Dr Pratibha Gogia, a Senior Consultant & Head of Department-Pulmonology & Sleep Medicine at Venkateshwar Hospital, Dwarka, has an experience of over 20 years in the field of Respiratory Diseases, Tuberculosis, Sleep Medicine & Interventional Pulmonology from varied health institutions. While interacting with BW Health, Dr Gogia affirms that India has enough pulmonologists to treat respiratory ailments of COVID patients. Below are the edited excerpts:
Being a frontline warrior, how have you been able to reinvent yourself post COVID?
It was a time and an hour of the need. We took this health emergency as a challenge. As we are doctors, we are trained to work for 36 hours during our training period. The pandemic compelled us to take the same rigorous schedule. I did not take a single day off for 12 weeks (during 2nd wave) and was working for at least 12-14 hours a day. In the process, we started getting anxiety related issues as we got used to being awake at night. Even though it had a deep impact on me, but then it re-emphasized that as a human being, as well as a doctor, we have a limitation. We can give the best treatment to our patients but the end result depends on several factors like the patient’s immunity, stage of infection and of course god’s grace.
What are the key learnings derived from the first and second waves of the pandemic?
This pandemic has been a big teacher in several ways. When it comes to the health sector, it told us our lacunas i.e., areas which we are unprepared for. In a big city like Delhi and Mumbai, we do not have as many as ICU beds as there should be. So, we have very few ICU beds per thousand population. Ergo, we need to beef up our govt healthcare system as well as private healthcare system and to give a huge emphasis on the critical care vertical of the whole system. This is because this outbreak can happen again and we should be better prepared in terms of (availability of) oxygenated beds, ventilators, skilled workforce, etc. Secondly, we need to organise our health set up in a better way. We need to have more preventive strategies such as handwashing, (physical) distancing and masking. Thirdly, it is vaccination (drive) which gives us an important message that prevention is better than cure. Fourthly, we also realised about the trainings of the doctors to handle this medical emergency. Lastly, we realised about the importance of Telemedicine for the first time and how far off patients in villages can get the medicare (out of it).
Tell us about your experience in handling COVID at Venkateshwar Hospital.
Before the pandemic had struck, I started training our ward boys and nurses (on) how they can take care of themselves and (their) families and (on) how they can make sure they don’t take the infections home by taking adequate precautions. I had regular sessions with our supportive staff and junior doctors on what they are expected to do while handling COVID patients. We created OPDs where there is a distance (created) between the doctors and patients. We created optimum atmosphere in the hospital so that neither the staff nor the patients are scared of getting infections in the hospital because it was a big social scare that one can get COVID (around that time). I took around 20-40 sessions of my staff and we have the minimum no of nurses and doctors during the functioning of the COVID wards in this hospital. So, we were well geared for the precaution and created a protocol for all our staff.
So how many patients did you treat during the first and second waves. And what are your estimations for the treatment of patients during the 3rd wave?
Being a pulmonologist, I have seen almost several thousands of patients till date and have seen the sickest of the lot. I must have seen 2,000 critical and sick patients during the second wave and several others during the first wave because am consulting COVID patients since May 2020. So (I have treated) 3,000 patients overall for sure. For third wave, I am just keeping my fingers crossed that we don’t witness such fatalities. The reason is the vaccination drive is going on in full swing with two-third of the population already getting jabbed (until now). But still, we have some percentage of the population (who are/could not be vaccinated yet) who are still vulnerable. So, the unvaccinated lot would be a major chunk in forming the third wave and children could form a major percentage of that. By all these numbers, what I am predicting is 1) It should not be that severe as the second wave was 2) Delta plus variant is the only point of concern as it is an unpredictable variant and since travel is opening.
Lastly, do we need more pulmonologists like you to tackle third and fourth waves of COVID?
There is no paucity of pulmonologists in India. The reason being that we produce 25 per cent of the world’s Tuberculosis (TB) cases every year, which is the most or the second most in the world. Pulmonology is relatively a new branch as earlier it was more about (treating) TB. In the last 20 years, all those pulmonologists have upgraded themselves in treating all aspects of chest diseases, including critical care. Even though there is no dearth of such chest specialists in India, the number it would have been less since the nature of the disease has been unprecedented.