COVID-19: Doctors of Lucknow hospital raise alarm over shortage of protective gear, express fear

Since health workers come in contact with hundreds of patients every day, they are at a risk of getting infected without protective gears. This is a representative photo is from Prayagraj’s SRN Hospital. Sanjay Kanojia/ AAFP/ Getty Images
28 March, 2020

“It has been brought to our notice from residents of various departments that the residents attending patients who are suspected to have corona virus disease as well as the suspected resident are working without PPE gears,” the Resident Doctors’ Association of King George’s Medical University, Lucknow, wrote in a letter dated 23 March. The letter was addressed to MLB Bhatt, the university’s vice chancellor and signed by Dr Rahul Bharat and Dr Mohammad Tariq Abbas, the association’s president and general secretary respectively. In it, the association requested that the vice chancellor provide personal protective equipment, or PPE, without delay. “We residents are scared in such working conditions causing emotional and psychological stress,” the association wrote. It specified that a dearth of such gear “threatens exposure and community spread” of COVID-19.

I spoke to health workers in Lucknow, the capital of India’s most populous state, Uttar Pradesh. According to them, paramedical workers are facing a shortage of PPE kits in almost all hospitals in Lucknow and in some hospitals, even doctors do not have sufficient number of kits. This shortage is prevalent in Lucknow’s KGMU and Dr Ram Manohar Lohia Institute of Medical Sciences, they said. Since health workers come in contact with hundreds of patients every day, they are at a risk of getting infected without protective gears. But hospital administrations have been unable to provide the number of kits that are required. 

The situation appears to be the same in many other regions of the country. Though the Prime Minister Narendra Modi’s appealed to the country to thank health workers, who are on the frontlines of the battle against COVID-19, the government has failed to change their bleak situation on the ground.  

KGMU employs around ten thousand paramedical workers. Of these, around two thousand and two hundred and forty four are permanent staffers, six thousand five hundred have temporary jobs and approximately one thousand are administrative employees. Employees of KGMU told me that several temporary workers have stopped coming to work due to lack of PPE kits. 

The workers’ union of KGMU has alleged that the administration is negligent about the safety of its employees. “Paramedical staff has no option but to use three-layered masks for eight to ten hours, when they are effective for just six hours,” Pradeep Gangwar, the union’s president, told me. “We are ready to give our full support to the university, but it will not be possible for us to work without protective kits.” 

Gangwar said that the union has appealed to the hospital administration as well as volunteer organisations to procure protective kits. According to him, “As the number of the infected goes up, the staff will be in increased danger as there are not many kits in store. No orders for procurement have been issued till now. In such a situation, if the paramedical staff does not get masks, sanitisers and gloves, then we will consider boycotting the hospital.”

The Resident Doctors’ Association of King George’s Medical University, Lucknow, requested MLB Bhatt, the university’s vice chancellor, to provide personal protective equipment without delay.  Courtesy Asad Rizvi

There is seems to be a dearth of N95 masks, a part of the required PPE, in RML as well, according to a statement by Shashi Singh, the general secretary of the Uttar Pradesh Nurses Association. The RML administration has said that the staff on duty will not be provided kits till a patient tests positive with coronavirus, Shashi said. Shrikesh Singh, the spokesperson of RML, denied that the hospital is short of masks. However, he said, the masks will be provided “only to staff members treating coronavirus positive patients,” in line with World Health Organisation guidelines. Shashi said that it is dangerous to tend to those suspected of having coronavirus without N95 masks. “If a member of stuff contracts coronavirus from a suspected patient, then the other patients receiving treatment at the hospital and their family members will get the virus. Who will be responsible then?” she said. 

Doctors of KGMU said that they are treating patients without protective kits. Every day, 200–300 patients from across the state come for treatment to the hospital. Bharat, the president of the RDA, explained some points on this shortage that had been discussed in the association. When a patient comes to a hospital, no one knows whether he or she is infected or not—due to this, it is dangerous for doctors and paramedical staff to come in contact with all patients without N95 masks, he said. If health workers do not use such masks, other patients in the hospital also risk contracting the virus. Confirmation of a COVID-19 case happens only after examination, but doctors and paramedical staff come in contact with patients before that, Bharat explained. There is enough time in the interim for the virus to spread from the patient to another person. According to him, PPE kits should be made available not only in out-patient departments for coronavirus, but also in OPDs that treat fever. Besides, general OPDs should be provided with masks and sanitiser, he said—all these facilities were lacking. 

Bharat told me that the RDA is due to brief the university’s vice chancellor about the situation in a meeting. “If the situation is not resolved even after the meeting, we will deliberate upon a boycott,” he said. Although some more kits were arranged after the RDA’s letter was sent, he said, “the number is far below what is required.” He added that some arrangements have been made since they wrote to authorities, “though they fall far below satisfaction.” 

When I contacted KGMU authorities regarding the matter, they said that the university had an adequate stock of masks and kits. Dr Sudhir Singh, KGMU’s spokesperson, told me that kits in store are being made available to doctors and nursing staff according to directives of the Indian Council of Medical Research, the nodal agency framing India’s policy for COVID testing. When I asked him why doctors of the university wrote the letter despite sufficient kits and masks being available, Sudhir said that those who wrote it were “not aware which doctors and nursing staff required kits and which did not.” 

But the concerns of the doctors at KGMU appeared justified. Around ten days ago, a doctor working at KGMU was tested positive for coronavirus. The infected doctor was immediately discharged from his duties and sent to an isolation ward for treatment. The treatment is ongoing, but he has not yet recovered fully yet.   

A staffer of KGMU’s administrative division told me, on condition of anonymity, that doctors also voiced their concerns about the shortage to Rajneesh Dubey, the principal secretary of medical education in the state, when he had come in on an inspection. According to the employee, because doctors were raising their voice about the lack of protective gear, the state administration has ordered 3,500 PPE kits and 4,500 N95 masks from Kerala for the university. These figures, however, fall far below their requirements, according to the doctors’ association. 

This report first appeared in Karwan, The Caravan’s Hindi website. It has been translated and edited.