Sunday, March 26, 2023

In the last article, we spoke about our experience and learning from the 1st wave and how mental resilience enables an organization to thrive in turbulent times.  In this review, we will highlight our experiences in adjusting to the new normal after the covid  wave.  The first wave which started in the end of March 2020, gradually tapered off somewhere in July/August 2020.  Prince Aly Khan Hospital had treated around 2000 patients in the first wave with a recovery rate of 80%. The patients were more of elderly age group and having comorbid conditions like diabetes, hypertension, heart disease etc.  We had also made operational of 50 bedded Covid Care Center in the Diamond Jubilee School, as a step down facility to deal with the enormous influx of patients that were coming for treatment. Donors were kind enough to donate for poor patients and infrastructure necessities. 

We had started an RTPCR lab which was NABL and ICMR certified, thanks to the donation received from a community donor.  We had conducted around 6000 free and 10,000 subsidized RTPCR tests in the community at that time.  Our hospital also donated ventilators and high frequency nasal oxygen machines to the MCGM to help support the government.

The team was mentally and physically exhausted because of the war that had been waged and it was now time to heal ourselves to the new normal. Our hospital caters to a lot of cancer patients who come from all over India.  Due to the lock down, these patients were unable to get treatment and had suffered greatly, though we had initiated teleconsultation services early on.

Our other non-covid specialties like cardiology, orthopedics, urology, gynecology, and neurology had all suffered a similar fate. The non-covid OPD and IPD services were restarted, gradually and though the number of patients picked up it was never the same again.  Most hospitals had suffered enormous losses due to the non covid work being affected and capping on covid treatments and have not been able to recover from those set backs.

The hospitals were almost limping back to normal, when we were struck by the second wave of covid somewhere in September/October 2020.  Thankfully with the experience of the first wave, the hospital swung into action on immediate basis with triaging and treatment of patients.  The clinical protocols were more or less defined and there was clarity on how to move forward.  The fear associated with the illness was lesser and there was optimism that contracting covid need not spell death sentence for the patient.  It was therefore easier to manage the second wave.  Ironically, we observed that the younger population was more affected and had higher complication rate. These were patients who treated themselves at home and came with complications at a later stage and were difficult to salvage. Our recovery rates was still around 80%, despite more than 50% patients having comorbid conditions.  Fortunately, the second wave was much shorter and it was smoother and less turbulent.  The teams knew what to do and were ably led by Mr. Amin Jiwani, our then deputy CEO.  He and the rest of the team worked tirelessly day and night to ensure supplies, bed management and allocation of resources. 

Our experience with the second and third wave taught us that proper planning and allocation of resources is of paramount importance.  The need for addressing mental health was reinforced and hence we started a mental health helpline for our staff with the aim of building mental resilience. 

We accepted and acknowledged that patients and doctors were likely to face financial hardships. Therefore, we revised and decreased our tariff keeping in mind the same. In the last quarter of 2020, the government was planning initiation of vaccination of healthcare workers and susceptible population.  Prince Aly Khan Hospital was one of the first few hospitals participating in this initiative.  In January 2021, our vaccination center was set up and approved by the MCGM and it has so far provided 61506 vaccinations out of which 14434 have been free.  We also have a partnership with CIPLA foundation for palliative care in Pune and together we donated 50,000 doses of covisheild vaccines to the MCGM for the underprivileged people.  AKDN also donated oxygen concentrators to the under privileged patients in Gujarat, thanks to donation received from one of our donors. 

While we understand that the waves of Covid have abated, the war is far from over.  Climate change has highlighted the need for climate resilience and environmentally sustainable healthcare systems.  Technology has played a key role in diagnosing and treating patients in times of the lock down and is going to be a key driver as healthcare evolves.  The Cowin App and other digital initiatives taken by the government for the healthcare delivery is proof that India is rapidly advancing in healthcare technology and are at par with any developing nation, as evidenced in the covid pandemic.  In years to come, digitalization, technology, artificial intelligence and augmented reality will play a very important role  in how healthcare is delivered to patients and we are looking at very exciting times ahead of us.

Prince Aly Khan Hospital was one of the first few hospitals which had set up the vaccination center which provided 61506 vaccinations & 14434 have been free

Courtesy : In Conversation with Dr.Shabana Khan, CEO – Prince Aly Khan Hospital , Mumbai, India.