A man and a woman in protective face masks walk past a graffiti on a wall in Mumbai, March 25, 2021. Photo: Reuters/Niharika Kulkarni/Files
On March 22, 2021, I’d been admitted to a hospital in Kolkata for gallbladder surgery. As I tucked in my hospital gown, my parents walked in wearing flimsy polythene aprons that would barely stay on their bodies. A gust of wind could have torn through it, but apparently, that sorry piece of plastic was going to protect my family from the virus. It was mandatory if they wanted to visit me. It cost 40 rupees each and tore at least a little bit when you tried to fold and pack it.
Recall the case of Indira Banerjee, a professor at Gujarat Central University. Her oxygen levels were falling because of a severe COVID-19 infection, but the Ahmedabad Municipal Corporation hospital turned her away earlier this month.
The reason? She had arrived in a private vehicle instead of an EMRI 108 ambulance. Banerjee’s oxygen levels quickly fell to 60%, and by the time a hospital in Gandhinagar managed to arrange a ventilation machine for her, she had died.
Even more recently, in a video shared on Twitter (among others by AltNews cofounder Pratik Sinha), a middle-aged mother is seen sitting on the road outside a hospital in Ahmedabad with her son lying next to her. He had also been turned away because they hadn’t arrived in an ambulance.
Outside Shardaben hospital in Ahmedabad, a mother is sitting on the road with her COVID positive son lying on the ground. Guidelines state that entry can’t be allowed unless you come in a 108 ambulance, so hospital staff is not letting them in. pic.twitter.com/Nv84KVE53X
— Pratik Sinha (@free_thinker) April 22, 2021
What purpose do protocols like these serve? Some are clearly business propositions, like the plastic apron.
Other ideas, like the need to use designated ambulances, directly cost lives.
And all these ideas are essentially performative. Medicos on the ground are required to think on their feet and modify procedures and requirements based on the intensity and variety of situations. If a person in dire need doesn’t or can’t use an ambulance to arrive at a healthcare facility, there is no reason care should be denied to them.
There is also no reason we should have to wear wafer-thin aprons that do nothing at all. Some airlines have also distributed such aprons to passengers occupying middle seats on flights. We already have “strong evidence” that SARS-CoV-2 transmission by air is much more significant than via surfaces.
Another example is that of ‘thermal guns’, the handheld, non-contact devices purportedly used to measure body temperature. Dr Shayan Ghosh, a dental surgeon in Chandannagar, expressed concerns about the market being saturated with devices made by uncertified manufacturers.
“They give you an approximate or random value. Oftentimes, I have received a low temperature marking for a patient whose forehead was burning up,” Dr Ghosh said.
In his telling, “People are engaging in ‘art and craft’ with the medical equipment industry. The sanitisers in many medical shops are locally sourced and don’t have isopropanol” – the actual disinfecting agent in the liquid. “A good test is to pour some on a surface and hold a matchstick to it. It’s supposed to burn away, leaving no residue. But now, most leave behind water, meaning they have been tampered with.”
Sudipa Majumdar (23), who was symptomatic at the time of our conversation, also flagged how performed safety often goes in hand with casual discrimination. For example, she recalled a doctor’s attitude at the M.R. Bangur Hospital, Kolkata, when Majumdar had visited to be tested.
According to her, a patient who had been severely sick for two days with COVID-19 symptoms, had previously visited the KPC Medical College and Hospital in Jadavpur, where a doctor had prescribed a test for which the institute also charged a hefty sum. Unable to afford it, she travelled to M.R. Bangur Hospital, which conducts the same test for free.
But here, the doctor simply told her: “Go get the test done from where you obtained this prescription.” When Majumdar questioned the doctor, he said, “There should be 3-4 days’ gap with enough symptoms if you want to get tested.”
Journalist Emily Chung has written that there are “wide variations in when patients are hospitalised – the average time from symptom onset varied from 1.5 days in one Chinese study to 11 days in another.” Performed instead of practiced safety could be one reason why this range is so wide. It would have been unethical to deny critical care to patients on any other day – but to do so on the basis of whimsical protocols is unpardonable.
It is important for us to protect ourselves. The ongoing, unprecedented second COVID-19 wave in India both provides the reason why and demonstrates what might happen if we don’t adhere to COVID-appropriate behaviour. However, our attitude towards these requirements should be reasonable at all times – and not at the anarchic extreme of the Kumbh Mela or the bureaucratic extreme in which critical patients are ignored for missing paperwork.
Meghalee Mitra has a master’s degree in English and is currently enrolled with an editing and publishing course. She is a freelance writer, editor and researcher.