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Knee-deep in Covid-19, our hospitals need steady supplies of PPEs, sanitisers and adequate staff

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We don’t want your salutes,” says Dr Hamid Mehmood, consultant anesthesiologist at the Dow University of Health Sciences. “What we desperately need right now are the PPEs (personal protective equipment).”

“Walking out of my home at 7:30 in the morning, leaving the kids asleep, I ask myself every day — ‘Do I really have to walk in that isolation ward of patients with Covid-19? Am I safe… the worst thought is am I bringing that virus to my home, to my kids, wife, and parents? What if I become a carrier?'”.

The anesthesiologist adds: “My only survival in these desperate times is via the PPE because I cannot distance myself from my patients. My arsenal, scarce though, is my trustworthy PPE.”

Helping Covid-19 patients in increasingly harrowing circumstances, Dr Mehmood says if healthcare workers get sick, then there isn’t going to be anyone to treat the patients.

Ensuring a smooth supply of the very basic PPEs, sanitisers, and bleach is taking up precious time of the Jinnah Postgraduate Medical Centre’s executive director Dr Seemi Jamali in her battle with this virus.

“We have PPEs for now, but we will require a lot more,” she says.

Dr Shobha Luxmi, who heads the isolation ward at the DUHS, says she has enough PPEs “at least for now”, but what her hospital needs immediately and urgently are sanitisers. At the moment, they are rationing on PPEs and diluting sanitisers to make them last longer.

The ration has extended to the N95 masks as well.

“Our N95 masks are our lifesavers, but in short supply. We use them very carefully and after each use put them in brown bags marked with our names to be re-used, till these wilt away,” says Dr Muneeba Ahsan Sayeed, infectious diseases physician at the DUHS.

“And can you please tell your readers, these masks are not for them, so do not cause shortage for us?” she asks, her voice filled with sadness. She says these masks are worn by healthcare workers so they can protect themselves while treating contagious patients.

Doctors in PPE carry out tests on a patient at a hospital in Muzaffargarh. — Photo courtesy: GoP.
Doctors in PPE carry out tests on a patient at a hospital in Muzaffargarh. — Photo courtesy: GoP.

At the Indus Hospital (IH), they have found a solution to make their PPEs last longer as well as to double their protection. “We wear another disposable gown on top of the one that comes with the PPE,” says Dr Fivzia Farooq Herekar, consultant internist and infectious disease specialist at the IH.

At the DUHS, they wear another pair of lower quality gloves over their latex ones and shed it after seeing a patient.

Doctors getting sick, hospitals short-staffed

Already, it has been reported that six doctors, some very senior ones, in Karachi have contracted the virus.

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“I think if doctors and paramedical staff elsewhere in the country are protesting and are hesitant to report to work, if not provided proper PPE, then it’s justified,” points out Dr Herekar. “Their panic is genuine.”

“But the situation is going to get worse,” anticipates Dr Mehmood. “We just don’t have enough manpower even if we have the PPEs for them. Our janitorial staff, even our nurses are too scared to go near a Covid-19 patient for fear of catching the virus,” he says.

Most hospitals, including private ones, had always been short of ancillary staff. “Some patients on ventilators who cannot move at all, need to be turned every couple of hours, some need to get their soiled pampers changed, or a patient’s room needs clearing and cleaning, which involves moving his/her stuff.”

At a minimum, Dr Mehmood says, a hospital taking care of 10 elderly patients infected with Covid-19 (and some on ventilators) needs 35 people for the duration of 24 hours — with each doing a six hour shift. “These include ward boys, sweepers, porters, phlebotomists, radiographers, on-floor duty doctors, nursing incharge, shift incharge, and the most important person, the consultant doing the rounds,” counts the anesthetist.

With Pakistan sitting on a ticking “time bomb” of Covid-19 patients, Dr Mehmood anticipates the virus will hit the elderly whose health condition is already compromised, especially those who are diabetic and those who are suffering from hypertension.

“We will need assistance for taking them to the washroom, help them with eating, you know little chores that do not require any special medical skill,” he says.

So what they will need, soon, says Dr Mehmood, is a brigade of young, energetic educated people who can, once provided a crash course in biosafety, quickly understand instructions on how to wear the PPE properly and store and doff it off carefully as well to avoid contamination.

Willing to volunteer, but not without proper SOPs

Twenty-five-year-old Mohammad Ismail, who founded a virtual group of science students, called Scientists Against Covid-19 Pakistan (SACP-19), and which today has over 3,500 young and eager Pakistanis from across the country, agrees with Dr Mehmood.

He says: “Even we would prefer that the most trained/most experienced people from among us go first as they are more likely to be careful compared to an eager undergrad who could make mistakes in their excitement.”

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Ismail adds that the only reason SACP-19 has not connected its young volunteers to the authorities so far has been the lack of availability of proper PPEs.

The SACP-19 is working to arm its members with a set of standard operating procedures (SOPs) in the Covid-19 context to ask of local authorities and hospitals as to whether these are being followed, before the group forwards its list of available volunteers.

The SOPs also require the availability of “isolated accommodation as it is not advisable for these volunteers to go back home for at least three weeks,” points out Ismail.

What it’s like to wear the PPE and the N95 mask

Not quite a hazmat suit, the basic personal protective equipment that healthcare workers in Pakistan are asking for includes a coverall made of an impermeable material, latex gloves, a face shield, goggles and masks (both N95 and the three-layered surgical mask).

It takes about 10 minutes to get into scrubs, wash up and wear the PPE. “Do not rush to wear the PPE as it needs to be donned on properly,” advises Dr Herekar.

But it is not the most comfortable of equipment everyone agrees and “adhering to the PPE protocols is quite a challenge” says Dr Sayeed.

“You sweat profusely,” she says, adding that one cannot remain in it for more than four to six hours. That is probably because DUHS is not air-conditioned.

However, most doctors prefer and feel safer to not be in an air-conditioned isolation room which may not have a negative pressure when a hepa filter is used, increasing manifold the chances of catching an infection.

“The infection is air-borne and without a hepa filter that controls the spread of particulate matter through ducts, those inside the wards can catch the disease,” says Dr Mehmood.

In addition, Dr Sayeed says: “You cannot drink, eat, go to the washroom,” once you’ve donned it. But the IH has a room next to the isolation ward where doctors can go sip some water if they need to.

An N95 mask. — Reuters
An N95 mask. — Reuters

But more than the coverall, it is the N95 mask that is terrifying.

“Breathing in and out takes a huge effort and your communication is impaired, and you need to speak louder to be heard,” says Dr Sayeed. “It saps my energy.”

“It needs getting acclimatised to,” agrees Dr Herekar, adding: “For those not used to it, or wearing it for the first time, it can cause dizziness.”

“And what a relief it is when you doff it,” she says, adding that “it does take both a physical and mental strain on you”.

A person wearing a PPE and working for 6-8 hours is the same as a doctor completing a duty that lasted 36 hours, she says.

Via_ DAWN.com

Analysis

Anti-Vaxxers Highlight Political Polarization in North America

Introduction: The Growing Divide The rise of anti-vaccine sentiment in North America has exposed a deep-seated and concerning divide within society, one that transcends the realm of science and health. This ideological schism not only jeopardizes public health but also underscores the intensifying political polarization in the region. Examining this issue from an analytical perspective, […]

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anti-vaccine sentiment

Introduction: The Growing Divide

The rise of anti-vaccine sentiment in North America has exposed a deep-seated and concerning divide within society, one that transcends the realm of science and health. This ideological schism not only jeopardizes public health but also underscores the intensifying political polarization in the region. Examining this issue from an analytical perspective, it becomes evident that anti-vaxxers are symptomatic of broader political, social, and cultural divisions that demand serious attention.

I. The Genesis of Anti-Vaccine Sentiment

Anti-vaccine sentiment in North America is not a new phenomenon. It traces its origins to a complex interplay of factors, including historical vaccine hesitancy, mistrust in government institutions, and the proliferation of misinformation through digital media. Understanding the historical context of vaccination resistance is crucial to addressing the issue effectively.

II. The Role of Political Ideology

One of the striking aspects of the anti-vax movement is its close association with political ideology. Research indicates that vaccine hesitancy is not evenly distributed across the political spectrum. Conservatives, particularly in the United States, are more likely to express scepticism about vaccines. This alignment raises important questions about the intersection of political beliefs and public health.

III. The Influence of Media Ecosystems

The media landscape plays a pivotal role in shaping public opinion, and anti-vaxxers have effectively utilized it to spread their message. The proliferation of echo chambers and algorithm-driven content on social media platforms has allowed misinformation to thrive. A critical analysis of the media’s role in perpetuating vaccine scepticism is essential.

IV. The Distrust of Institutions

The erosion of trust in public institutions, including healthcare agencies and government bodies, has contributed to the rise of anti-vaccine sentiment. Scepticism towards these entities has fostered a climate of uncertainty, which anti-vaxxers have skillfully exploited. A closer look at this crisis of confidence is necessary for finding long-term solutions.

V. The Influence of Celebrity Advocacy

Celebrities have emerged as influential figures in the anti-vax movement, leveraging their status and platform to amplify vaccine scepticism. The public’s susceptibility to celebrity endorsements and their impact on vaccine uptake must be analyzed to better understand how misinformation spreads.

VI. The Globalization of Vaccine Hesitancy

Anti-vax sentiment is not confined to North America. It is a global issue with varying degrees of impact in different regions. Understanding the transnational nature of this problem and how it interacts with local dynamics is essential for comprehensive solutions.

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VII. The Role of Education and Health Literacy

The quality of education and health literacy also play a significant role in vaccine hesitancy. Analyzing the disparities in access to quality education and healthcare, and their impact on vaccine attitudes, is crucial for developing targeted interventions.

VIII. The Challenge for Public Health

Public health officials and healthcare providers face a formidable challenge in countering anti-vax sentiment while respecting individual autonomy. Striking the right balance between public safety and personal choice requires careful consideration and a multifaceted approach.

IX. Bridging the Divide: A Way Forward

Addressing the political polarization and anti-vaccine sentiment in North America requires a multi-pronged approach. Strengthening trust in institutions, improving media literacy, promoting science-based education, and fostering open dialogues are essential steps toward finding common ground.

Conclusion: A Shared Responsibility

The issue of anti-vax sentiment is symptomatic of the deep political polarization in North America. Tackling this issue requires a collective effort from all sectors of society. While public health authorities play a vital role, individuals, communities, media outlets, and policymakers must come together to bridge this divide and protect public health. Failure to do so not only jeopardizes our ability to control infectious diseases but also weakens the social fabric that binds our diverse and vibrant continent together.

FAQs

1. Are anti-vaxxers the new pariahs?

The term “pariah” suggests an outcast or someone marginalized by society. While it may be too strong a term to universally label all anti-vaxxers, it’s undeniable that they face increased scrutiny and criticism due to their stance on vaccines. Anti-vaxxers are often met with scepticism and even ostracism by those who believe in the importance of vaccinations. The negative attention they receive stems from concerns about public health and their role in spreading misinformation. Still, it’s essential to engage with anti-vaxxers in a constructive manner to address their concerns rather than alienate them further.

2. Have conservatives always been anti-vaxxers?

No, conservatives have not always been anti-vaxxers. While there is a correlation between vaccine hesitancy and some conservative political ideologies in recent years, it’s important to avoid making sweeping generalizations. Vaccine hesitancy is a complex issue influenced by various factors, including historical context, misinformation, distrust in institutions, and individual beliefs. Conservative individuals, like those from other political backgrounds, have a diverse range of views on vaccines. Public health is a matter that should transcend political lines, and addressing vaccine hesitancy requires understanding its multifaceted causes.

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3. What are your thoughts on COVID anti-vaxxers?

COVID-19 vaccine hesitancy, like vaccine hesitancy in general, is a cause for concern. Widespread vaccination is crucial for achieving herd immunity and effectively managing the pandemic. COVID-19 vaccines have undergone rigorous testing and have been proven safe and effective. Those who choose not to get vaccinated may put themselves and others at risk. It’s essential to approach COVID-19 anti-vaxxers with empathy and provide accurate information to address their concerns. Public health measures should be guided by science and designed to encourage vaccination rather than stigmatize those who are hesitant.

4. Anti-vaxxers, why are vaccines so bad?

Vaccines are not inherently “bad.” In fact, vaccines have been one of the most successful public health interventions in history, saving millions of lives by preventing serious diseases. The perception that vaccines are harmful often stems from misinformation, myths, and misconceptions spread by the anti-vax movement. It’s crucial to rely on scientific evidence and expert consensus, which overwhelmingly supports the safety and efficacy of vaccines. Any concerns about vaccines should be addressed through credible sources and open, informed dialogue with healthcare professionals.

5. What is your view on anti-vaxxers? Aren’t they cowardly and delusional?

Labelling anti-vaxxers as “cowardly” or “delusional” is not a constructive or empathetic approach. Anti-vaxxers are individuals who often have genuine concerns, albeit misguided ones. It’s essential to engage with them respectfully, listen to their apprehensions, and provide accurate information based on scientific evidence. Addressing vaccine hesitancy requires patience, education, and understanding. Name-calling or stigmatization only deepens the divide and hinders the efforts to build trust in vaccines and protect public health. Treating this issue with empathy and patience is more likely to lead to positive outcomes.

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Canada

Socio-Economic Implications of Canadian Border Closure With U.S

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After doing a  detailed analysis of the situation emerging from the closure of the border between    Canada and  US, it could be assessed that how damaging the decision is for the  Economy of Canada, and how beneficial, it will be for Canada, if it decides to re-open the Border which is closed over the fears of an outbreak of Covid-19 Pandemic.

Since, some people think that given the maximum number of  Covid-19 cases and several deaths worldwide, the decision should stay as there are thousands of cases and deaths over covid-19 in the US. They deem it a good step to keep the border shut over the fears of  Novel Corona Virus with the US and Mexico

Though some sections consider the move as a right decision based on the covid0-19 statistics some experts term it very dangerous for  Canadian Economy as it will be affected as major industries such Tourism and Travel, Immigration affected very badly and economic cannot be put on hold for long as the numbers show that  75% to 80% Canadian exports go to the US while 30% to 40% US exports make their way in  Canada.

Thus the economy has been hit very badly due to this prolonged closure and shutdown of Economic activities will ultimately pose a grave threat to falling in Recession and Falling of  Reserves.

The Canadian authorities will have to swallow a hard pill to re-open the b border for essential and non-essential travel since both types of entries in the country contribute to the economy of the country.

At the moment, Canada has limited Covid-19 infections as compared to the US that has a massive number of infections in the world.

According to the Border Management Experts, this could be the only problem that might have prompted  Canadian Prime Minister to extend the closure for another month until some  SOP’s may be developed to ensure on border covid-19 Testing and Scanning so that preventive measures should be taken to keep the infection ratio low in Canada.

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 The World economies are affected very badly over the lockdowns announced to prevent Covid-19 outbreak and their economy has been under pressure already and the financial experts predict the worst type recession shortly. 

The people of both countries are of the view that the Prolonged border closure has caused an economic crisis and several Industries such as Hotel Industry, Travel Tours and Immigration, Food and beverages Industry, sports Industry, Education have been affected very badly and both Canada and the US cannot afford to sustain more jolts to their economy as economic activities have dropped to almost  80%  and ring the alarm bells for the leadership to decide immediately what their next plan will for the border.

Whether they will reopen it in phases or provide restrict access to essential travel such health workers, Airline Crew, Food and Goods services, People visiting ailing relatives and other related activities that fall within the purview of  “ essential”.

Although, the global Pandemic has created a situation like recession which is going from bad to worse each Passing day, yet in such scenario “keeping borders Closed” for trade and Business Opportunities and other travel, entertainment industry, will incur an irreparable loss to the Economy of both Canada and US as both countries have signed several Trade Agreements and US has been losing millions of Dollars in terms ” US Entry Waivers” and this is putting pressure on world’s biggest economy

Even it is a great blow to the Immigrants who wish to travel to neighbouring countries.

Both Canada and the United States are providing millions of dollars to people as relief package, Health and social security and other procurements such  Covid-19 testing kits and establishing new isolation and Quarantine centres as the infections surge in the US and worldwide.

In such circumstances halting economic activities are suicidal for  Canada and Virus affected the US  by keeping borders close for non-essential or optional purposes despite putting some curbs on essential travels such putting immigrants in 14 days quarantine and other immigration-related curbs. 

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The economists fear that what would be the consequences if the covid-19 vaccine was unavailable till the end of the year 2021, will they still keep the border closed, sounds like insensible and disastrous for all types Industries and Sectors including  Immigration and Border services. 

So, it would be prudent on the part of Both Canada and US  to think over the re-opening of their border so that people intending to visit their relatives on both sides of borders may have uninterrupted access and they must be facilities at the border checkpoints for covid-19 so that the fears of  Canadian authorities about getting soaring infections may be dispelled by assuring them safety measures at border crossing points.

Furthermore,  the fears cannot be treated with medicines but they could be soothed with confidence-building measures as the statistics show that  65% Canadian fear to get contracted by Virus while over 60% US people have a similar situation for contracting virus.

Despite all this, nobody knows that when these borders will reopen for general people apart from essential travel as most people are in the grip of fear and prefer staying at home as per WHO guidelines, that may be the issue that both Canadian and US Governments are lingering on the issue and prefer extending closure as both nations enjoy cordial relation and the closure is a mutual decision of both countries.

Recently, though some Tour industry groups recorded their protest and demanded to re-open the border. The decision could not be influenced until the general public presses their respective Governments to review the decision and take some bold steps to save their economies falling to prey to this pandemic.

Both Canada and the US  cannot afford to lose millions of Dollars in border trade and border revenues such as Entry waivers, customs etc to boost their economies.

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China

Global Socio-Economic Impact of Covid-19

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The Pandemic originating from Wuhan China has enveloped the whole world and the catastrophe caused by covid-19 is beyond speculation.  Schools, Colleges, Universities and business are closed for an indefinite period and the World has gone into self-isolation while the countries imposed lockdown in the world in the severely hit areas to contain the outbreak at massive scale.

The pandemic has affected all the countries especially China, France, Italy, Germany, US, UK, Iran, Egypt and third world countries i.e Pakistan, India, Bangladesh, Sri Lanka and  Afghanistan and some African countries.

There are some countries which are severely impacted socially and economically while some countries have sustained moderate impact owing to taking timely preventive measures as per circulated guidelines of WHO and Local Health ministries of respective Countries.

With President Donald  Trump clipping the wings of  UN’s apex health body by cutting the financial support amid the Global Pandemic, the catastrophe is expected to go from bad to worse as WHO  will experience the funds’ shortage that will ultimately contribute to a deep humanitarian crisis

The world posts a bleak picture already as all business activities have been suspended, the markets have been closed for an indefinite period, the stock markets crashed and the unemployment ratio suddenly jumped to historical high due to covid-19 Pandemic. Even OPEC members have decided to cut the oil production given the pandemic situation. 

The Global economy has been severely impacted by the shocks of the deadly virus that prompted companies like Google, Yahoo, Microsoft, Face book, Twitter to ask their employees to work from home to avoid contracting  Covid-19.

All the industries have been impacted badly that include entertainment, Sports, food franchise has completely shutdown creating panicking situation all around as once busiest streets and markets have started presenting deserted look.

This global economic warrants that if the early remedy to cure covid-19 is not discovered, the future will be dreadful to predict. The mighty economies such as China, the US, France, Italy, UK, Germany has been seriously impacted by this deadly virus. The situation is haunting the people around the world, bringing misery of greater proportion as compared to Word War II, Ebola, SARS, MERS, Plage and Yaws.

The Daily Wage workers, Private workers, drivers, hawkers, shop keepers and thousands of similar workers have lost their jobs and the opportunity to earn their livelihood. The companies have preferred work from home option for their employees to limit the outbreak and avoid contracting covid-19.

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It is alarming that hundreds of workers have filed as unemployed. The lengthy lockdowns have created serious humanitarian and economic crises and the experts are of the view that the circumstances are fast moving towards the global recessions and may take a long time to recover from this catastrophe.

Though China has been able to contain Covid-19 and even lifted restrictions on outgoing flights with some strict SOPs, yet the Covid 19 seems to be an invisible predator waiting for its prey regardless of any region. The virus has impacted all the zones i.e with the cooler, hotter or moderate atmosphere.

The only solution to fight this pandemic is social distancing, maintaining the hygienic environment and avoiding crowdy spaces. The Governments around the world have imposed strict lockdowns and the frontline fighters (Health workers) around the world doing a marvellous job to protect their fellowmen even at the cost of falling prey to this deadly virus.

While fighting this pandemic. Many health workers have been tested positive. Even, some frontline soldiers lost their fight to this pandemic and laid down their lives to secure the future of their respective country.

Education is being imparted through digital platforms as online education is increasing for students. Though students are facing some issues such as the connectivity, Sound quality, Video Quality, yet in this emergency, the Schools, Colleges, Universities and other online course websites are striving to provide some light of  Knowledge in these difficult times.

The booming industries such as restaurants, hotels, motels and  Aviation have been closed for an indefinite period.

Coronavirus Pandemic has brought catastrophe in the world impacting all the industries and has caused economic slowdown throughout the world in all the major continents who are thickly populated such as Asia, Europe, the Americas and Africa.

Unfortunately, despite 151598 deaths worldwide and over 2.21 Million confirmed cases covid-19, all eyes are hooked towards the discovery of vaccine to treat the patients and save their lives. At the moment, only plasma therapy is being conducted and some common medicines are being used such as cough, flu fever-related medicine.

Though human trials have been started by some  Pharmaceutical companies, the experts are of the view that it may take one and half year for the vaccine to be available in the market. It is also estimated to be the costliest vaccine ever keeping in view its global implications and rapid speed of pandemic spread in the world.

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It is estimated that Europe, Asia, Middle East to suffer a lot especially, Italy, France, UK, Iran and US as the ratio of deaths is higher than other countries especially US where average deaths per days have surpassed all other nations that prompted Trump to cut funding to world health Organization accusing it of mishandling the pandemic and delayed response to mitigate its implication while  WHO head has refuted the allegations.

The covid-19 has also impacted Sports, News & Media, Entertainment and Services Industries to the extent that. All the sporting events have been suspended, series and Leagues have been rescheduled and big events such as  PSL, IPL, FIFA  World Cup, Olympics Games and others have been completely cancelled raising concerns among the players. Even the players are facing the trauma having travel history to the epicentre of Covid-19 Pandemic and tested positive.

 The Entertainment industry has been heavily impacted as all the dramas, Films and comedy shooting and recording has been postponed till indefinite period and all the events including concerts have cancelled due to covid-19 and actors have lost the source of living.

The services industry especially the skilled and non-skilled have been subjected to starvation as all the roadside small business such as Hair Cutting Salons, Cobblers, Gold and blacksmith shops, Electricians, Booksellers, daily wages workers and Masons have lost their living owing to lockdowns globally.

 Finally, the Print and Electronic  Media are partially impacted though they are a very vulnerable community as they have been busy in coverage of the pandemic around the world and are prone to contracting the deadly virus due to close contact with Patients at Quarantine Centres and the Health specialists working at the hospital and temporary health centres specially set up for an emergency.

The Print Media has been hit hard as people consider it risky to read a Print copy of newspapers over covid-19 fears and prefer paper or online edition of the newspapers. Hence, such a trend has impacted the Newspaper  Sales badly.

On the other hand, electronic media such as News Channels, Radio and Digital Media such as Websites, YouTube are grabbing people’ attention.

The Social Media is also buzzing with Covid-19 updates though  Social Media and Silicon Valley companies have asked their employees to work from home and follow the preventive measures these include Twitter, Yahoo, Facebook, Microsoft and Search Giant  Google.

The world should be united to fight this global pandemic that is haunting the world. The US should release funds to help WHO work effectively for global health and expedite the process of vaccine discovery as each day will deprive the near and dear ones of the families around the world. With collaborative efforts, the world can win this war against the pandemic.

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