Even as the union government stated that it did not have data on the number of healthcare workers who had died due to COVID-19, the Indian Medical Association (IMA), the largest body of allopathic practitioners in the country, claimed that no country has lost as many doctors and healthcare workers to the pandemic as India. According to IMA, 450 doctors lost their lives fighting the pandemic as of September 23, 2020. IMA came out with the list of doctors after Dr Harsh Vardhan, Minister for Health and Family Welfare, recently told the parliament that the government does not possess data on the number of healthcare workers who died due to COVID-19.
The highest number of casualties related to COVID-19 has been in Tamil Nadu, where 64 doctors lost their lives to the pandemic, according to IMA. Tamil Nadu was followed by Andhra Pradesh with 57 deaths, Gujarat with 47, Karnataka with 43 and Maharashtra with 40 deaths. 378 of these doctors were aged above 50, while the remaining 72 were below 50.
Clinician mortality 15%: IMA
In India, doctors suffer four times the mortality of ordinary citizens. The mortality rate among private practitioners is eight percent. “As per data from Centers for Disease Control and Prevention, only 160 plus doctors lost their lives in the US. They have a greater number of doctors, COVID-19 cases and COVID deaths. In India, if 100 doctors get infected, 15 die because of the disease,” said Dr R V Asokan, Secretary-General, IMA.
The majority of the doctors who lost their lives to the pandemic are general practitioners. While 282 general practitioners died due to COVID-19, the number of specialists is 168. “The patients approach nearby doctors when they develop headache, fever, back pain and other problems. The doctors spend quality time with the patients and clinically examine them. The contacts of the doctors are the infected patients, which increases the viral load and the severity of the infection. We have been educating doctors since day one. But the constraint is that their clinics are small rooms with no ventilation. If three to four persons accompany a patient, physical distancing won’t become effective. It increases the chances of getting infected,” said Dr Asokan.
Dr Shivkumar Utture, President, Maharashtra Medical Council, also observed that high viral load could be one of the reasons for the high number of deaths among doctors in India. “Unlike the public, doctors come in direct contact with the patients and so their viral load is pretty high. So, the doctors have to take extra precautions while treating the patients,” he said.
Raising concerns over the quality of the PPE kits and N95 masks, Dr Utture, said, “Unfortunately in India, we don’t have standardisation of PPE kits at all. There are thousands of companies engaged in the manufacture of PPE kits. But the quality of PPE kits is not ensured. Even today we are getting N95 masks with just the print on it. These sub-quality PPE kits and N95 masks increase the chances of infection. Ideally, quality should be standardised. Not only the material, but the stitching, joints and all have to be certified,” he said.
He attributed a poor work environment as another reason for the high number of casualties among doctors. “Healthcare workers, including doctors, have been working for long hours in PPE kits. They can’t even drink water, and at the end of the day, they feel tired. They are not given enough time to recuperate, and it has affected their immunity levels. The low immunity level also contributes to the death of healthcare workers,” said Dr Utture.
Dr Utture cautioned that casualties among doctors can affect the healthcare system in the country. “Every doctor we are losing could be treating thousands of patients. The government should take a policy decision to utilise their services in a proper way and protect them. We can’t afford to lose doctors as COVID-19 is a long[-term] problem,” he said.
Meanwhile, IMA alleged that the government concealed the morbidity and mortality of doctors, nurses and healthcare workers, despite acknowledging their contributions during the pandemic. IMA stated that if the government does not maintain statistics about the total number of doctors and healthcare workers infected, and killed, by COVID-19, it has lost the moral authority to administer the Epidemic Act 1897 and the Disaster Management Act.
‘Duplicity of the govt’
IMA also said that the development has exposed the hypocrisy of calling healthcare workers corona warriors, while denying them and their families the status and benefits of martyrdom. “The doctors and healthcare workers not only get infected in the line of duty, but also bring home the infection to their families, including children. To treat these martyrs indifferently is a sacrilege. To tell these families and children to fend for themselves is injustice of the highest order,” said IMA. It added that indifference to the sacrifice of doctors and healthcare workers is the reality of the COVID-19 fight and that it appeared that they were treated as dispensable.
IMA has also come out against the statement of Ashwini Kumar Choubey, Minister of State for Health and Family Welfare, that public health and hospitals come under the states and therefore, data on insurance compensation is not available with the union government. The association said this amounted to abdication of duty and abandonment of the national heroes who have stood up for the people. The body said, after the government having formulated an unfriendly, partial insurance scheme for bereaved families to struggle with, the ignominy of the government now disowning them altogether stared at them.