The Rajiv Gandhi Government General Hospital, Chennai. The MMC is its affiliated university. Photo: SwiftRakesh/Wikimedia Commons, CC BY-SA 3.0.
Note: This article was first published on April 28, 2020, and was republished on April 30 to accommodate an update from MMC’s nephrology department (added at the end).
Chennai: The Madras Medical College (MMC) and the Rajiv Gandhi Government General Hospital in Chennai was until recently one of the busiest hospitals, with about 10,000 patients visiting its premises every day. But since the novel coronavirus outbreak, things have drastically, and surprisingly, changed for the worse.
On Monday, two more of the MMC’s postgraduate students tested positive for COVID-19, the name of the disease the virus causes, and bringing the number of healthcare workers thus affected at the hospital alone to 23. Seven of them were discharged last week. The remaining 16 include medical, paramedical and other workers, most of them from the hospital’s cardiology ward. Since the first of them tested positive – a doctor treating a COVID-19 patient in the ward, according to sources – the ward has stayed shut.
Sources also said the two postgraduate students who tested positive on Monday had been in contact with a conservancy worker, employed on a contract at the postgraduate students’ men’s hostel, who had tested positive for the virus. MMC officials said however that the entire hostel premises had subsequently been disinfected and that all students had been tested.
But today, after confirming that the two postgraduate students had tested positive, the men’s hostel has also been shut.
The outbreak has sent a wave of panic coursing through the postgraduate and compulsory rotatory residential internship (a.k.a. CRRI) students.
MMC has more than 200 house surgeons in its present batch, plus about 350 postgraduate doctors currently working in the hospital. The Tamil Nadu government had extended the term for the students of the last batch until the end of April 2020.
“102 postgraduate students were tested and we were first told that all of us were negative,” one student of MMC who didn’t wish to be named told The Wire. “But the senior professors on the other hand asked the trainee doctors to not come to the hospital. Today, they have said two of us have tested positive.”
This student has been staying at the MMC hostel, and has been confined there for the last five days due to the lockdown.
He also said the MMC didn’t test its trainee students until they protested. Since the hostel and the mess have both been closed, the students’ council has made alternative arrangements for food but many of them are worried about how long their solutions can last.
A trainee doctor said they hadn’t been given any personal protective equipment, not even N95 masks, to attend to their patients, many of whom often walk into hospitals without knowing they have COVID-19. “Since the first week of April, we have been working in three wards attending to these patients without any protective gear.” The wards were only closed on April 20.
A woman trainee doctor said that earlier, a staff nurse had tested positive, triggering another wave of panic among trainee doctors who had worked in the same ward. “We had to protest for a long time, and finally, 60-70 samples were tested,” she said. “We have not received the results yet and obviously all of us are scared.”
One of their professors had informed them over a WhatsApp group that all of them had tested negative, but the students weren’t convinced. “The professor asked us to report to work at our concerned departments. We were told that 50% of students would be made to work for fourteen days, and after that, all of us would be quarantined.”
On Monday, sources at the hospital said the hospital’s administrators had visited the trainee doctors and promised personal protective equipment to everyone who had to report to duty.
“We were told to keep one-third of the trainee doctors in reserve, one-third in quarantine and to send one-third to work,” the woman trainee doctor said, adding that trainees in reserve were asked not to come to the hospital for 15-20 days. “They have also promised to give us multivitamin tablets.”
However, the Rajiv Gandhi Government General Hospital had issued a press release on Sunday (April 26) denying any problems and claiming that two-thirds of its trainee doctors will be summoned to work as and when necessary.
The release said, “The postgraduate students have been employed in all departments, and all medical services were discharged without any break.” It also claimed “471 doctors, 363 nurses and health workers” had all been tested for the coronavirus and their results had come back negative.
Dr R. Shanthi, a member of a Chennai-based NGO named Doctors Association for Social Equality (DASE), accused the Tamil Nadu health department for what she argued was its non-scientific approach. She alleged the entire medical system had collapsed in the state’s capital.
“It is now evident that MMC has been compromised and students are stressed. This government has failed to create exclusive hospitals to handle” coronavirus patients “and has instead created isolation wards in every hospital,” she told The Wire.
As a result, she continued, Chennai’s hospitals have become no-go zones for people with ailments other than COVID-19, for fear of contracting the virus, even as a large number of healthcare workers have become overtly exposed to the virus.
“In Chennai, we have about 500 [people with COVID-19] in various places, including MMC, Stanley, Kilpauk and Omanthur hospitals. It has affected the entire medical community – including doctors, students and healthcare workers.”
Update, April 30, 2020:
A technician in MMC’s nephrology department, who was handling a dialysis machine, also tested positive for COVID-19 on Monday (April 27). About 50-60 patients are currently being treated with dialysis every day there, considering the Tamil Nadu government had specially arranged for patients to continue treatment without any obstacles during the lockdown. However, sources at MMC said that technicians and doctors in the department had treated a patient with COVID-19 without proper protective gear.
Other technicians have tested negative. However, the sources said they weren’t confident about the results because they are all still asymptomatic. “There are plans to test all patients who had come for dialysis on the same day,” a source said. “But the nephrology department has been maintaining absolute secrecy on this issue. The doctors and technicians are very scared.”
Since people undergoing dialysis already have low immunity to diseases, staff members are worried that the dearth of proper safety measures could end up further affecting the patients, as well as other doctors and technicians.
S. Jeeva Bharathi is a journalist in Chennai.