Confronting COVID-19: A Chronicle of Resilience at Bharati Vidyapeeth Medical College

The COVID-19 pandemic, a global health crisis originating in Wuhan, China, rapidly transformed the world in 2020. Terms like "coronavirus," "social distancing," and "pandemic" became ingrained in our daily vocabulary. In December/January, the World Health Organization (WHO) declared the virus an epidemic and later rechristened it as the COVID-19 we’ve all come to know now.

Early Preparedness and the Road Ahead

This unprecedented challenge demanded swift and decisive action. We proactively addressed the emerging crisis at Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital in Sangli. Recognizing the gravity of the situation, discussions about the coronavirus began as early as January 2020. We swiftly established an isolation facility, demonstrating our commitment to preparedness even before the Government of Maharashtra officially designated it as a dedicated COVID-19 treatment center. This proactive approach proved crucial in our fight against the pandemic.

However, the initial phase presented significant hurdles. While we aimed to set up a "Negative Pressure Isolation ICU," the nationwide lockdown severely disrupted supply chains, hindering our progress. Despite these challenges, we collaborated closely with the district administration, command and control center, health officials, and experts. These collaborative efforts resulted in the successful implementation of containment measures, with the "Islampur Model" serving as a testament to our proactive approach in managing the initial wave of infections.

Scaling Up: Expanding Capacity and Overcoming Challenges

As the number of COVID-19 cases surged, the government requested a significant expansion of our isolation and ICU capacities, increasing the bed count from 14 to 60. This presented formidable logistical and resource constraints. We faced shortages of critical supplies like PPE and oxygen, creating significant challenges in providing adequate care.

To address these challenges, a dedicated core team was formed. This team meticulously planned and addressed the multifaceted issues, comprehensively assessing infrastructure, drug availability, equipment, human resources, and oxygen supply. We established a robust system with dedicated teams for duty management, infection control, drug and treatment management, biomedical waste management, and data management. This comprehensive approach ensured efficient coordination and effective resource allocation.

Innovations for Safety and Efficiency

The safety of our healthcare workers was paramount. We innovated by developing customized face shields and PPE with hydration systems to enhance comfort and protection. We also continuously improved infection control protocols and ensured the availability of high-quality PPE. These measures were crucial in safeguarding our frontline workers and minimizing the risk of infection within the hospital.

Overcoming Oxygen Supply Challenges

The efficient delivery of oxygen proved to be a significant hurdle. We diligently investigated and resolved issues related to oxygen pressure fluctuations, ensuring uninterrupted supply to all patients. This included procuring additional oxygen cylinders and installing a new header line to optimize pressure delivery. These efforts were crucial in ensuring the continuous and uninterrupted oxygen supply to patients requiring critical care.

Addressing Staff Concerns and Well-being

Mobilizing and retaining healthcare personnel amidst the pandemic presented unique challenges. Addressing staff concerns regarding safety and well-being was crucial. We implemented measures such as:

• Dedicated COVID-19 Care Centers: Providing treatment and support to infected staff members.

• Enhanced Staff Support: Offering counselling sessions, insurance coverage, and paid leave for quarantine periods.

• Incentivizing Staff: Recognizing and appreciating the dedication and sacrifices of our healthcare workers. These measures were crucial to maintain morale and ensure the well-being of our dedicated staff.

Continuous Improvement and Adaptability

As the situation evolved, we continuously adapted our strategies. This included:

• Establishing a dedicated RT-PCR laboratory: Enhancing diagnostic capabilities and accelerating patient care.

• Improving patient flow: Implementing a streamlined admission process with triage, rapid antigen testing, and efficient patient transfers.

• Scaling up infrastructure: Expanding bed capacity, upgrading X-ray facilities, and enhancing dead body preservation facilities.

• Addressing staff shortages: Implementing flexible duty schedules, mobilizing resources from other departments, and integrating postgraduate students into the COVID-19 care team was crucial to ensuring efficient and effective care delivery to a growing number of patients.

Community Engagement and Support

The pandemic posed significant emotional and psychological stress for healthcare workers. We recognized the need for counselling and support and organized sessions for paramedical staff, nurses, and doctors, focusing on self-protection and wellness. We also implemented a policy where no more than 50% of our faculty were on duty at any given time, ensuring that staff had time to rest and recuperate. Additionally, we reduced non-COVID admissions and postponed elective surgeries to allocate more resources to COVID-19 care.

As the virus spread, the patient load increased, and bed availability became a significant issue across the city. We received constant requests from government officials to admit patients, often beyond our capacity. To manage bed availability, we developed a real-time data system that relayed information about vacant beds, streamlining communication with other hospitals. When tensions escalated due to patients' relatives grieving, we sought assistance from local police, who set up a police chowky on-site to ensure the safety of staff and control crowds.

Technological Advancements and Improved Care

Recognizing the need for timely testing, we established an in-house RT-PCR laboratory, inaugurated on October 2, 2020. This facility quickly became one of the best in the region, having received NABL accreditation. We were able to perform RT-PCR tests at government-recommended rates, further contributing to our community's ability to fight the virus.

As the virus spread to rural regions like Kadegoan and Turchi, we set up treatment facilities, ensuring that underserved areas also had access to critical care.

Looking Ahead: Vaccine Administration and Continued Vigilance

As the pandemic gradually slowed down, we consolidated our isolation facilities and prepared for the next phase—vaccine administration. We quickly established a vaccination facility and prepared a team to manage the distribution and administration process.

Conclusion

While we've made significant strides in managing COVID-19, the pandemic is not over. We continue to monitor the situation, ensuring we remain prepared for any resurgence. Every team member's strength, resilience, and courage are overstated.

This account of our journey is a testament to the dedication and resilience of our entire team, from the faculty and nurses to paramedical staff and ward boys. Their unwavering commitment has been instrumental in our fight against this pandemic. We remain committed to overcoming this challenge and ensuring the safety and well-being of our community.