The fatigue is evident from the dark circles around his eyes.

“Our sleep pattern is disturbed ... We don’t get enough sleep these days,” acknowledges Dr Aftab Phul, the focal person for the Covid-19 isolation ward at Hyderabad's Liaquat University Hospital (LUH).

Being the only tertiary care hospital in lower Sindh, LUH is handling patients not only from Hyderabad but from other adjoining districts as well. Located in the centre of the city, the sprawling LUH isolation centre currently has more than 20 coronavirus patients in isolation.

And as infections continue to rise, the pandemic is taking a heavy toll on healthcare workers, increasing their workloads and testing their commitment to the profession.

“As doctors, we don’t get sentimental and are ready to face any kind of situation,” says Dr Phul, adding in retrospect that he was ready to respond to the Covid-19 situation in line with the standard operating procedures laid down by the Sindh government, ever since the pandemic reached this part of the province.

Besides handling the isolation ward, data sharing and management is another huge task that doctors have to carefully tackle. “We have to attend the district administration’s meetings and respond to their calls. There is no time limit now; we are on our toes round the clock as a patient can be brought in at any time and a call can be received from the hospital or district administration at any moment,” the 33-year-old adds.

The evolving nature of the fight against the virus means that planning workdays ahead of time is nearly impossible.

“I just reach the hospital keeping in mind that before anything else, I have to check the data. And then there is no set timeline for work and I don’t know which task has to be responded to first," says Dr Phul.

Starting his shift in the morning, Dr Phul spends the better part of his day, until 11pm on average, looking after the isolation ward and dealing with other auxiliary services as the hospital's focal person. Due to the workload, he often does not get the chance to respond to calls on his cellphone, unless they are from familiar contacts.

Despite rising Covid-19 cases among healthcare workers across the country, the medic is not frightened about putting his own life on the line.

For Dr Phul, the determination to be ready to face any emergency came on the very day he graduated to professionally join the medical community. In the current scenario, he says, "we do take precautions while coming into contact with positive patients [inside the isolation ward] in line with the government SOPs."

“Even then, we have to work here," he adds.

Being on the frontlines, one would expect healthcare workers to be frequently checked for having contracted the virus. But Dr Phul explains that doctors don’t have to get themselves screened "unnecessarily" unless they exhibit symptoms because the process requires them to be in quarantine for 24 hours.

"If all doctors start screening themselves then everyone will have to be in isolation. Who will work then?” he asks, before answering himself: "Unless a system is developed professionally in the medical community, doctors are not going to get themselves screened [regularly]."

'Please take care of yourself'

Under normal circumstances, doctors leave the exertion and solemnity of their tiring shifts to return home to their families — their source of comfort and their support system. But like almost every other aspect of human life, the pandemic has forced changes in this often intimate interaction as well.

And for Dr Phul, his family's safety comes before anything else, even if that means unprecedented physical distances have to be adopted.

“I have [physically] distanced myself from my family completely. I live in a separate rented house. A cook there, who maintains a safe distance, serves food to me and no one else visits me," he reveals.

He says he decided to move to a rented accommodation near his own house in Qasimabad because he did not want to put his family at risk.

Dr Phul has not seen his family for the past nearly three weeks, and all conversations take place over the phone, that too around midnight.

“Kaisay ho? Apna khayal rakhna (How are you? Please take care of yourself),” is the advice he gets from his mother every time he calls her.

While dealing with a steady stream of patients, Dr Phul has encountered two extremes in people's attitudes towards the novel coronavirus, about which much still remains unknown.

He says that the educated, well-to-do social strata is often "over cautious" about Covid-19, but on the opposite side of the spectrum, there is a class "which simply doesn’t believe that a thing like the coronavirus even exists".

"Many educated people call us and tell us that it is a Western sort of conspiracy," he shares.

But knowing full well the lethality of the virus, Dr Phul enters the LUH isolation ward in full personal protective equipment (PPE), and at the back of his mind is always the protection of his staff who deal with infected patients day in, day out.

"Staff members working in the isolation wards face the threat of the virus directly. They are doing a great job without any incentive," the doctor says. "Their colleagues are working other jobs in the same pay scale which are not as potentially dangerous or harmful as an isolation ward."

But not all patients who test positive end up in the isolation ward.

"Patients are mostly stable and even asymptomatic," says Dr Phul, adding that it is often the anxiety of having tested positive that takes a toll on the patients even though they are often physically fit. The situation often turns serious when a co-morbidity is part of a patient's medical history.

“I sit with them and try to counsel them about the disease," says the doctor regarding the more anxious patients. "Some patients are treating corona diagnosis like a death certificate because they have seen videos of people dying in large numbers in Western countries where the virus first wreaked havoc."

As part of his counselling, Dr Phul tells the patients that once their 14-day incubation period is over, "it will be just like the common flu".

“They are told that the situation is far better in our country and they need not be worried,” the doctor says.

'Why would I get scared?'

While medical workers like Dr Phul are being hailed across the world as heroes, there are other members of the healthcare community who often don't make it to the headlines or primetime news bulletins.

Zakir Ali Mashoori is one of them.

At just 21, he has been serving as an ambulance driver at LUH for the past nearly two years. “I am not a permanent employee,” he tells Dawn.

These days, he is performing duty in an ambulance that brings coronavirus patients to the isolation ward or to transport LUH doctors for emergencies duties.

“I wear PPE while driving and performing duty for the hospital’s isolation ward,” the tall, slim Mashoori says.

"I have driven many patients and also transported some bodies to Tando Mohammad Khan," he reveals.

Asked if he is scared about contracting the virus himself, Mashoori does not hesitate for a second.

“Why would I get scared?” he says. “It is my job and I have to do it.”

The only time he is concerned is when he thinks of his family. But with no alternative options, “I just wear the protective kit and then leave all thoughts behind,” the young man says.

His parents keep advising him to take care of himself and wear protective gear at all times while performing his duty. “They tell me not to get too close to the patients and not to go on duty without wearing the kit. But what should I do? I have to be in the ambulance whenever needed because it is my duty,” he says, the dedication to his job palpable.

Mashoori's workday starts at the hospital at around 8:30am and he returns home at 11 in the night. Once home, he tries to takes all precautions to keep his family members safe. “I change my clothes, take a bath and then sit with my family or have dinner,” he says.

The disposable PPE are burnt after each use, he adds.

Asked if he has been tested for the virus so far, Mashoori has an answer ready: "I didn’t get my test done. I am told that one should go for a test only if they show symptoms and Alhamdulillah I have no symptoms.”