Transcriber: Keyur Patel Reviewer: Emma G
I’m going to share my experiences with COVID,
which made this Indian gesture of greeting others universal.
COVID taught us a lot of things,
and these lessons will be used for centuries to come.
I, Dr. Amit Nagpal, I’m here to share my side of the story.
A story from healthcare professionals point of view.
So if you can recall, this all started in early 2020s,
and I first paid attention to the news of this new virus outbreak.
Originating from China and then spreading across the world.
I remember in the early March,
we heard about outbreaks spreading across different parts of India.
This was a time when we started with our own COVID task force.
I was one of the core member of the task force.
So in early March, we started seeing a lot of patients.
So we decided to have a committee
in order to start preparing for the COVID outbreak.
Though some may believe that lockdown did not help us
because everybody got infected anyway.
But it definitely gave us time to prepare in advance. It was very confusing.
I had no experience of handling such kind of situations, medically or logistically.
But we relied on the data or experiences of our colleagues
from different parts of the world.
So we laid out guidelines.
The few issues or situations
that we faced in the early part were to start with being
one of the largest charitable hospitals in Navi, Mumbai,
was catering both COVID as well as NON-COVID patients.
The most difficult task was to accommodate suspected cases.
If you can recall, RTPs are used to take nearly three days to come.
So when RTP said is not there and you have a suspected case,
you cannot keep that case with non-covid patients,
because there are chances of transmitting the infection to non-covid cases.
So we had to develop areas in the hospital itself,
where we can isolate such kind of cases.
And as soon as we get the report, we can move them to different areas.
So this was, again, part of the planning.
And then it came on to us.
COVID during the first wave peaked for nearly 3 to 4 months.
And by the end of the fourth month, things started to settle down.
We gathered a lot of data and that data was analyzed by researchers
all across the board, which helped us to create our own guidelines.
We were not sure whether we will have another wave or not, but we were prepared.
We started treining our students.
You know, being a medical college hospital,
you have a great pool of students.
Back in the days, we had nearly 400 residents.
So we decided to segregate them in different areas.
Students from medicines stream will take care of critical patients
or patients who are on oxygen, while others, like from surgical stream,
will take care of slightly stable patients.
So this was part of the plan.
In 2021, what we noticed is there is a new wave which is coming up
and we were really excited to handle that.
Although, of course, we all were tired.
So it came and what do you think
how did we perform with the policies of planning that we did,
which we learned from the first wave?
We failed miserably. It broke the backbone of health care system across the world.
There was a huge influx of critical patients who were requiring oxygen.
Most of the hospitals across the country were facing issues with oxygen.
I remember most of the colleagues
remain uninfected during the first wave,
but in second wave, everybody got infected.
We were struggling with manpower,
lack of resources, at some places lack of oxygen as well.
It was a really difficult time. None of the medications worked.
Now, you'll be amazed to believe this,
that there is no strong evidence for any anti-covid medication till date.
We used everything, we tried everything.
Now, the question was, why few patients with severe COVID disease,
COVID lung disease improve with treatment and others couldn’t.
I would like to share one incident
which changed my perspective towards COVID.
We received a patient, 45 year old male,
from a small setup, and the family got him shifted
for better care at D. Y. Patil.
Now, this patient had extensive lung disease.
In medical terms, we call it ILDs
Such patients require a lot of oxygen and they usually go on to a ventilator.
So I remember counseling patients, wife and daughter every day, you know,
preparing them for a bad prognosis,
because usually such patients don’t make it,
by then I had enough experience of handling such kind of patients.
So I was really skeptical about the outcome of this case.
But the family was really hopeful.
And back in the days, we used to do a lot of video counseling,
so the patient can see the relative right in person.
We cannot allow relatives inside the ICU, so we do video counseling.
And I used to see how the family is speaking to the patient
and constantly encouraging him,
asking him to just hang in there for a few more days.
For weeks, there was no improvement.
But to my surprise, after a month, the patient started to improve
and this very patient, we were able to discharge after a really long time,
almost up to five months.
This very patient changed my perspective towards my patients in the ICU.
I learned two things from this.
First - expensive medications don’t really work in this kind of disease.
And second, we need to motivate our patients.
Now just imagine, you are admitted in the ICU.
You can’t see daylight for days and sometimes weeks.
You can't see other people faces. Everybody is wearing PPE mask.
So everyone looks like a polar bear.
You can’t see human emotions. It’s a very depressing environment.
So I started spending more time in the patients cubicles talking to them.
Of course, if it’s possible, asking them about their family,
their jobs, just to, you know, start a conversation.
And requesting them to just hang in there for a few more days. This really help.
The second wave lasted for nearly three weeks.
And it was a really difficult time for all of us.
Now, to conclude my talk,
I would like to share a few take away messages for you.
To start with, now, I don’t want to scare you,
but there’s a conspiracy theory that the COVID could be a man made disaster.
Now if it’s a man made disaster,
in that case, there are more pandemics
or such kind of outbreaks we might see in the near future.
So as a nation, we better be prepared.
In COVID, we learned how to work in a team.
So it’s time when community and the health care system come together.
And make sure that we implement strong policies to avoid all these issues.
Now India, harbours bright minds,
we have a lot of people who can make strong policies.
But the problem is implementation of those policies.
We do do strict surveillance, as a result of it, you see people
take advantage by stockpiling essential goods and medications.
This is what the whole world faced.
No, we need implementation as well as strict surveillance in such cases.
I, as a medical educator, I believe there is a strong revival
happening in the field of medical education.
It’s taking its own pace and I’m pretty much comfortable with that.
We are changing the whole environment of medical classrooms
from didactic lectures to student centric experiential learning.
And I happy that my institute is one of the pioneers in India.
If you compare us with Western countries,
of course we are behind, but we are catching up with them.
We're using medical simulation
and trying to incorporate it in medical education.
And I believe we are the first universities to do that
for undergraduate medical education.
So we need to use the technology to bridge this gap and to make good doctors.
There’s a very famous saying,
“We don’t want to stop bad doctors from doing mistakes,
we want to stop good doctors from doing so.”
And I remember Mr. Joshi mentioned this about suspension of disbelief.
Well, I use this phrase a lot in medical education, medical simulation.
In simulation, what we do, we try to create real life
like in moment situations using an advanced technology.
It could be a simulator, it could be anything.
And train our doctors, nurses, paramedics in handling that.
So you don’t need another pandemic to train your doctors to manage that.
You can do that safely in a controlled environment
and you can repeat it any number of times
till your health care professionals are comfortable to manage it.
The last and the most important message
that I would like to share is more GDP to health care.
Now, as you may know, we are the fifth largest economy
because we overtook UK and achieved that stage.
And we are hoping to become the third largest.
I will shared with this data in today’s talk very soon.
So with a huge economy, we need to have a strong healthcare system as well.
Now, I would like to ask as a nation,
how much percentage of our GDP goes into health care?
Yes, oh, come on. More than one person, you’re not that bad.
It’s roughly around 3.01, this data is from 2019.
We don’t have a recent data, 3.01%
And how much is UK spending which we just overtook?
Nearly around 10%
So for a strong economy, we need a strong health care system.
If we have a strong healthcare system and the nation is investing
a good amount of GDP into health care,
we’ll have good citizens, healthy citizens,
which will definitely help us to bring our economy forward.
So I thank you so much for sitting patiently
and attending through the experiences that I wanted to share.
So this is my message - move GDP to health care.
Thank you. (Applause)