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TRIBUTE TO COVID WARRIORS HEALTH WORKERS

I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard – won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.  
                                        Hippocratic Oath

Background:
COVID – 19, a Pandemic and deadly virus held the world hostage in an unprecedented and unparalleled manners. Since the virus infected its first host, a 55years old man from Hubei Province in China in November last year, the virus exponentially spread across the globe disregard to all manmade and natural boundaries and barriers. First Corona case reported in India in January 2020, the virus travelled from China through an Indian host. COVID 19 or Novel Corona Virus, according to World Health Organization, was first reported in Wuhan, capital of Wubei Province of Republic of China on 31 December, 2019 at WHO office in China. It was reported as an unknown Pneumonia infecting people of Wuhan. First host of COVID 19 was probably a 55 years old man from Wuhan. Wuhan is a famous for its meat and sea fish markets and major supplier to other parts of China. Wuhan is a major city of population and major Industrial hubs of global industrial giants including Apple Inc. WHO declared the critical medical development of Wuhan as Public Health Emergency of International Concern on 30 January 2020 and subsequently WHO announced the name of the new virus as COVID 19 on 11 February 2020.

Conspiracy theory surrounding rise of COVID 19, as reported by various media houses citing expert’s comments and view of world leaders including US President Donald Trump indicates that the virus is ‘laboratory made’. Wuhan houses China’s Wuhan Institute of Virology (WIV) which made more eyebrows raised with suspicion. US President Donald Trump claimed COVID 19 as lab origin in China. BBC News covered the news under headline – ‘Coronavirus: Trump Stands by China lab origin theory for virus’ on 01 May ’20. According to May 14, 2020 Indian Express report the union minister Nitin Gadkari also hinted the virus to be lab made. Amid all claims and counter claims, according to W.H.O. report dated May 15, 2020, the virus has infected 4307287 people world and its death toll reached 295101. India has 51401 active cases, 27919 cured and 2649 deaths according to Ministry of Health and Family Welfare as on 15 May 2020. Toll of virus is rising and number still counting.

India Fight Back: Angels in White
India fights back Corona since the first infection of Coronavirus reported on 30 January 2020 in the state of Kerala. Ministry of Health and family Welfare spearheaded the fight against the virus with its high powered public health committee, National task Force under the chairmanship of Dr Vinod Pant, Member Niti Aayog. NTF includes all directors of 18 nationalized health institutions including Secretary Department of Health. NTF Research Group works under the same ministry for research, coordination and production of vaccine in India. Under the World Health Organisation guidelines to tackle epidemic like adopted in the case of Chicken Pox and Ebola outbreak, India adopted a comprehensive strategy to include disease surveillance, case finding, contact tracing, quarantine and management of infected patients at COVID 19 hospitals all over India. In this direction doctors and paramedic staffs are working overtime to undertake maximum tests in 363 government and private labs all over India. WHO also recommended maximum testing of people including asymptomatic ones.

Health workers and volunteers are collecting samples from maximum people randomly as well as from Hotspot areas.  According to ICMR records as on 16 May 2020, 2134277 samples have been tested so far. India has increased daily testing capability significantly. Contact tracing is another challenging task of health workers in order to contain the spread of the disease. In this process the health workers reach out to every person who are suspected to have come into contact with an infected patient. Overall health infrastructure of India according to Central Bureau of Health Intelligence report 2019 (National Health Profile 2019) indicates that 713986 government hospital in India and hospital bed to citizen ratio is 0.55/1000. The ratio is not distributed uniformly across the country. West Bengal has maximum bed to citizen of state at 2.25/1000 and Bihar has the least i.e. 0.11/1000. 5.8% of hospital bed is ICU bed i.e. 33, 699. Estimation says out of these ICU bed only 17850 to 25556 will have ventilators.  Indian health system infrastructure for 1.366 billion of citizen will fall short if mass scale infection reported across the country. The government dealt the situation tactfully and efficiently and rise of infection graph has been delayed in order to create a time window to strengthened health’s infrastructures. Makeshift COVID hospitals have been created like railways created train coaches to hospitals, military hospitals open to civilian. Government involved corporate giants such as Maruti and Mahindra for mass production of ventilators. It is a big challenge to heath workers in India to fight the deadly virus with fewer health infrastructures contrary to our population.

Roles of COVID warriors
Every Indian fights Coronavirus in own terms.  Different government agencies and non-government organizations are fighting this virus in India day and night nonstop. COVID warriors of India brave against the virus to defeat an invisible and seemingly invincible enemy putting their lives in peril in the line of duty and service to the nation. Nation pays tribute to all doctors, nurses, paramedical staffs and health care professionals who are relentlessly working to save lives of as many citizens in the country. The strategies adopted to defeat a seemingly invincible virus are multi prong and multi directional. Fight is underway managing infected patients and providing best medical treatment. India achieved good recovery rate as compared to other nations in the world. It has crossed above 32% as per report of NDTV on May 1. They are tasked to bid adieu to those citizens who became victims to the virus. In present circumstances they are also being tasked to perform most sacred and sentimental duty of conducting ‘last rites’ for peaceful heavenly journey of departed souls. While the world is praying with their children and dear ones held together, frontline warriors held those infected ones in their arms, leaving behind their own wards at home. Advisories are also being issued by them for effective prevention from being infected by the virus. They are working relentlessly against all odds and against time to find a solution to Pandemic in the form of a vaccine. They are also reaching out to those people who didn’t report to hospital due to various social stigmas and ignorant by conducting house to house screening.

Medical Council of India, apex body for medical study in India decided to tap MBBS students from 536 medical colleges in India to help doctors in this fight. They will used in sample collection etc. Different types of hospitals to manage infection are generally categorized into three – hospital for suspected case, hospital for mild case and separate hospital for severe case patients. Medical Mentors are provided by 14 major nationalized hospital led by All Indian Institute of Medical Science. Specific COVID related instructions and helps will be provided to far flung rural areas in the country, according to Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare press briefing dated 12 April 2020. 
The fight is a unified effort from every medical professional. Ministry of Health has erected an army of 11.57 lakhs doctors irrespective of specialty including retired doctors. Nurses or midwifes play a significant roles in this fight. Their roles have been recognized by none other than Director General of World Health Organisation Dr Tedro Adhanom Ghebreyesus on May 05, 2020, International day of Midwife. Government has incorporated 882947 Asha workers, according to a report by First Post. Asha workers or accredited social health activists basically meant to fight child mortality in India shall be used for spreading social awareness of health issues. According to WHO, health workers at the frontline of the COVID 19outbreak response are exposed to hazards that put them at risk of infection. Hazards include pathogen exposure, long working hours, separation from family and psychological distress, fatigue, occupational burnout, stigma and physical and psychological violence.

Challenges to Health Workers
In most COVID hospitals in the country, nurses have a shift of 14 days in a row in disease wards. Post rotation of 14 days they are required to be quarantined for another 14 days. Cases have come into light where nurses who had completed one rotation were asked to report for second round of duty. Hindustan times published a story on 12 April 2020 of case in Delhi’s Rajiv Gandhi Superspeciality hospital in which nurses were asked by hospital authority to report for COVID duty immediately after the had done first rotation. Psychological and physically health workers are the one who suffered the most amid crisis. Prolonged separation from the family for months made their family and children suffered. Some doctors and nurses are staying separately in a same house from their family due to fear of chances spreading the disease to near and dear ones. A report of HT on May 6, 2020 recoded a total of 548 doctors, nurses, paramedic infected by COVID in India. Chances of getting infected by the disease to health workers is so high that social stigma against them have erupted. Cases have come to light in which residents’ welfare society ill-treated health workers. Economic Times covered a story dated 12 April about an ordeal went through by a nurse of a super specialty hospital in Delhi. She was eight month pregnant and has one year old child. Agony she went through while waiting for the ambulance to come keeping away her one year old son away from her is heart touching story of any human being.

Health workers are the real warriors in this battle between humanity and seemingly invincible virus. They braved all challenges and hazards in the line of duty. Every person has suffered and affected by the pandemic. Maximum of us lost the jobs, livelihood, education and characteristic of being a social animal but we are with our near and dear ones. We are sleeping a peaceful nights and playing with our children because we know heart in heart these health workers relentlessly fighting our battle too. Some of them have converted laboratory and health institute as their home in search of most needed vaccine. We salute all warriors in this battle for survival of human kind.       

-By NP SINGH
MA (J&MC) 2
Amity University Kolkata

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