Winning battles in the COVID War–Some of the success stories of Railway Hospital, Perambur:


Much has been said about COVID-19 and its wildfire spread. And much more about those who succumb due to pre existing conditions or co-morbidities. But through the info storm raging all around, one hospital has been silently doing its best to treat the patients who have entered its portals and seeing remarkable success. Railway Hospital Perambur, through its committed, team based approach, has seen several patients, some of whom had complex, much demonised ‘co-morbid’ conditions, come back from death’s door. As on this date a total of 135 COVID patients have received active treatment at the Perambur hospital and walked out winning the battle against the novel coronavirus.
Railway hospital is not a scheduled COVID Care hospital. “When our patients came for other ailments and were found COVID positive during investigation, we had to make a choice. Provide them COVID care or refer them elsewhere. We decided to go ahead and address their COVID symptoms along with treatment for their ailments” says Dr. Nirmala Devi, Medical Director of the Railway Hospital Perambur. “We had to quickly upscale our resources and begin treating our patients for COVID 19 too” she says.
For instance, Saroja* ,an 80 year old, a diabetic, who came with fever, breathlessness, cough and altered sensorium and was also found to be COVID 19 positive. Patient was treated with High Flow Nasal Oxygen Therapy along with other measures. She was cured of both. ’It felt like a personal achievement for every one of us’ says Dr. Kalanidhi, the nodal physician.   
Or for that matter, Seetha, a known diabetic, who had rhythm disturbances with heart rate of 32- 35/min and fever. She had been scheduled for insertion of pacemaker and was routinely screened for COVID -19 before the process. She was found positive and was given medical management with Oxygen with other necessary drugs. The patient’s heart rate has stabilised, she is cured of COVID after hospital care and discharged. “The doctors explained to us the situation so well that we were convinced we were in good hands” says a relieved family member.
Madhavi, 50 yrs of age, known patient of severe Interstitial Lung Disease, DM (Diabetes Mellitus), HTN (hypertension), DLP (Dyslipidimea), RA (Rheumatoid arthritis) presented with chest pain, myalgia, extreme breathing difficulty and fever, saturation rate of 44% and COVID positive. Inspite of  the severely affected lung condition, Non invasive Ventilation & high flow oxygen helped in her cure and discharge to Institutional quarantine.
“We started an extensive awareness programme among railway employees from day one. So we had a lot of patients turning up for treatment”. says Dr. Sinha Roy, pulmonologist and treatment lead of the team. Known for his skill and good bedside manners, his professionalism invariably convinces the patients and family to cooperate in the treatment. ‘Dr. Roy called us at midnight to arrange change of ward. Such was his commitment’ says a family member of Mallan, a patient with DM/HTN/CAD (Coronary artery disease) who came with fever, breathing difficulty and low saturation of 78%.  With Oxygen supply and, High Flow Nasal Oxygen, he soon rallied around and was discharged, much to the joy of his daughter, a nurse herself.
It is the team approach that has made the difference. Led initially by Dr. Nanda, then Principal Chief Medical Director, every one in the team was onboarded with individual responsibilities and all have pooled in irrespective of their seniority or specialisation. “We all do night duties and ward duties whether we are from ENT or pathology, HOD or junior doctor. says Dr Mussarrat, from the same hospital.
The decision to treat COVID patients led to sudden up scaling of facilities with attendant administrative issues, like getting additional manpower, equipment, maintaining cleanliness, giving nutritious food to patients and getting repairs done for the hospital, etc. The hospital got excellent support from other railway departments, like personnel, finance, stores and civil and electrical engineering wings etc. All worked together like a well oiled machine. This was possible because of the support from the top management. “The procurement that used to take months earlier now got done in days taking cognisance of the gravity of the situation” says the medical Director.
The comprehensive care given by the Railway Hospital, makes patients choose treatment here even for COVID 19. Like Santhanalakshmi, a 50 year old with uncontrolled DM & Hypertension, presented with fever, cough, and breathlessness with low saturation level. She was successfully treated with multi pronged care including O2 therapy and aggressive glycaemic control.
Almost all these patients had co-morbid conditions, sometimes even severely so. But what made the difference was that the patients’ complete cooperation possibly because of the confidence generated by the team. “We were personally explained regarding the treatment and given good attention” says the son of a discharged patient.
It has not been a bed of roses all the way, especially when some patients don’t pull through. It was especially difficult for the team, when two of their young and dedicated nursing supervisors got infected. Employed as Nursing Superintendents, they came into contact with COVID positive patients while working in ICU managing seriously ill COVID patients disregarding their own safety. Both needed oxygen therapy and symptomatic treatment. Happily for the team, both could be discharged fully cured.
There have been critics, who, unaware of the efforts taken by the team, would constantly give adverse reports, often factually incorrect, among the employees, and sometimes even misleading the media. But these don’t deter the team. “We are a close knit, multi disciplinary hospital giving comprehensive care. Whatever isolated wards available in the hospital, are now earmarked for treating COVID-19 patients. Vacant railway quarters nearby have been taken up for institutional quarantine facility. Even the doctors and other support personnel are allotted vacant quarters as quarantine accommodation. “These have very sparse facilities but no one is complaining.” says Dr. Murthy, who is handling administration.
Railways has been much applauded for its Shramik specials for guest workers, Parcel expresses ferrying essential goods etc. But the silent battle valiantly fought by these medical warriors, and the success they have achieved is no less valuable in this war against the Pandemic. It is events like these that build hopes in the hearts of those who dread the disease.
(* Names of the patients changed for protection of privacy)