24 April,2021 07:06 AM IST | Mumbai | Vinod Kumar Menon
A large crowd waits for shots at a vaccination centre in Dahisar on Friday. Pic/Satej Shinde
Long queues at vaccination centres and testing sites, essential set-ups in the war against COVID, could be aiding the virus in a big way, say health experts from the city, Navi Mumbai and Alibaug. "The core issue that is getting ignored at this moment is the large turnouts at vaccination and testing centres which do not have any exit time practice," said a doctor at a COVID care centre in Navi Mumbai.
COVID protocols go for a toss during a testing drive for workers at APMC market
The doctor added, "It is also a fact that these set-ups do not have any yardstick to ensure stringent adherence to COVID protocols. Moreover, the spread of the infection through urinals and toilets at these centres is also a concern as they are not sanitised after every use."
According to Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle, COVID-appropriate behaviours-correct usage of masks, regular washing of hands, 6-foot distance and use of sanitisers-are ignored at testing and vaccine delivery points. For example, hospital services, including the COVID testing and vaccine centres present a pathetic sight. People are seen standing and loitering for many hours in unending queues. This environment becomes an ideal setting for efficient transmission of COVID. Thirdly, hand hygiene by sanitizing hands by washing with soap and water for at least 20 seconds each time, or washing with alcohol sanitiser each time hands touch handles, doors, fomites etc in public spaces."
Dr Hira said hospital engineers are expected to coordinate the logistics of patient/client processing in all areas of hospitals. If they fail to plan smooth client processing despite the fact that crowding disrupts physical distancing which can be risky, it should be considered negligence on their part. He wondered, "Is it difficult to digitally stagger patients/clients in batches per hour instead of block appointments provided by date in Aarogya Setu?"
Dr Hira added, "Historically, the public health system across India has ignored to streamline patients/clients with courtesy. Instead, there is a sense of neglect of health rights in everyone since times immemorial. Now that COVID pandemic is seen to be ruthless to such negligent acts, it's time that all public frontline workers began to practise COVID-behaviours, starting first with themselves."
On the other hand, Dr Hira said, there is an exodus of doctors, nurses, technicians and administrative staff fueled by burnout, trauma and disillusionment in the US. "According to a Kaiser Family Foundation poll, roughly 3 in 10 health-care workers have considered leaving their profession. More than half are burnt out. And about 6 in 10 say stress from the pandemic has harmed their mental health. Many front-line workers talked about the betrayal and hypocrisy they feel from the public they have sacrificed so much to save - their clapping and hero-worship one day, then refusal to wear masks and take basic precautions the next, even if it would spare health workers the trauma of losing yet another patient. Research has shown that health-care workers are especially prone to burnout because of the workload, pressure and chaos that they deal with. Such burnout, studies show, can result in increased risks to patients, malpractice claims, worker absenteeism and billions of dollars in losses to the medical industry each year. Situation in India and elsewhere is no different," he added.
State minister Aditi Tatkare, who is also the Guardian Minister of Raigad
Dr Wiqar Shaikh, professor of medicine at Grant medical college, expressed concerns over asymptomatic carriers at vaccination centres and labs. He too pitched for entry of beneficiaries/ patients in fixed numbers with strict adherence to COVID-appropriate behaviour for such places. "Under no circumstances, a crowd should be allowed to gather either at testing or vaccination centres. If the vaccine is out of stock, they should immediately leave the centre, for which the centre operators will make appropriate announcements in advance," he said.
A state doctor who requested anonymity suggested setting up more smaller units for better distribution of load. "This will by default reduce the overcrowding at one set-up," he said, putting emphasis on pre-registration. The doctor added, "Also in areas marked as hotspots, home vaccination should be started so that a large area can be covered within a short span."
State Minister Aditi Tatkare, who is also the Guardian Minister for Raigad district, said, "With an intention to curb any spread of infection, we have already separated the vaccination area and the testing centres for COVID. The civil hospital in Alibaug is only for vaccination and with private partnership a testing centre is being opened at the Senior Citizen Hall building in Alibaug, where RT-PCR, Rapid Antigen and COVID Antibody test would be conducted at government rate. This would help decentralise and reduce the crowd gathering at one place [the civil hospital]. Also, directives are given to the staff at these centres to maintain hygiene of the urinals and toilets, so that the spread of any infection can be curtailed."
