• Study reveals over 41pc Covid-19 medical staff faced violence
• Pims staff may close coronavirus ward next week

ISLAMABAD: With casualties from Covid-19 continuing to mount across the country, the National Command and Operation Centre (NCOC) has issued guidelines for the upcoming Christmas events to prevent the spread of the virus.

On the other hand, a study has revealed that over 41 per cent of healthcare workers handling coronavirus patients in three cities of the country have faced violence.

In another development, the staff of the Pakistan Institute of Medical Sciences (Pims) in Islamabad, where over 100 critical Covid-19 patients are under treatment, may suspend the service at the coronavirus ward in the upcoming week.

According to data issued by the NCOC, 87 deaths and 3,179 new cases were reported on Saturday with 279 ventilators in use throughout the country.

In Multan, 46pc of the vents allocated for Covid-19 patients were occupied, 41pc were in use in Islamabad, 34pc in Lahore and 21pc in Peshawar.

The number of active cases was recorded at 40,921 as of Dec 19 with the national positivity ratio at 6.61pc. The highest positivity ratio was reported in Karachi at 11.8pc, followed by Peshawar, 9.23pc and Mirpur, 7.92pc.

Guidelines

Terming events related to Christmas a major challenge, the NCOC announced guidelines to mitigate person-to-person spread of the virus.

“Christmas events could amplify the transmission of the virus and potentially disrupt the country’s response capacity. With the pandemic in full rage, the safest thing that can be done during this Christmas holiday is to stay home. There should be limited in-person contacts during holiday preparations and celebrations. In such events, prevention of importation of the virus from one household to the other and various places like shopping malls and churches are an essential element in avoiding or minimising the occurrence of infection and of serious outbreaks in these settings and beyond. Precautions are required by public, especially the Christian community, to protect themselves and prevent transmission,” the centre said.

It asked people to undertake minimal necessary travel during the holidays.

“Social visits during the holidays and family get-togethers should be avoided. Christmas shopping should only be restricted to minimal essentials and crowding in markets is not advisable. The traditional gift exchange and large-scale home gatherings are likely to increase transmission so they should also be avoided,” it said.

The NCOC has advised to limit duration of events and regularly disinfect Christmas trees and decorations in public places.

Churches have been asked to arrange thermal screening of peo­ple at entry gates while prea­chers should deliver sermons on the virus and preventive measures. Windows and doors of churches should be kept open for ventilation on Christmas day, no carpets or mats be laid down as the virus was airborne, benches washed with chlorinated water regularly and everyone should wear a mask and maintain a distance of at least one metre from others during prayers.

Health workers face violence

According to a study, conducted by APPNA Institute of Public Health (Jinnah Sindh Medical University Karachi), University of Lahore and Khy­ber Medical University with the support of the International Committee of the Red Cross (ICRC), over 41pc of the healthcare workers taking care of Covid-19 patients in the three cities of Pakistan had faced some form of verbal and physical violence while battling the pandemic.

The study surveyed 356 healthcare workers, including doctors, paramedics and laboratory technicians, from 24 health facilities in Karachi, Lahore and Peshawar.

“There is an erosion of trust between patients and healthcare workers in Pakistan,” said Dr Mirwais Khan, who heads the Health Care in Danger (HCiD) initiative of the ICRC.

“We needed to see if Covid-19 was making it worse,” he said.

The study conducted in May and June during the peak of the first wave of coronavirus in Pakistan showed that 41.9pc participants experienced violence during their Covid-19 response, with 6pc reporting physical assault.

The study defined acts of violence to include verbal and physical assault as well as stigma and ostracisation from patients and their families.

A third of those interviewed reported being falsely accused of causing injury or death to patients.

A medical registrar at a hospital in Karachi said it was “demoralising” to face a “barrage of insults” while on duty.

Among the recommendations offered by the study to help bring a change in attitude towards health workers are tackling misinformation on social media, creating stronger support for healthcare staff at work when dealing with psychological stress, training them on better communication with patients and their attendants and de-escalating violence.

The reasons that led to rise of violence in hospitals included demand of attendants to hand over bodies immediately and not to mention Covid-19 as the cause of death.

A doctor from a public-sector hospital in Peshawar said: “They wanted to take the body immediately as they feared the community would otherwise not attend the funeral of the deceased.”

A doctor from a private hospital of Lahore said: “I felt very disheartened and tired. I stopped fighting this. I almost agreed to all the accusations.”

Family concerns and pressure to quit job or take temporary leave was also a major effect expressed.

The study suggests a way forward by building trust between healthcare workers and the public, dispelling myths and misinformation, enhancing institutional practices to address issues related to patient care and improving the response to any untoward incident by enhancing security and surveillance.

Pims ward

Lives of around 100 critical patients might be at risk as Federal Grand Health Alliance (GHA) Chairman Dr Asfandyar Khan on Saturday revealed that the Pims staff was pressurising the alliance to suspend services at the coronavirus ward.

“We have been protesting against the privatisation of the hospital but unfortunately the government seems least interested in addressing our issues. Majority of the employees believe that, as the hospital is going to be privatised, they should suspend service and avoid infection as sooner or later they will be dismissed from their jobs,” he said.

Mr Khan said it would be unfortunate to take such a step but in case of a collective decision, the GHA would have no option but to suspend service in the upcoming week.

Pims Joint Executive Director Dr Minhajus Siraj said there were around 100 critical patients in the hospital who could not survive without continued observation of the staff as their oxygen level fluctuated.

Last month, President Dr Arif Alvi had promulgated Medical Teaching Institution (MTI) Ordinance under which a board of governors (BoG) would deal with the affairs of Pims once it becomes an MTI.

The BoG, whose members have been notified by the Ministry of National Health Services, will have control over the functions of the hospital and would be empowered to dismiss employees. Besides, they would also lose the status of civil servants.

Workers have been protesting against the ordinance, suspending all services except the emergency department and the coronavirus ward, for the last three weeks.

Published in Dawn, December 20th, 2020