A coronavirus disease (Covid-19) patient, who works as a healthcare worker at the All India Institute of Medical Sciences (AIIMS) in Delhi, during an interaction on Wednesday with the former Congress president, Rahul Gandhi, lamented that the testing has drastically reduced in the national capital despite a significant increase in viral infection and fatality rates.

“This is, indeed, a sad state of affairs. I want to inform you about some statistics. On May 27, the infection rate in Delhi was 13.7%. We were doing 7,000 tests per day. By June 12-13, our infection rate had crossed 30% and we are doing under 5,000 tests per day,” said Vipin Krishnan, who has been working at AIIMS for the past two years.

“This is surprising given that our deaths and infection rates are increasing, but we have reduced testing. I don’t understand what is happening?” he asked Gandhi.

Krishnan was joined by three other nurses — Anu Ragnat from New Zealand, Narendra Singh from Australia and Sherlylmol Puravady from the United Kingdom (UK) – who shared their experiences with Gandhi via a video-conference link about fighting the Covid-19 pandemic as frontline healthcare workers.

The conversation covered a range of subjects, including the reason behind Indian nurses are sought after across the world and working in a Covid-19 environment that has had an impact on their family lives.

Krishnan, who belongs to Kerala and along with his wife is in quarantine after both tested Covid-19 positive, shared statistics about the skewed ratio between doctors and nurses to patients in the country.

“We have 1.2 million registered allopathic doctors in India. We have around 3.7 million registered nurses in India. The ratio is 1:1,500 for doctors to patients and 1.7:1,000 nurses to patients in the country,” he said.

“However, the WHO (World Health Organisation) had recommended that the ratio should be 1:1,000 doctors to patients and 3:1,000 nurses to patients. Though we are way short of human resources, we are still fighting hard,” Krishnan added.

Gandhi said the doctors are a frustrated lot and do not know how to move forward in terms of conducting Covid-19 tests and are facing enormous challenges such as putting a patient, who has contracted SARS-CoV-2, which causes the disease, next to a non-Covid-19 patient.

“I think the government is trying to manage the perception and trying to give a sense that the problem is not as bad as it is. But I believe that we have to face the problem. We should accept and define the problem accurately and then fight it. I don’t know how you react to that,” the former Congress chief said.

“You are absolutely correct,” Krishnan replied.

“We have a pandemic situation and the AIIMS director has said that we will peak in June and mid-July. So, even the Delhi chief minister has stated that they are expecting 5.5 lakh cases. We are having 10,000 beds in Delhi. Can you imagine the gravity of the situation, if 5.5 lakh people were to be admitted? Of course, they won’t come at the same time, but on average we will have lakh patients a day. I can’t imagine the gravity of the situation. What will we do?” he asked.

Krishnan claimed that outpatient departments (OPDs) in many government hospitals have ceased to function. “We have no way out. We have to think about how to help non-Covid-19 patients. I have also received many calls from cancer patients and others asking for help but we are unable to help. Most of the beds are being allocated for Covid-19 patients, not just in AIIMS but in most government hospitals.”

Krishnan also talked about the difference between government and private hospitals in the country.

“There is a sea of difference between government hospitals and private hospitals in India… When we look into the private sector, there are a lot of discriminations. Private nurses are saying that their salaries are being cut. How will they care for their families during this pandemic? In such a situation, I think the government must help them and pay their entire salaries. In this condition, it is difficult for them to survive,” he said.

Asked by Gandhi if he was scared, Krishnan replied: “I don’t think we are scared of the Covid-19 pandemic. To save the country, we have to fight at the frontlines. My own experience showed that. I was not scared but now that I have been infected, I am still not scared. I want to tell you and the government that once I recover, I want to go back to the Covid-19 ward.”

He also demanded that doctors and nurses should be included under the risk allowance category of the central government, as they are losing their lives while fighting against Covid-19 as frontline workers like the army personnel, who are busy guarding the country’s borders.

“We can compare this (Covid-19) to a bio-war. It is not a bio-war, but a virus, a small microscopic organism is challenging the world and the country at large. So, we are fighting like the army or the air force. I’m not comparing this with our force. But at least I think you will agree with that we are fighting as an army,” Krishnan said.

“Yes, you are a non-violent army,” agreed Gandhi.

“We are exhausted but we are fighting in the frontline without any fear or favour. We will win. You and the government are with us. I have complete faith that we will fight this war against Covid-19 and win,” added Krishnan.

He also claimed that the voice of healthcare workers is not being heard while making policies. “When a policy is being made related to nurses and the medical profession at large, the experts should be asked for their inputs. Then, only the policies should be made. Unfortunately, that has not been happening in our country. Many organisations’ leaders are not being called when it comes to policymaking decisions.”

While Ragnat shared her experiences in New Zealand, Singh gave an account of how the Covid-19 battle is fought in Australia and Puravady talked about the challenges faced by the UK.

In Australia, Singh, who is from Rajasthan, said initially Covid-19 was thought to be a simple flu and not taken seriously. “But once the viral outbreak became widespread, we saw it on news every day. And then Italy’s mortality rate started climbing. That was time we started thinking that it was not the simple flu. This is really serious. I think we have to take this viral outbreak seriously,” he said.

Talking about her experience in the UK, Puravady, who also belongs to Kerala, told Gandhi that they were quick to use the personal protective equipment (PPE) units such as surgical masks, aprons, and gloves even before the lockdown restrictions were announced.

In the UK, she said people are respectful of healthcare workers. “We have dedicated shopping time for the National Health Service (NHS) staff or the care workers. Every Thursday the government is putting it as the clapping for the care workers and things like that. So it is so supportive, all supermarket authorities are very supportive.”

Ragnat, who is also from Kerala, said the figures could have gone up easily into five digits if New Zealanders were careless.

“So, I think going hard and going early was the motto of Prime Minister Jacinda Ardern. She’s done absolutely well. I think going hard and early was really the right thing and that really flattened the curve in New Zealand,” she added.

Ragnat said the New Zealand government had the beginning itself announced a $10-million package, including accommodation for healthcare workers. “If you don’t want to go back home to an immune-compromised family member, you can stay either in a hospital or in nearby motels and the government would pay for that. Listening to the rest of the team, I feel like we are in a blessed position actually,” she said.

Asked by Gandhi why Indian nurses are valued so much abroad, Puravady said they are very hardworking and dedicate their lives to the profession.

“They don’t care about themselves. They see the patients in front of them as either their parents or children, their mother, their brother or sister,” she said.

“I think we are go-getters. We are always on the frontline. I think we are ready to cope in any country in any situation, in any scenario, and easily adapt being in few other roles,” she added.

The dialogue was a part of Gandhi’s series of video conversations with global and Indian thought leaders to discuss the Covid-19 crisis and its consequences on the country’s economy.

In the past, the Congress chief had interacted with former Reserve Bank of India (RBI) governor Raghuram Rajan; Nobel Laureate Professor Abhijit Banerjee; Harvard Professor Ashish Jha; Swedish epidemiologist Johan Giesecke; Bajaj Auto managing director Rajiv Bajaj and the former US under-secretary of state Nicholas Burns.

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