Moneylife Foundation

COVID-19: Smart OPDs To Help Keep Our Doctors Safe

Aravind Natarajan 21 April 2020

At a time when COVID-19 positive cases are rapidly on the rise, medical professionals, our first line of defence in this pandemic, are not only more susceptible, but are testing positive in large numbers.

Moneylife Foundation’s work to provide protective gear to hospitals, as part of its COVID relief work has given us a ring side view of the urgent need to reduce exposure of doctors and medical staff, especially to walk-in patients with signs of COVID exposure. Read this article on the ground reality of what healthcare workers face.

After several doctors tested positive in a single day at Sion Hospital, Dr Avinash Saknure, of the Maharashtra Association of Resident Doctors (MARD) brought to our attention a ‘Smart COVID 19 OPD’ (out patients department), that allows no-touch screening of patients and sent us the video below.

Thanks to the generous support of a specific donor (who wishes to remain unnamed), the installation was completed on Monday, 20th April.

This is based on 'No-touch technique' and encompasses special facilities like digital stethoscope, pulse oximetry, infra-red thermometer,etc.

The OPD has been designed in the form of two partitioned cubicles and is useful to screen routine patients without physical contact while also taking swabs for suspected cases of COVID-19. The cubicles have also been fitted with a mic and speaker similar to an arrangement in multiplexes, which allows doctors to interact with patients for a better understanding of their medical history.

In this system, the doctor can examine the patient from one side of cubicle with the help of gloves with the doctor's side being isolated from the patient's side.This unique setup also allows the doctor to sanitise the patient's chamber with the help a simple switch.

This protection has traditionally been in terms of personal protective equipment (PPEs), masks, gloves and face shields and now perhaps more innovatively through a ‘Smart OPD’ as designed by AYU Devices.

The idea for this OPD, says sources came from Dr Ranganath and it has been designed to his specifictions with the assistance of Krea Design Solutions.

“This OPD setup is not for all routine OPDs; this is exclusively for screening and fever OPDswhere the risk of getting infected is much more than any other OPD, where you need to do other physical examinations,” said a doctor while explaining the use and limitations of the smart OPD.

That doctors cannot physically examine patients remains a negative factor; but at this time, the greater need is to protect front line medical workers from infection, at least from obvious cases where symptoms suggest a possible COVID infection.

Another big advantage is that the Smart COVID OPD, assembled as a leak proof barrier, while allowing thorough examination of the respiratory system will reduce the need for recurrent protective gear such as Personal Protection Equipment (PPEs), which are in short supply and tends to be expensive precisely because it has to be discarded after use.

There are requests from many top public hospitals to have such OPDs.

If you would like to help with the relief efforts of Moneylife Foundation, you can donate here

COVID-19: The Ground Reality of Our Healthcare Workers

Akshay Naik 17 April 2020

With the rapidly increasing number of COVID-19 cases in India and especially in Maharashtra, the situation for health care workers is reaching a dangerous level. Support for our medical professionals, who are our frontline of defence against COVID-19, is dwindling in many cases and severely lacking in some.

In Mumbai, Municipal Commissioner, Pravin Pardeshi is understood to have mandated that each ward officer should, "supply PPEs to Medical Officer of Health (MoH) for use by dispensaries and health posts with staff, cemeteries, maternity homes, solid waste management personnel (only if required), and ambulances." There has been an indication from the municipal commissioner that the supply number of PPEs is sufficient to cater to all needs, with promises of 700 PPEs for G North Ward and 1000 for G South Ward.

However, Moneylife Foundation, which has been working relentlessly at procuring and supplying key protective equipment finds that the reality is quite different—our findings are based on first hand information from all key hospitals, which continue to report new cases of doctors and medicare personnel testing positive with frightening regularity.

For starters, the quantity of PPEs from each ward officer are quite insufficient and in many cases have not even been delivered. Doctors who are handling COVID-19 cases in major hospitals around Mumbai say, that with 3 shifts of healthcare workers per day and the nature of the PPEs requiring them to be single use, demand for them has increased exponentially and there is dwindling supply. With a rise in the number of cases, an increased number of doctors have also been deputised to assist, which has lead to an added demand for effective PPEs.

“I think the requirements are growing. Besides COVID wards, emergency work, deliveries, surgeries, mortuary workers, labs etc also require protection. MCGM supply as far as I understand may not be enough nor consistent,” says Dr Mehta, who has been coordinating with Moneylife Foundation for the past few weeks in connection with aid relief. (we are protecting the names of doctors because of mindless disciplinary action reported by the media against those who speak out).

Due to the shortage of PPEs, in key patient facing functions, a growing number of healthcare workers are coming in contact with COVID-19 patients, there has been a steady rise in the number of doctors and nurses being quarantined for safety. Doctors who are already quarantined and those who are working in COVID wards across the city, are afraid to go home to their families. Even hospitals are finding it difficult to arrange appropriate accommodation for them. Ideally for at-risk healthcare workers, accommodation should be provided near hospitals to cut down on their travel time. But often this has not been logistically possible.

Here again, there is a mystery. The municipal corporation, under Praveen Pardeshi has worked with the hotel industry association to take over many hotels for doctors to stay. Even luxury hotels have offered their rooms for medical professionals and some have been taken over under emergency powers available to the municipal commissioner. Here again, the number of rooms offered seems limited and selective. Many key personnel in leading hospitals such as JJ Hospital and Sion Hospital urge for more facilities and are also looking beyond hotels to schools and performance halls that are shut down, but have basic infrastructure such as water and toilets.

There have been reported cases of doctors working in COVID wards living in their cars to avoid going back to their families after their duty.

Doctors, especially faculty members living far away from the hospital are having a hard time commuting as they do not have proper means of transport during the lockdown. Many healthcare workers who are in touch with Moneylife Foundation have suggested that doctors working in COVID wards should be accommodated in nearby hotels or hostels for ease of convenience and safety. They also suggested that empty school buildings near hospitals should be utilised for emergency accommodation of healthcare workers.

In early April, the Tata Group had opened Taj Hotels to accommodate doctors and nurses working in COVID wards. This is a great initiative that is also being followed by Hotel Sahil (Mumbai Central), which is currently hosting healthcare workers from Nair Hospital. A few doctors from Seven Hills Hospital have also reported that a number of doctors are currently being accommodated in a hostel nearby and some in the nearby Renaissance Hotel. Many doctors who are under quarantine or taking precautionary measures have now resorted to staying back at the hospital or nearby hostels.

Government hospitals in Mumbai, are also facing shortages of testing kits, which means that every symptomatic patient cannot be tested and this is adding more pressure to the already over stressed healthcare system. Doctors working in COVID wards have urged the government to allow tie ups of government hospitals with all private labs, which they hope will significantly increase the rate of testing. They have also stressed the importance of secluding COVID-designated hospitals and not allowing patients within the premises for any malady other than COVID or for patients showing symptoms of COVID.

Expressing concern for his colleagues a doctor from Nerul stresses thalt “all doctors at the screening zone of hospitals should have N95 masks with a face shield at the very least, as they are the first point of contact. PPEs should be a must for all those involved in COVID zones.” Fearing for the many doctors and interns posted at screening duty in peripheral areas, Dr Jain further added that they should also “perhaps be provided police protection in case of any hostilities.”

These healthcare workers are bravely facing the pandemic as our first line of defence and should be supported by the government with effective PPEs, increased testing and better logistical support if we are to curb the spread of the virus.

At the request of a doctor from Sion Hospital, Moneylife Foundation has found a generous donor to help procure a Smart Covid OPD that will allow contact-less screening of suspected COVID patients. If successful, many other donors are willing to help make things a little safer for medical warriors, whose lives are at risk in this raging pandemic.

The alumni association of Mumbai University’s economics department has joined Moneylife Foundation in this relief work focused on medical workers and hospitals.

To donate please click here.

Moneylife Foundation's Covid Relief Efforts

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