By Dr Shalini Pandya

I am a consultant physician and diabetologist working in private practice for the last 20 years in Ahmedabad, India and am attached to a corporate hospital.

The COVID pandemic has been a humbling experience for all - the developed and the developing nations. We in India have had our share of epidemics of Leptospirosis’ in 1996 during my residency and then Dengue and Chikungunya in early 2000, H1N1 in early 2012 which are now endemic but this virus just caught all of us off guard.

A sudden lockdown in March 2020 in India, following the COVID pandemic warnings, brought our busy routine to a halt. As we didn’t have any cases at that time we actually enjoyed rare family time in the initial days, lapping up all the news from television and online articles.

In April 2020, we started having our first cases and online consultations started. Seeing the mayhem in the USA and in European countries where our colleagues were seriously infected, we (my husband and I ) resigned ourselves to the fact that one of us might not survive by the end of the pandemic. A frantic search for acquiring PPE, sanitisers and masks for clinic staff and ourselves started. Subsequently with each wave we learnt management of COVID. I remember the consultations would begin at 10:00am with a lunch break at 5:00pm and I would be counselling my patients online till midnight.

I made a video with instructions regarding diet, sanitisation, isolation, daily monitoring of vitals and warning symptoms of progression to severe disease, which I used to send to all my patients to save time in counselling . I would receive scores of phone calls from frantic and crying  patients, fellow doctors and relatives from all over India asking for advice or a bed in a hospital. Shortage of drugs, especially Remdesivir, Tocilizumab and oxygen supply, made me feel helpless and I did lose some patients during the first wave. I started getting nightmares of patients crying for help or me doing consulations in my sleep.

In spite of the busy schedule I would try to stay updated attending conferences online or reading up the latest articles. By the second wave we had made a home care team of paramedics who would inject the drugs and monitor the patients while I did daily online consultations. We managed many patients at home and prevented hospital admissions in moderate cases. In between the waves I had patients with uncontrolled diabetes thronging the clinics and started picking up Mucor and Long COVID cases.

By January 2021, India had its first lot of vaccines and we, the medical fraternity, were the first to get vaccinated and we started taking talks and making videos to advocate the importance of vaccinating everyone.

Personally, I have had COVID twice in last year post-vaccination, the Delta variant in April 2021 and Omicron in February 2022. Both times I got better with supportive therapy at home. While I was down with fever I still had to do 30-35 consulations daily. It was a Herculean task to manage home and work as the house help was on leave and so the whole family pitched in to do household chores. I lost my maternal aunt as she refused hospital admission fearing isolation, which unfortunately was a common scenario in first wave. Also I lost my MD teacher and mentor to the Cytokine storm despite the best medical treatment. Meanwhile my 96 year old diabetic great grand uncle survived severe COVID after one month of admission, my husband & in laws were treated for moderate Covid with domiciliary treatment and did well. One of my patients delivered a healthy baby after severe COVID and Chikguniyia. My daughter, an intern, posted in a COVID ICCU had her set of horrifying and victory tales to tell. So it was a year of loses and many small victories and makes me wonder whether there was a huge interplay of destiny and genetic predisposition in outcome.

I published a study in a local journal  -  Role of  Favipiravir in 110  patients having mild to moderate COVID after the second wave.

I think the pandemic has taught us:

1. The value of life - life is unpredictable and we need to slow down and cherish each moment.
2. Tough times makes one tougher to handle the situations (very long hours of work) and innovative -- suddenly online consultation and new sanitisation protocols became the norm.
3. Online knowledge sharing is a boon and the sector was underutilised prior.
4. Home care facilities should be developed so that the hospital burden is less.
5. Media needs to be used proactively for advocating vaccination and disease awareness and we need to be wary of discussing treatment protocols and bed shortages on television, which unnecessarily creates panic.
6. Global medical interaction and help should be the way forward.

Hopefully this is the end of the pandemic and not the lull before the storm.

More About Dr Shalini Pandya 

• MBBS from Baroda Medical College
• MD internal medicine from NHL Medical College, Ahmedabad
• Senior residency in Dept of Endocrinology from SGPGI (Sanjay Gandhi post graduate institute) Lucknow
• Assistant Professor in PS Medical College, Anand
• Private practice for last 20 years in Ahmedabad. Attached to Sterling hospital (corporate hospital)
• Area of interest is Diabetes
• Aim in life is to provide better care and life to my patients
• Hobbies - reading books, travelling and learning about new cultures
• Published articles and case reports in local journal pertaining to Diabetes, Hypoparathyroidism and COVID