Dr Chino Mannikarottu, a California-based internal medicine specialist, feels that media has been focussing only on New York to judge the intensity of COVID 19 in the United States. She says this approach paints a wrong picture about the actual impact on the ground. In an e-mail interview with Onmanorama Dr. Chino shares her thoughts.
How the COVID-19 pandemic is being handled in your place?
I’m in California and things are under much better control here. We have several cases but it’s being handled well. Social distancing and hand washing are the keys to prevent the disease spread. We are flattening the curve and therefore well prepared for any surge situation. We are well prepared in terms of ventilators and medical personnels. So as a physician, I feel positive. Overall, the global statistics that people need to know before they panic is 80 % of the people tested positive for COVID-19 get better on their own, 20% require hospitalization and only 5% require the Ventilator and ICU-level care. People do come off the ventilator and return to their normal lives.
If a person catches ordinary cold or cough, is there a need to be extra cautious?
For ordinary cold and cough, you should consider self isolation for a day or two. If symptoms get better and you’ve not been in contact with anyone who tested positive, then you need not get tested. But if you have had exposure to someone positive or if your symptoms are worsening or if you’re developing new symptoms such as shortness of breath, you should get yourself tested.
Apart from the general precautions that WHO has laid down what other measures are being adopted there to fight the virus?
Apart from social distancing and hand hygiene, it has been recommended by Centres for Disease Control and Prevention (CDC) last week that public wear facial masks. This is due to several asymptomatic carriers now who are being found and who may spread the virus inadvertently. All schools, colleges, restaurants and other non-essential stores are closed down and ‘shelter in place’ order is being followed in California. People are also careful about grocery shopping, with only few people inside the store at one time and others waiting outside the store at 6ft distance between each other. A lot of people have been wiping down grocery bags and other packaging items with disinfectant wipes. Cleaning steering wheels, car doors/seats, door knobs, basically everywhere you touch, all these have become regular routine to people here.
The situation of basic amenities, how are people managing there, especially the Malayali community?
For Indian grocery shopping, there are options for curbside pick up. You can order the items via website, they will gather the items and bring to the outside of the store. You can stay in your car and pay for the items with your credit card. Among the Malayali community there is great camaraderie. Many Malayalis I know, who live in the same neighbourhood, have been shopping for two or three other families and leaving it at their doorsteps. This way we are minimizing people going out for grocery shopping.
As a medical professional, how do you manage trauma of those you serve and those around you? What is the message you convey?
Well, as medical professionals, we are used to seeing trauma on varying degrees on a daily basis. We are trained to deal with contagious diseases and protect ourselves while doing that. We are used to seeing death in the young and the old. But of course, the mass causality of COVID-19 and the rate at which it’s spreading makes it unprecedented. Definitely, being a physician in a global pandemic brings about its own challenges. I try to take it one day at a time. I work hard like the rest of my team when I’m at the hospital and do what’s needed of me from a medical standpoint. Honestly, I do not get the time to fear! But when I get home to my family, like any other person going through this pandemic, I worry about my family that includes my husband and 2 young kids. I try to wear as much protective gear as I can while at work so as to protect other patients, my family as well as myself. I’m fortunate to have many resources at hand to do the same. I have immense respect for healthcare workers around the world dealing with this traumatic situation within their limitations to their best of their ability. I would like to tell everyone as someone in the frontline, that it has not been easy but we will continue to do it and no one will be abandoned due to any reason. We can get through this if we continue as a society to look out for each other. I urge everyone to continue to stay home and protect the vulnerable population around you. And, remember this virus does not discriminate; your age, race or ethnicity does not matter to it.
Lockdown has brought about an imbalance in the work proportion in the society - while a majority of people have been rendered less active there is a minority, which covers health service providers, police and security, burdened with heavy loads – how do you view this?
I do not think it’s something particular for this pandemic. Any kind of global medical crisis would lead to that. Everyone in those professions are fully aware of the risks and associated issues when they sign up for such jobs. I can only speak for myself. As a doctor, it has not crossed my mind that I’m working more than someone else at this critical time. It’s what I signed up to do and I consider that as an honour and privilege.
What has changed in your professional life since the pandemic?
Well, as doctors we are trained to save everyone and do everything possible for the same. In a pandemic however you realize that you cannot be heroic at all times and save all lives. There is no emergency in a pandemic. People are going to die and it’s hard emotionally as a doctor to accept. But of course many people survive the infection and those success stories do keep us going.
I sincerely hope and pray that the world gets through this quickly. Cases in India are rising based on the numbers we get to see which is alarming to some degree. I’m very happy that in Kerala strict measures are undertaken and most people are taking it very seriously. I do not know the exact picture of testing status and availability in India. If we look at countries like South Korea, we know how they have managed it well and that was through mass testing. Even here in the U.S, we saw cases rise when testing significantly increased. I hope we can increase testing further in Kerala with the current developments that have happened.
(Dr Chino Mannikarottu M.D is an Hospitalist, Department of Internal medicine, Scripps Memorial hospital, San diego, California)