TUESDAY, APRIL 30, 2024
Juino De Souza: The public grievance is that whenever a COVID-19 infected patient is taken to the Goa Medical College and Hospital (GMC) he hardly gets a bed. The COVID patient is treated like an outcaste. Even a medical practitioner was kept on stretcher for two to three days and was not given a bed in the GMC. What is the current situation?
Dr Shivanand Bandekar: When Coronavirus came to Goa it was a scary message to everybody. Each one thought looking at COVID they will get COVID. There was a time when people were not walking out of GMC campus thinking that virus will come and attack them. It was a social problem. But the GMC was the first institute to start COVID ward; 113 ward which had 40 beds was designed as COVID ward. Later on, 11 more wards were added and raised our bed capacity to 500 beds. Our non COVID work also suffered. I remember when we closed ophthalmology, ENT and skin wards and converted them into COVID wards. It was not only GMC but in KLM and AIIMS and everywhere in the country there was a problem and flooding of patients. In that I don’t deny that may be one or two patients might have got late bed. The medical practitioner was actually given a bed but he said that he would like to go to a private hospital. We hardly kept him for six to eight hours. But it went out as a wrong message.
But let me assure now people of Goa that the second wave is on and are totally prepared. If you find any problem in getting a bed you can directly call me and I have a team, whose numbers would be published in the newspapers and they can be contacted. This time we are more prepared and more systematic to take care of you.
Juino: There are lot of complaints that vaccine against COVID-19 is not efficacious and has adverse reactions and side effects. Is the vaccine safe for pregnant women and people with heart diseases? Is there sufficient stock of Covishield vaccines and how safe is it?
Dr Jose de Sa: The vaccine supplied to Goa is Covishield vaccine, which is well tested vaccine by ICMR and approved by the Union Ministry of Health Family Welfare, Government of India. This is well tested vaccine on field and given to many States in India. Goa and many States are given Covishield vaccines while some States are given Covaxin vaccines. Both these vaccines are equally good and equally effective. There are some misunderstandings that there could be some reactions. But to tell you frankly we have so far vaccinated 1.38 lakh people in Goa and all these people have taken it very safely. They may be one or two cases of reactions post vaccination which is bound to happen when we use any vaccine. But vaccine is safely used and its side effects are very very less. Next day after vaccine some people might get mild fever or headache and there are no major side effects.
People have accepted this vaccine but I am sorry to say that people are not coming forward to take this vaccine. Since the response is so not so good we are now organising “Tika Utsav” and going down to the villages and to the grassroots level to mobilise people. Right now we are focussing on people 45 years and above to get vaccinated. We started vaccinating healthcare workers, frontline workers, people who are over 60 years and people aged between 45 and 59 with co-morbid conditions. But we are opening up for people above 45 years to get vaccinated.
Dr Shivanand Bandekar: Directorate of Health Services are really doing a good work by giving vaccines. But people are worried whether the vaccine is very effective because there are some incidences that even after second dose people have got COVID infection. But let me share with people of Goa that if you are taken two doses as per the first formula i.e second dose after 28 days but now after eight weeks, it has really worked. But if by chance you get mutant virus this infection will never kill you. This is great in vaccination plus symptoms are very mild. Fundamental rule of this vaccination is that you are going to give memory to your immune system. Covishield has 78 per cent efficacy and still leaves a margin of 22 per cent which people can get infection. But these 22 per cent will never have severe infection and there will be no mortality. Let this message go to everybody.
Juino: Large number of tourists are arriving in Goa and flocking to beaches during summer and are getting crowded. What is the State administration doing to ensure that there is no crowding and social distancing is strictly maintained?
Narayan Gad: First and foremost at the Collectorate we have a control room 24x7. Any eventuality or information received by the control room is compiled and appropriate action is taken. At every taluka level there is a task force headed by the deputy collector/SDM and the entire machinery is at the disposal of the task force. Whenever a COVID positive is detected, the task force does contact tracing. We have given directions to all deputy collectors, mamlatdars and health officers that once a person is tested COVID positive then at least five of his immediate contacts – primary or secondary are to be traced. After tracing them data is compiled and collated and again appropriate action is taken by the task force. Recently we have issued guidelines about maximum number of participants allowed in the outdoors and indoors and directions have been given to the deputy collectors, mamlatdars and the police to ensure that the standard operating procedure (SOPs) are strictly followed.
The drive of putting fines on violators is on everyday besides educating them about the importance of maintaining physical distance.
Juino: Does GMC have adequate infrastructure like number of beds and oxygen to tackle rising COVID-19 infected cases and a second wave?
Dr Bandekar: GMC is now much better prepared as far as infrastructure is concerned for the second wave, which is rising steeply. Right now GMC admits critical patients which was my suggestion during one of the experts committee meeting because GMC has got super-speciality consultants. Most of the time we saw co-morbidity that was killing patients with COVID, was diabetics. And we are the only institute having endocrinology, which has ultimate power to heal diabetics. Right now we have 150 patients admitted in GMC.
In South Goa district hospital, Margao we had commissioned 150 beds and now we have commissioned another 150 beds and the hospital has the capacity to go up to 500 beds if COVID-infected cases rise. ESAI Hospital will also be denotified by the collector as COVID hospital due to increasing COVID cases.
When we started we had only one or two HFNO (high-flow nasal oxygen). COVID is nothing but oxygen therapy and oxygen has to be made available everywhere. This we made available in GMC and now every bed in South Goa District Hospital as oxygen port. We are using lot of oxygen and only oxygen saves patients. We have also brought non-clinical staff onboard. About 60 such staff have been given refresher course about what is to be done in COVID cases.
Juino: Does Goa have adequate testing facilities for COVID-19?
D’Sa: We do rapid antigen test in all our 37 units. On an average 2000-2500 RT-PCR tests are done every day at five centres across Goa and the reports are given by evening. For private hospital the government has fixed capping for these tests. If we find one COVID-19 patient, we go for contact tracing not only among relatives but we go for 30 contacts and collect their swap samples.
Juino: What is the line of treatment for COVID-19 infected patients in the State-run GMC?
Dr Bandekar: We have all SOPs in place now. If a patient has mild symptoms like fever, loss of taste and if he has co-morbidity like diabetic, hypertension then we don’t allow him to go for home isolation because he needs monitoring. Three to 10 days is called critical period where you can get the cytokine storm. We keep these co-morbid patients under observation and if we find that his saturation is dropping then he is immediately given all the required things.
People think that COVID-19 infection is like any other common cold, which is wrong. These persons stay at home with fever, with breathlessness, with change in taste, with diabetic and with hypertension. They are in complete denial mode and then they get into severe breathlessness.
Every week we do death audit and try to find out the cause of death. We found that many patients rushed to the hospital with CT severity score of almost more than 18 to 20 out of denominator of 25. If a patient’s score is 20 out of 25, it means 80 per cent of his lungs were involved. No ICU can save such patients. We have 200 ventilators and there is no shortage of ventilators and no shortage of HFNO.
Juino: Is district administration acting vociferously against those found violating Sops specially those visiting Goa from other States?
GAD: We take all required measures. We are not shying away. Whenever we get information that a particular area has become a hotspot or likely to become a hotspot or epicentre, we take measures to declare it a containment zone. Recently we declared a containment zone at Porvorim.
Juino: What is your message to people to Goa who are not turning up for inoculation at the health centres and doses are getting wasted if not used within four hours once they get opened?
D’Sa: An individual should take vaccine and protect himself/herself. They should not think of wastage. They should come forward and mobilise others who are 45 years and above to take the vaccine.
Juino: What is your message to the people of Goa?
Dr Bandekar: Behavioural change is required in the people. We have to learn to live with COVID-19. There is second wave and third wave and we do not know when it will be zero. Socially we must cooperate with the SOPs given by the government. COVID is not common cold because we have ill-effects of it. Follow SOPs, take vaccine and if you are still unlucky we are there to take care of you.
