“It may have been my destiny to reach early on May 23, as my early response with the doctor concerned, saved others from being directly exposed to the patient. I was not scared, but others were, they were crying upon hearing that they would be the first lot of people to handle the COVID positive patient”, shared a nurse deputed at the isolation ward catering to the needs of the solitary COVID positive patient in Sikkim.

If concerns have to delve on how the patient is doing, the health professional, let us call him Dr XYZ, to avoid future stigmatization, shared that the patient is fine, without any symptoms. A second test was also conducted on him and it shows that the viral load is less now. 

“We have stopped on hydroxychloroquine as his viral treatment has now ended. It is only the symptomatic treatment that is being given to him. He underwent 5 days of flu medicine but will be taking the medicine for another 5 days. Another test will follow on the 14th day since being tested positive”.

Another health worker highlighted the excellent manners and tolerance of the patient. “We could not have asked for a better first COVID positive patient; he is patient, abiding and his cleanliness routine is even better than ours. We have put him under surveillance for the full stretch of 24 hours, disinfection and cleaning are conducted every 3 hours of the whole ward, and we maintain strict surveillance on his movement and with whom or what he is coming in contact with. He is currently on oral medicine, and his being a vegetarian, high protein diet which is a requirement is being provided through eggs and paneer.”

On the spread of the virus to his fellow inmates at the Rabong quarantine facility where he was initially based, the health workers maintain that he kept a strict discipline even there, thus resulting in the negative results among the primary contacts and even the health workers. “He came to the hospital wearing an N95 mask, so he was cautious in his approach. He feels that he may have got the virus when during the bus journey from Delhi to Siliguri, they made a night halt in one roadside lodge, that could be the place where he got the virus. In Delhi, it appears he was staying in a hostel with a common mess hall but with individual toilet facilities”.

Currently, STNM Hospital is functioning with the Out-Patient Department (OPD) being catered to but the restriction on new admissions is being curtailed with patient enrollment occurring in CRH Manipal. On the day that the positive case came to light, there were 280 In patients; the same has been substantially reduced, informed a health worker. 

“If we have to visit the patient, then all of us in the isolation ward do it collectively. We give him food, water and take care of all his requirements, from his phone to his need for books. He is alone in the isolation ward, with three doors sealing him afar. We are in contact with him throughout from the intercom service”. The health workers at his disposal have counselled him well about the stigmatization that could follow, so he is using the phone but not sharing information about his treatment.

Health Director-General Dr. Pempa Tshering Bhutia asserts that “all the primary contacts have tested negative, all of whom were brought to STNM and have been sent to a special quarantine facility in East District for further observation, but they seem to be out of danger and transmission of the virus”.

The positive patient was in the Triage level when he was identified as positive, among the four levels of the hospital devoted to COVID. “It was the confirmatory test that came as positive that put us all frenzy, there was denial at first, crying followed for many nurses, with the thought that they were the first to respond and be exposed to the positive patient. It took us 4 hours to shift the patient to the isolation ward, everywhere he had been or was being taken to had to be cleaned and disinfected”, shares a health worker.

31 health workers – including sanitary staff, doctors, nurses and technicians are catering to Sikkim’s sole COVID-19 positive patient. Out of these 31 workers, 19 are doctors and nurses who were directly exposed to the patient. “On May 22, the test had come through as positive on Truenat and upon a confirmatory test which was carried out under the supervision of doctors and nurses. We expected it to be negative as any other time, but that was not the case this time with RT-PCR from NBMCH in Siliguri, confirming the same. We were involved in sealing, cleaning and disinfection of the sample”, stated a health worker.

Before the arrival of the positive patient, the hospital staff was conducting dry runs, supervising other nurses and doctors on the various guidelines. 

Now, it has been a week since they were exposed to the patient. “We had our sample tests conducted for 14 of us on Thursday and the result came through as negative on Friday, following which we have been given a hotel for quarantine for the next 14 days. Tests for the remaining 17 will be conducted on Friday. The ordeal for us every day since the exposure has been reaching an isolation ward to our single sharing or in one case double sharing room, at the adjacent annexure building. Between those two commutes, we take a shower once at the hospital and take another after reaching the room. We cannot come close to any of the other staff at the hospital and have very little idea about what is happening outside of the top four levels of the hospital and the annexure building where we are staying”, stated another health worker.

Some exceptional work in the hospital is being carried out by the sanitary workers to keep the premises clean.”If they don’t work there is a chance of virus spread, so they must all be equally appreciated, as they are getting more exposed to the patient than the doctors and nurses. They are at the risk of virus spread through air particles from coughing, talking as these are air particles or drops we let out while sneezing and coughing which may linger around in his clothes and the waste”, it was informed.

On the quality of the PPE and it is the only barrier between the patient and health workers, a health worker stated, “We cannot complain on the PPE as many of us are using PPE for the first time apart from training. There are two types of PPE that we have, one is thicker and heavier, the other is thinner and easy with mobility. It gets really hot inside the PPE, and to add the twin layer of masks one surgical mask and the other N95 masks, results in more intake of carbon dioxide, making it easily fatigued due to lack of oxygen. I had never worn a gumboot before, so couldn’t comment if it was comfortable or not”.

However, the health workers complained that the management on the hospital’s part with the first COVID case could have been better. “Being the first group, we had to set many things that were not considered during our training. There was no room for complaining as it was a life and death kind of situation during the initial rush. But, when the second group of doctors and nurses come, they will feel at ease, as all the work has been laid out for their ease. But, they must also not compromise on quality, treatment and the availability of safety equipment, as that could put them in threat of virus spread”, informed the health worker.

With the health workers or the first batch eyeing their quarantine from Saturday, two health workers will hand over all the responsibilities to the next batch. “I am a bit worried about facing the crowd after being in isolation for over a week, there is the fear of stigmatization as well. But since our work is done now, we will be away from the hospital for at least 28 days and around 2-3 months before we have to cater to another COVID positive patient. “

By Pankaj Dhungel, Journalist at East Mojo & Sikkim Express. The author can be reached at pankajdhungelsikkim@gmail.com

Views/Opinions expressed in the article or write up is purely of the author/writer and not of The Sikkim Chronicle, including statistical data, which was provided by the writer. For any queries or contradictions, the author can be contacted in his/her email id.

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