Maharashtra has emerged the epicentre of the Novel Coronavirus outbreak in the country with Mumbai reporting the highest number of cases in the state. With more and more healthcare providers getting infected, hospitals are becoming the hotbeds of virus perpetuation.

On Monday Wockhardt hospital in central Mumbai was sealed by the municipal corporation of greater Mumbai (MCGM) after three doctors and 26 nurses there tested positive for Novel Coronavirus. Last week, Jaslok Hopital in south Mumbai was sealed after its staff members tested corona positive. Ten of its staffers including six nurses are infected. Entry and exit of both hospitals have been sealed and restrictions imposed as more medical staffers continued to test positive for the new virus. The BMC has identified about 200 containment zones in the city of Mumbai so far.
 
On Monday, Jan Swasthya Abhiyan Mumbai, United Nurses Association Maharashtra, Clinical Nursing Research Society and Nursing and Paramedical Staff Union in a letter to the Mumbai municipal commissioner, Praveen Pardeshi, raised the issues and safety concerns being faced by nurses in public and private hospitals in the city while treating COVID-19 patients. The collective says that 265 nurses are under observation to contain spread of virus in a single private hospital alone.      
 
The letter states that as the nurses amongst all the staff are exposed to patients for the longest period, the administration and state should ensure supply and availability of personal protective equipment (PPE) for them.
 
“Given the hierarchy in medical profession nurses are undervalued, under supported and do not get the attention as frontline workers. It is sad that many nurses are appealing to charitable institutions to donate PPE and that even when donation in terms of supplies are being received nurses do get access to protective gear,” says the letter.
 
The letter states that hospitals lack adequate precautions for infection control and triaging putting the safety of nurses at risk and must be transparent in providing COVID -19 test results to nurses who test positive. It says that there is lack of nutritious food and adequate facilities like beds, food and mattresses for nurses who have been quarantined in hospitals and nurses are being made to work overtime without adequate rest. It also says that nurses who have been advised quarantine are told to continue working.
    
The nurses have demanded that that PPE must be provided to them as per the health ministry (MoHFW) protocols, proper infection control and triaging protocols followed,14-day quarantine period must be maintained irrespective of COVID test result, nurses working in isolation wards should be given formal training, nurses must have appropriate working hours with breaks, given nutritious food, provided accommodation near hospitals to minimize risk of infection to their families and others, and that private hospitals must adhere to MoHFW guidelines and also regularly report to MCGM or state administration on the no. of COVID positive patients, number of nurses quarantined and care being provided to COVID-19 patients.
 
The charter of demands also asks that nurses be included in statewide committees of Maharashtra government to ensure their participation in decision making.
 
Ranjana Athavale, member, Nursing and Paramedical Staff Union, Mumbai, said that BMC nurses are not getting adequate PPE and if available these are being given to doctors working in Corona casualties, OPD and ward. “We are told to wear N95 mask and corona kit only for positive patients. This is leading to nurses getting infection.”
 
Athavale added that though not as effective, even a HIV kit would help in such a time but that too is not available. “If we become carriers of COVID-19 we will infect all patients who come in contact with us. It is very essential that health workers be given protective gears so they don’t spread the disease,” she said.      
 
A nurse who did not wish to be quoted said, “We are hoping that by raising these concerns any misappropriation of supplies will stop. If the government had designated a single centralized facility for all coronavirus patients the issue of PPE shortage could have been avoided. The government should have stopped export of PPE earlier as it knew about COVID-19 pandemic.” The nurse said that as the testing kit is very expensive they are only testing patients with symptoms. “The government must increase testing. We are getting many patients who were asymptomatic but tested positive. They are carriers of COVID,” she added.          
 
Inayat Singh Kakar, lawyer, activist and a signatory to the letter, said, “The hospitals are not taking adequate precautions to ensure that nurses and frontline staff who are risking their safety for us are protected. Four hospitals in Mumbai have shut down completely or partially because staff members are getting infected. It is a grave concern because we still have not reached peak infection. Just as the Seven Hills Hospital, a designated COVID facility has taken over a hotel where they have lodged all their staff members, all hospitals must ensure that their staff members don’t have to travel risking infection.”   
        
On Monday Maharashtra recorded 57 new COVID-19 positive increasing the number to 868. A total of 45 people have died in the state so far. As many as 66 patients have recovered. In Mumbai four patients died on Monday, with the death toll rising to 12. The total number of positive cases in Mumbai was 526. Other cities in the state too recorded increase in positive cases. Pune now has 101 cases, Pimpri 39, Sangli 25, Kalyan-Dombivli 23 and Navi Mumbai has 22 cases.