A Doctor's Lament: 'All of Us Let Our Guard Down'

For more than one year now, but certainly for the last month and a half, the coronavirus pandemic is completely controlling our lives. It is all pervading.

Every news channel, every newspaper and every social media platform is full of terrible news items and posts.

All around people are blaming the system, the governments at the Centre and in states, and in fact, everyone else. Laments are flying thick.

Undoubtedly, the families have been destroyed and the survivors devastated. But time has also come to introspect and face the truth honestly.

Without a doubt the governments of the day were at fault one way or the other, we as citizens were no less, in throwing all caution to the wind, patting ourselves on the back and celebrating our victory over coronavirus.

Late night parties, banquets, weddings in full regalia, conferences all had returned. Social distancing vanished and the masks were nowhere to be seen.

Somehow, we got ourselves to dwell in a comforting sense of being insulated and secure from the affected man on the street. And then the vampire struck with vengeance, the likes of which the current generation is unlikely to forget in a hurry.

But what was our response as a nation, as a society?

Fuelled by fear, all the stakeholders went into a state of panic, be it the government functionaries, the administration, the doctors themselves or the common man on the street.

Self-medicating, We Brought in More Problems

We started self-medicating on the basis of pure hearsay or what the next-door neighbour did. We rushed to the friendly neighbourhood chemists who were ever obliging, delivering over the counter anything and everything one asked for, including steroids, Remdesivir and Tocilizumab without even a semblance of a prescription, with impunity.

We went on to hoard oxygen cylinders just in anticipation of the worst, when actually none was needed.

All this got compounded with the rapidly changing and evolving guidelines, because of the very inherent lack of knowledge of the virus which mutated at a rapid pace creating confusion even in the minds of the treating physicians.

The consequences have been horrendous whichever way one looks at them. Panic in the air pushed people into clamouring for oxygen, Remdesivir and Tocilizumab and several other drugs with unproven benefits in most cases they were eventually used for.

The medical consequences of all this have been emergence of virulent strains of the coronavirus and very rare diseases like Mucormycosis with equally grave prognosis.

As a result, doctors despite doing their best, faced dissatisfied and many a time violent and aggressive relatives because they could not save every patient under their care.

At the last count more than 900 of the doctors were dead protecting the patients against the very disease to which they themselves succumbed.

Not many appreciated that there was unpredictability as to which patient would worsen and when. Hence, guidelines notwithstanding, many doctors succumbed to the social pressure to err more on the side of over treatment with off label medications of unproven benefits or those licensed for emergency use.

Plasma therapy though supposed to be used only as a salvage measure, that too on experimental basis, was touted as some kind of a magic potion resulting in an unending harassment of families procuring it.

A number of patients who do not require admission in the hospital continue to occupy beds on flimsy grounds and for social reasons stretching the hospital facilities to the extreme. In the process, the beds to the most deserving have been denied. These services definitely need to be optimized.

State of the Healthcare Worker

The healthcare workers, in fact, have found themselves in a situation much worse than any other person, experiencing untold misery on account of the disease suffered personally and by their families, and physical and mental exhaustion because of the sheer overwhelming scale of the problem.

As a doctor who has been through this, I can just ask my countrymen to spare a thought as to ‘could all this chaos be prevented if public at large had not lowered their guard and listened to the expert advice’.

We all can set the things right by just playing our roles responsibly. The patients and the public in general, needs to listen to the experts and doctors to stay at home and observe COVID-appropriate behaviour so that they lend a helping hand in reducing the burden of the hospital services.

We must all deeply appreciate that whatever measures you take, they will not guarantee life, especially with the unpredictability that is true for any disease but more so far COVID-19. Stay calm and refer to the expert.

As far as the doctors and other health care workers are concerned, they should treat as dictated by the guidelines and protocols and not come under any kind of political, social or psychological pressure.

The government must ensure that none of these drugs are black marketed and have to be routed through the proper channels. The chemist and pharmacist should be held accountable for any such drug dispensed over the counter.

Netas in the garb of helping their constituents should stop politicking over the breath of life.

Most importantly, while reporting the facts, the media needs to strike a balance between hope and despair.

(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavour is to help people lead a healthy life without medication. He can be reached at [e-mail])