COVID-19: Pregnant women and senior citizens need extra measures of protection

COVID-19 has been particularly tough on pregnant women and senior citizens. Swati Amar speaks to doctors and caretakers to understand what proactive measures are to be taken to protect the vulnerable.

The recent surge in COVID-19 cases in the city is a matter of great concern for Chennaites. Swati Amar unearths special problems of certain sections of people that are facing the pandemic differently.

Baby on the Way

Dr Priya Selvaraj, a fertility specialist, clinician and embryologist, and the assistant director of GG Hospital has been witness to how pregnant women are facing the COVID-19 situation: “We never stopped seeing pregnant patients during COVID (the pandemic). In fact, obstetrics care was one of the specialities where we instituted specific recommendations as per the norms of both international and national committees.””

Dr Selvaraj further quotes studies from China and other countries, which show that COVID positive pregnant women did well during delivery. Until almost two months into the pandemic there had been no reported maternal death or fetal demise, nor had there been reports of possible congenital malformations or torrid course in NICU facilities. 

“If the mother had comorbid conditions such as pregnancy-induced hypertension or diabetes or asthma then the morbidity rose, but until recently there was no evidence of maternal-fetal transmission. There are studies citing changes in the placenta and circulatory system of the mother which if managed well can reduce fetal growth restriction in utero or thrombo-embolic phenomenon in the mother,” says Dr Priya.

According to Dr Priya, counselling pregnant mothers and women contemplating pregnancy during the COVID situation is of utmost importance.

“Life cannot stop and one must cope with the new normal and the norms. Fertility treatment takes precedence among women who have cancer and need fertility preservation to attain motherhood, and those who are known poor responders and cannot postpone chances at motherhood as their age and general condition may not allow it.”

If pregnant women are made aware of the precautions and safety measures, and if they can keep up their immunity with good diet and medications as prescribed, one need not be too worried about COVID-19. Since pregnancy is a vulnerable and immunocompromised state, even her family should strictly adhere to the protocols and safety measures.

Dr Priya gives credit to good triage systems in most maternity hospitals that never stopped their practice during the pandemic. At these hospitals, social distancing is maintained on the premises as well. Attenders are restricted. Antenatal visits are limited to only mandatory cases. Doctors are made available on phone as well as online calls and emails. All emergencies are triaged by experts and involve rapid testing for Covid, before admission. Healthcare personnel follow specific protocols in cases where the patient’s COVID status is unknown.

Speaking about the safety measures and precautions taken by the GG Hospital, Dr Priya says, “We instruct all mothers to wear masks covering their nose and mouth. Face shields are a choice. All of them have to compulsorily undergo triage. There is a separate area designated to receive symptomatic COVID-status unknown mothers.”

If the expectant mothers do not have  history (travel or contact) they are asked to proceed to the scan area for their check up. Sanitiser dispensers are made available at regular distances for all visitors. Masks are provided to those who do not have it or request for one. The PPE suits worn by doctors ensure face and hand protection. Regular patients are already well informed of the precautions against COVID-19 spread in place at the hospitals which are reiterated during every visit.

Based on her experience thus far, Dr Priya says, “Very few (patients) seem perturbed. Most of them feel confident about the stringent measures. We also give them supplements to keep their immunity high and instructions on hygiene of the nose and throat areas. We sanitise the (common) area after every patient (visit) and they themselves are a witness to the process which gives them the confidence and trust.”

Not everything is sugar and spice

Head & chief diabetologist at M V Hospital for Diabetes in Royapuram Dr Vijay Vishwanathan talks about how people with diabetes must take special care during these times. According to him, diabetics with elevated blood sugar levels  are prone to COVID-19-related complications such as lung damage and thrombosis.

“People with diabetes must receive early treatment for issues such as foot infection which can prevent them from undergoing an amputation. We tell all our patients to isolate themselves if they have fever or any other COVID-19 symptoms and advise them to wear a mask at all times,” says Vijay.

Senior citizens in ECR 

COVID-19 affects senior citizens the most and it is of prime importance for the society as a whole to ensure they are safe and taken care of. Secretary of Vishranthi Charitable Trust and the niece of the founder Savithri Vaithi, R Srilekha says, “When we came to know about the onset of the pandemic we shut our doors to all our donors who used to personally visit our offices at the ECR where the home (for the aged) is or our administrative office in Alwarpet. The donors used to interact with our grannies who participated enthusiastically in their events, be it a birthday or a marriage party. These live interactions as well as emotional ties with the grannies attracted donors to reach out to us creating the main connection between Vishranthi and the public.”

Vishranthi’s donors were understanding as they realised that if one senior person at the facility got infected it could affect all 200 senior residents, their average age being 70 years. However, the aged home’s main source of donation was through walk-ins and because of their move to stop donors from visiting, Vishranthi lost out on donations during the initial days of the pandemic. 

“We did not want to compromise on the quality of food, medical and personal care received by the grannies,” says Srilekha. “When the excess provisions that we usually stored started depleting we resorted to food substitution in the menu list. The grannies were understanding about it,” she adds.

Vishranthi employs nearly 15-20 housekeeping staff from outside to keep the premises clean, especially the 29 toilets that are used by the inhabitants. Not only were they facing a cash crunch, but whatever they were receiving as donations could not be apportioned for salaries. Moreover, they could not allow outsiders to come to work on the premises.

Hence, Vishranthi made the tough decision to discontinue the services of outside staff. The staff who continued to stay in the home continue to maintain the premises and many grannies have extended their support in cleaning vessels, sweeping and mopping. 

Vishranthi also received help from some organic farm owners who donate vegetables and fruits that get delivered to the facility every alternate day. Donors connect with the home regularly to find out what the needs are. Vishranthi has started requesting wire transfer of donations to avoid personal visits. The Collector along with other government officials visited Vishranthi mid-April to see how the home was managing operations during the pandemic and was much impressed to see that everything is going on as normally as it was before. 

Vishranthi has an in-house doctor who visits the home regularly and also in times of need. There have been a few deaths by natural causes during this time. Relatives of the deceased were informed and cremations were arranged by Vishranthi with the support from the Corporation that sends an ambulance on request.

Srilekha lives in the Velachery area and keeps sending WhatsApp messages to the grannies. “Without people visiting them from outside, the grannies have learned to live an active life by engaging in bhajans, songs, games and prayers. They have understood that they should stay united and also help one another. They have also understood that they need to bury their differences and be more accommodative, and sometimes when a crisis strikes, they should depend upon one another for support and succour. This positive attitude of the grannies is encouraging and is the underlying reason why we are able to sail through the pandemic without hassles,” says Srilekha.

In their twilight years if these grannies could tide over a crisis holding each other’s hands, what prevents us from looking towards a better future and society in the times to come? The onslaught of COVID-19 has indeed left a lesson for us—that all living beings are interdependent. Only functioning in unison can see us through these trying times.

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