'25 doctors have died in 16-17 days'

'The available workforce is getting depleted.'
'We need to appoint doctors and frontline health workers immediately.'

Patna-based Dr Ajay Kumar, 70, begins answering calls from anxious COVID-19 patients as early as 6 am.

The calls come not only from Bihar, but from Delhi, Mumbai, Bangalore and Hyderabad.

"I have answered 150 calls till afternoon. People are so starved for medical advice on COVID-19 that we received calls till 2 am in the first few days," says Dr Kumar, MD, acting president of the Indian Medical Association's Bihar chapter.

Forty doctors associated with IMA-Bihar posted their numbers online giving free teleconsultation to help the state government deal with the unprecedented second wave of the pandemic.

"The calls have not stopped coming."

"The main problem faced by people is that they have no information about which hospital they can go to. This has created mayhem," says Dr Kumar, who has been practicing medicine for 41 years and was former additional director cum joint secretary of the health department, government of Bihar.

"In this situation we have tried to prescribe them medicines and medical advice. Most Covid patients have mild symptoms which can be treated and cured in home isolation itself."

"We tell them how they can be managed at home. Only when we find their symptoms are serious, do we tell them to go for hospitalisation."

Dr Kumar was himself infected with the virus in the first wave and says 15% of Bihar's doctors have been infected with COVID-19. He says he has lost friends and relatives to the deadly virus.

"25 doctors have died in the last 16-17 days and the available workforce is getting depleted. We need to appoint doctors and frontline health workers to fill vacant posts under epidemic provisions immediately."

After the IMA initiative, Dr Kumar says doctors associated with the medical wings of political parties also volunteered to help.

"In Bihar there are 300-400 doctors providing free Covid consultation online."

One of the common questions from callers is what to do when the oxygen level starts falling and they can't get a bed.

"I tell them how they can lie in prone position and do some spinal exercises. I ask them to do steam inhalation."

From the phone calls, he has also realised that people had forgotten about the Covid protocols of last year.

"I was surprised that some were asking if they should wear masks and drink warm water, etc. This practice should have become a habit and ought to have been followed from last year itself, but it was evident from their questions that they were not."

Bihar is seeing a sharp rise in cases in the past couple of weeks. In the last ten days, it has seen an upward of 10,000 cases every day. On April 29, the state added 13089 number of positive cases, a record spike since the start of the pandemic.

"The situation is not as bad as Delhi or Mumbai,," says Dr Kumar, "but if the infection rate in Bihar was as high as in Delhi and Mumbai, then there would have been dead bodies on the road because the infrastructure of Bihar is not as good as those states."

"Bihar is ramping up its health infrastructure and adding beds. These are not normal times. COVID-19 should be treated as A frontline emergency," Dr Kumar says.

"The IMA had advised the state government to allocate 80% beds in government hospitals only for Covid patients. Other than that only the emergency and trauma departments should be operational."

"Like other states," Dr Kumar adds, "Bihar also has problem of availability of oxygen as most of our oxygen supply comes from outside. Many hospitals are unable to admit patients even though they have beds because they don't have oxygen."

Dr Kumar suggests that it is very important that hospital resources and infrastructure should be known to the people.

"There should be a central portal where occupancy, availability of oxygen, vacancy should be known to the public so that they don't have to run from hospital to hospital helter-skelter," Dr Kumar suggets.

90% patients don't need hospitalisation. Only 70% who get hospitalised need oxygen, he says.

"Only 3%-5% people need ventillators. Unfortunately, those who are put on ventilator their chances of survival are very low."

"We should ensure that people are administered oxygen in time so that they do not reach the stage of needing ventilator support. Some patients will die, but what we need are beds, oxygen and timely treatment."

"It is only through science and god's grace that we can fight COVID-19."

"We have to be led by science. We have to frame our response and policies on the basis of science."

"The response to the pandemic has shown that politicians, policy makers and unfortunately even some doctors have not shown a scientific temperament."

"In spite of the warning from WHO to India, just see how political rallies and religious congregations were organised."

"Political leaders are role models, but see how they behaved during this period. They have ignored the scientific warnings which said that India will go through a violent second phase," says Dr Kumar.

"We need scientific temperament in our leaders, administrators and doctors. We have lacked the scientific temper and hence we are in trouble," asserts Dr Kumar.

IMAGE: Dr Ajay Kumar

Reports suggest that the infection has reached rural Bihar with many districts recording higher number of infections after the return of migrants from Delhi, Mumbai, Gujarat.

"We have suggested a two-week lockdown to the state government," says Dr Kumar. "We are not in favour of an extended lockdown, but a limited lockdown all over the state or in certain areas with a high positivity rate are absolutely necessary to break the chain."

The doctor's advice to fight the pandemic is a strict adherence to Covid appropriate behaviour.

"Yes we can talk to people, but it should be from a distance wearing a mask. Now masks should be used even in the house because one man infected will infect others."

"Have nutritious food and as far as possible. Do not panic."

• THE WAR AGAINST CORONAVIRUS

Feature Presentation: Aslam Hunani/Rediff.com