Doctors treating COVID-19 patients are struggling with the feeling of helplessness, as the health system continues to crumble under the pressure of increased cases in the second wave of coronavirus pandemic. Dr Krishna Kadam, Senior Psychiatrist at Maharashtra Institute of Mental Health and Sassoon General Hospital said that the inability to help patients due to shortage of resources is adding severely to the stress of the health workers dealing with COVID patients. Recently, a doctor in Delhi died of suicide due to severe stress.

“What has been affecting the doctors and the healthcare workers the most is that the patients are right in front of them, but they cannot help anyone as they either don’t have an injection or a bed at their hospital. The doctors were a bit more prepared to deal with COVID this time around. The treatment protocol was clearer than the last time, line of management was defined. They were acquainted with the likely complications of the disease. But what they were not prepared for was the shortage of the very means required to treat the patients,” Kadam said.

Talking to Indie Journal, Dr Aniket Joshi of the Association of Physicians of India, Pune branch, said that it was the kind of stress doctors had never seen before. “It’s not just the unprecedented rise in the number of patients. There was a shortage of essential medicines and oxygen, this was followed by a number of notifications from the government regarding their usage. It was difficult to keep track of it all. Doctors and hospital owners have been under constant stress. Several asked the patients to be diverted to bigger hospitals with oxygen plants, but those too were full soon. COVID is a challenging disease, doctors need to keep track of the new mutations, new treatment protocols all the time. It’s difficult to cope up amid all the chaos,” Joshi expressed.

"COVID is a challenging disease, doctors need to keep track of the new mutations, new treatment protocols all the time. It’s difficult to cope up amid all the chaos."

COVID has increased the work hours of the doctors like never before. Dr Avinash Bhondwe, Maharashtra President of Indian Medical Association (IMA) says, “Constantly, something or the other is happening. There is no time for a break. For the past 15-16 months, doctors on COVID duty have worked without a holiday. Earlier, we would get 1 week of quarantine after three weeks of COVID duty, but with the increased number of patients and a limited number of doctors, it is not possible now. The doctors have no choice but to keep working with COVID patients continuously.”

There are not enough doctors for the daily surging number of COVID patients in India. Presently, not just the practicing doctors, but resident doctors from different specialisations too are on COVID duty. Recently, the Central Government has also decided to bring in final year medical interns to treat COVID patients.

“When the number of COVID cases subsided in November last year, we were hoping to get back to our academics. For an entire year, we had not had our regular training. But the second wave began, and we are back to COVID duty,” said Dr Akshay Yadav, a resident doctor from Mumbai who has been on COVID duty over the last 14 months on and off.

“It is mentally torturous to see young patients die. It’s much harder on resident doctors. Every day is demotivating. But I have to go back to work the next day, no matter what,” Yadav said.

"Most of the doctors are not used to seeing so many of their patients die. Especially the doctors who are already suffering through mental illnesses like anxiety or depression."

“Treating patients during COVID is so stressful. Most of the doctors are not used to seeing so many of their patients die. Especially the doctors who are already suffering through mental illnesses like anxiety or depression have been affected the most over the last year,” Bhondwe said.

Moreover, the doctors are also worried about getting infected with the disease themselves, thus putting the safety of their families as well in jeopardy. Over the last year, over 100 doctors have died because of COVID across the country, and so many more have been infected by the disease.

While the work is stressful, there are hardly any means available to relieve stress anymore. Bhondwe adds, “We cannot socialise or visit friends or family due to COVID threat and lockdowns. Entertainment is very restricted. There is no place for exercise. So most of the stressbusters are unavailable, inaccessible.”

Dr Kadam of Sassoon General Hospital is also the coordinator for the Man-Samvad helpline opened by the hospital last year. “While the helpline is open for all, around 15 to 20 percent of the calls that we have received over the last year are those of the healthcare workers. Our department is also open to any doctor from the hospital who wants to talk,” Kadam said.

However, most hospitals don’t have such a safe space for the doctors to talk about the stress that they face while on duty. “The only thought that helps me get back on my feet every day is the patients that I manage to save every day. It will be great if the hospitals or the government could start counseling facilities for the doctors on COVID duty,” Yadav said.

While the associations of doctors and healthcare workers keep in touch with their members, Joshi asks who is going to provide the counseling? “Psychiatrists are often trained in dealing with stress and consequences related to different diseases. However, no one is sure of anything related to COVID. At present, we just try to talk to each other and comfort each other as best as possible,” he adds.