As India experiences a rapid surge in new daily covid-19 infections, likely because of the highly transmissible omicron variant, its healthcare workers fear the worst, just months after a wave of delta infections claimed the lives of hundreds of their own.
In large metro cities, it is estimated that nearly 75% of all new cases are caused by omicron. In Delhi, sequencing suggests that 81% of the current surge comes from the new variant. Whatever happens, chronically under-resourced health workers will bear the brunt.
Healthcare workers—doctors, nurses, hospital cleaning and administrative staff—are all at an increased risk of contracting covid-19. India began vaccinating its healthcare and frontline workers nearly a year ago on Jan. 16, and will only start offering a “precautionary” third dose from Jan. 10.
While vaccines are still largely effective against severe disease and hospitalization, the omicron variant can still infect the fully vaccinated. Major cities like Delhi, Kolkata, Mumbai, and Chennai have reported several clusters of infections among healthcare workers.
As many as 100 doctors, paramedics, and other staff have tested positive at Delhi’s largest hospitals. According to one estimate, more than 1,000 doctors have already tested positive for covid-19 across the country, in this latest wave.
For doctors, it brings back grim memories of losing colleagues last year. Nearly 800 doctors died during India’s second wave, according to the Indian Medical Association. For hospitals and state governments, it is a question of juggling the safety of doctors while saving as many lives as possible.
Though the relative number of hospitalizations continues to be lower than it was during the delta wave, the surge is still capable of overwhelming India’s already insufficient healthcare infrastructure, both in terms of physical capacity and human resources.
Doctors at public hospitals have been asked not to isolate if they come in contact with a covid-positive patient, according to a report in The Indian Express newspaper.
Such doctors will continue seeing patients, with strict covid-19 protocols, and properly sealed masks and personal protective equipment, the report said, citing a memo from Delhi’s Lady Hardinge Medical College. During the past pandemic waves, staff working in covid wards had to self-isolate for a period of 10 days to two weeks after completing a fortnightly shift.
This change in quarantine protocol comes as early evidence suggests that while hospitalizations are rising fast, most patients do not need oxygen support, and remain in the mild-to-moderate category of the disease. But if a medical worker tests positive, they will need to isolate themselves for seven days if their symptoms are mild, or they are asymptomatic, under the revised quarantine rules (pdf) from the Ministry of Health.
India already has a healthcare worker shortage, with less than one doctor for every 1,000 people. For context, the US has 2.6 doctors per 1,000 people, according to a 2018 World Bank estimate.