely essential to ration important medical resources. Close interaction with local government should be a continued collaborative effort necessary to tackle the problem. A system of allocation also needs to be put into place.
What message would you like to give to the front-line workers facing negativity in forms of violence?
This very unfortunate that we hear cases of targeting doctor- often by patients’ family who is upset. But what they should understand is that hospitals and doctors have tried their best. In this regard the medical community should talk to the media and spread the word that by doing so, people are destroying the trust in the medical community.
Local NGOs should also help and spread the message. The law doesn’t allow violence against health care workers and hence, in such cases, FIRs should be filed and we should let police take the required action.