COVID-19: The Second Wave, a Tsunami

As the initial surges of COVID-19 subsided towards the end of last year and some semblance of normalcy returned, the world was beginning to settle down to lick the wounds and gather the pieces.  At our hospital, which had seen almost 8000 cases till Feb 2021 while marking a year of our battle against this dreaded pandemic, the non-COVID areas were returning to their usual activity and patients were back in large numbers for ailments other than COVID.

By the end of Feb’21, the COVID zone, which had seen a flurry of activity all these months, was now restricted to just a single ward with four patients, the nadir we had reached. The staff in the zone was limited to just a medicine resident with hopes of closing down the remaining ward too.

Maybe we spoke too soon, as within next few days, the numbers rose exponentially to 40s and 80s although mostly asymptomatic or mildly so. Still hopeful, and in denial, I thought this was just a blip and won’t last long, so we decided to continue with the resident, and I offered to visit and take daily rounds with him to advise regarding the management of these cases. While next 6 weeks could be managed this way, uneventfully, we could see the surge of cases around us in the city and in our own hospital.

Unlike the previous year, this time around the things were different. There was a big surge of cases with 80-120 admissions on a day, with most patients coming in on day 5-7 of illness, having managed at home with symptomatic treatment, but noticing breathing difficulty and falling SPO2, something almost all were aware of and monitoring at home. A large proportion of patients had already started on steroids, advised by their GP, often a bit prematurely, but ineffective in controlling the worsening of the disease. The ICU and the oxygen enabled beds were filling up fast and need for these beds was increasing.

Every day, the reception saw large crowds of people bringing in patients with fever and hypoxia waiting for beds to be made available. There were some who came in ambulances or with oxygen cylinders in their cars, patiently waiting for beds to be allotted. Not all could remain civil or patient as their patient was gasping, and were seen hurling abuses and threats at the doctors and staff. There were unfortunate instances of patients being driven in their cars, dead on arrival. They would be taken into the wards, only to be given a bed to have a dignified packing of the mortal remains to be transferred to the mortuary before the final journey. To be able to receive such an end was itself a luxury in a city which had run out beds in all its COVID hospitals.

The doctors and the staff at the reception needed to be at their politest best, while dealing with these patients and kin. Standing in front of them, protected against the virus with their masks and PPE, our team was not safe against the rage that was brewing. Being under the stress of having this illness, and denied a bed at other hospitals they had already visited, they were looking at us with hope and almost a sense of entitlement. Army being their parent organization, was expected to deliver and be their last resort. To be able to accommodate this swelling crowd, in the limited number of beds available with us, was becoming a challenge and the waiting list was fast swelling up. But often they were willing to wait, with their lungs starved of oxygen, and the virus marching relentlessly within as they had nowhere to go.