T.

JOHN COLLEGE
(Affiliated to Bangalore University)
Gottigere, Bangalore-560083

A MINI-PROJECT REPORT
ON
“A STUDY ON THE IMPACT OF STRESS ON THE MEDICAL
PROFESSIONALS DURING PANDEMIC TIMES AT APOLLO
HOSPITAL”

Submitted by

Aishwarya B Poojari
MBA193967

Department of Management of Business Administration

T John College
2019-2021

1
 INDEX

INTRODUCTION 3-5

INDUSTRY PROFILE 6-9

COMPANY PROFILE 10-13

ANALYSIS OF THE STUDY 14-16

FINDINGS AND 17-18

SUGESTION

CONCLUSION 19-20

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 INTRODUCTION
Coronaviruses are a large family of viruses which may cause disease in animals or humans.
Seven coronaviruses can produce infection in people around the world but commonly people
get infected with these four human coronaviruses: 229E, NL63, OC43, and HKU1. They
usually cause a respiratory infection ranging from the common cold to more severe diseases
such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome
(SARS) and the most recently discovered coronavirus (COVID-19) causes infectious disease.
This zoonotic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2). The WHO originally called this infectious disease Novel Coronavirus-Infected
Pneumonia (NCIP) and the virus had been named 2019 novel coronavirus (2019-nCoV).
On 11th Feb 2020, the (WHO) officially renamed the clinical condition COVID-19 (a
shortening of Corona Virus Disease-19), which was announced in a tweet. An outbreak of
COVID-19 caused by the 2019 novel coronavirus (SARS-CoV-2) began in Wuhan, Hubei
Province, China in December 2019, the current outbreak is officially a pandemic. Since
knowledge about this virus is rapidly evolving, readers are urged to update themselves
regularly. The virus is typically rapidly spread from one person to another via respiratory
droplets produced during coughing and sneezing.
It is considered most contagious when people are symptomatic, although transmission may be
possible before symptoms show in patients. Time from exposure and symptom onset is
generally between two and 14 days, with an average of five days. Common symptoms
include fever, cough, sneezing and shortness of breath. Complications may include
pneumonia, throat pain and acute respiratory distress syndrome.
Currently, there is no specific antiviral treatment or vaccine; efforts consist of symptom
abolition supportive therapy. Recommended preventive measures include washing your
hands with soap, covering the mouth when coughing, maintaining 1-meter distance from
other people and monitoring and self-isolation for fourteen days for people who suspect they
are infected.
The standard tool of diagnosis is by reverse transcription polymerase chain reaction from a
throat swab or nasopharyngeal swab. The infection can also be diagnosed from a combination
of symptoms, risk factors and a chest CT scan showing features of pneumonia analysis of
more than 44.000 cases from China, the death rate was ten times higher in the very elderly
compared to the middle-aged.
The death rates were lowest for under the 30s there have been eight deaths in 4.500 cases.
And deaths were at least five times more common among individuals with diabetes, high
blood pressure or heart or breathing problems. There was even a rather higher number of
deaths among men compared to women.

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What is Stress
Stress is the body's reaction to any change that requires an adjustment or response. The body
reacts to these changes with physical, mental, and emotional responses. Stress is a normal
part of life. You can experience stress from your environment, your body, and your thoughts.
Even positive life changes such as a promotion, a mortgage, or the birth of a child produce
stress.
How does stress affect health?
The human body is designed to experience stress and react to it. Stress can be positive,
keeping us alert, motivated, and ready to avoid danger. Stress becomes negative when a
person faces continuous challenges without relief or relaxation between stressors. As a result,
the person becomes overworked, and stress-related tension builds. The body's autonomic
nervous system has a built-in stress response that causes physiological changes to allow the
body to combat stressful situations. This stress response, also known as the "fight or flight
response", is activated in case of an emergency. However, this response can become
chronically activated during prolonged periods of stress. Prolonged activation of the stress
response causes wear and tear on the body – both physical and emotional.
Stress that continues without relief can lead to a condition called distress – a negative stress
reaction. Distress can disturb the body's internal balance or equilibrium, leading to physical
symptoms such as headaches, an upset stomach, elevated blood pressure, chest pain, sexual
dysfunction, and problems sleeping. Emotional problems can also result from distress. These
problems include depression, panic attacks, or other forms of anxiety and worry. Research
suggests that stress also can bring on or worsen certain symptoms or diseases. Stress is linked
to 6 of the leading causes of death: heart disease, cancer, lung ailments, accidents, cirrhosis of
the liver, and suicide.
Stress also becomes harmful when people engage in the compulsive use of substances or
behaviours to try to relieve their stress. These substances or behaviours include food, alcohol,
tobacco, drugs, gambling, sex, shopping, and the Internet. Rather than relieving the stress and
returning the body to a relaxed state, these substances and compulsive behaviours tend to
keep the body in a stressed state and cause more problems. The distressed person becomes
trapped in a vicious circle.

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STRESS ON MEDICAL PROFESSIONAL DURING
PANDEMIC TIMES
The rapid spread of SARS-CoV-2 has put severe pressure on health systems around the
world. Understandably, there has been much emphasis on the effect of the pandemic on the
health of the population, as well as the consequences of the potential loss of life from the
overwhelmed public health systems.
The effects of frontline medical practitioners have also been severe. Healthcare workers are
one of the groups at greater risk of infection. However, the negative psychological effects of
working on the frontline of the pandemic have also been significant.
“Medical staff were incorporated into the frontline battle against COVID-19. Additionally, it
was not possible to set up isolation rooms consisting of an anteroom and clean zone because
of insufficient equipment once the hospital rapidly became a designated COVID-19 centre.”
“Medical staff must be equipped with full-body protective equipment under negative pressure
for more than 12 hours, including double-layer protective equipment, double - face masks,
double – layer gloves, isolation caps, foot covers, and protective glasses.”
“To avoid being infected while removing protective equipment, staff members cannot eat,
drink, or use the bathroom during working hours. Many of them are dehydrated due to
excessive sweating and a rash. Medical staff working in the quarantine area must always
maintain close contact with people with the infection.”
Once they remove their medical coats to return home, the fear of putting their families at risk
starts creeping in. The shortage of testing kits and hospital beds, the race to find a vaccine
and the inability of India to control the virus… all these are discussed but what is missing
from the list of talking points in the mental well-being of our healthcare workers.
Lovleen Malhotra, the counsellor Dr Singh reached out to, offers some insights. Since the end
of June, 20 doctors have reached out to her for Covid-19 related counselling. “There’s no
doubt that their mental health is deteriorating. The exhaustion, the grief, the anxiety, the
stress they all are increasing.

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INDUSTY PROFILE

INTRODUCTION
Healthcare has become one of India’s largest sector, both in terms of revenue and
employment. Healthcare comprises hospitals, medical devices, clinical trials, outsourcing,
telemedicine, medical tourism, health insurance and medical equipment. The Indian
healthcare sector is growing at a brisk pace due to its strengthening coverage, services and
increasing expenditure by public as well private players.
Indian healthcare delivery system is categorised into two major components - public and
private. The Government, i.e. public healthcare system, comprises limited secondary and
tertiary care institutions in key cities and focuses on providing basic healthcare facilities in
the form of primary healthcare centres (PHCs) in rural areas. The private sector provides
majority of secondary, tertiary, and quaternary care institutions with major concentration in
metros and tier I and tier II cities.
India's competitive advantage lies in its large pool of well-trained medical professionals.
India is also cost competitive compared to its peers in Asia and Western countries. The cost
of surgery in India is about one-tenth of that in the US or Western Europe. India ranks 145
among 195 countries in terms of quality and accessibility of healthcare.

The healthcare industry is a segment inside the economy which offers drugs, medicines and
other services for patients with preventive, healing, rehabilitative, and soothing care. Thus,
we can say that health care services comprise the grouping of tangible and intangible facet
where intangible features dominate the tangible aspects. Rooms, beds and other decors are
included in tangible things. The different forms of services related to health and welfare are
provided by healthcare industry. The sector is considered as social sector which is governed
at state level with the assistance of central government. The current industry is divided into
many subdivisions, and governed with various interdisciplinary teams of skilled professionals
and paraprofessionals to cater the health needs of individuals

Historical Background of Indian Healthcare Industry

There are the evidences for the existence of healthcare even during the time of Ramayana and
Mahabharata, but it has changed substantially with the passage of time and has gone through
significant changes and upgraded a lot with the up gradation of Medical Science and
technology.

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 Substantial increments in healthcare facilities and in the number of healthcare personnel is
seem to be happened during 1950's and 1980's, but the total number of certified medical
professionals seems to be fallen down in as we have 4 practitioners per 10,000 in 1980s
which is reduced to 3 per 10,000 in 1981. The reason behind this decrement is the fast
population growth in country. There were around ten beds on 10,000 individuals in 1991. The
growth in the number of primary health centres is also seems to be happen during the decade.
These centres are considered to be the keystone for rural health care system
There were around 22,400 primary health centres, 11200 hospitals and 27400 dispensaries
were established in India in the year 1991. These services were initiated as a part of tiered
healthcare system with a focus to provide maximum routine facilities to the vast majority of
people in town and refer only critical cases to urban hospitals which are having more
advanced facilities. These centres would basically trust on skilled professionals to fulfil their
maximum requirements.
The healthcare industry of India functions with the help of both public and private sector. The
services and facilities governed by the government of sate as well as of central comes under
public healthcare system. The system is helpful in a way as it provides varied number of
services and other facilities at free of cost or at concessional rates to the people of rural areas
as well as the to the people of lower income group in urban areas. Yet there is a long way to
go as till now the industry is going through a phase of development.

Segments of Healthcare industry

The healthcare industry consists of eight segments. These are:
 Hospitals: Hospitals are of utmost important among them. Hospitals deliver complete
medical care facilities, begins with diagnoses to surgical treatments, or to continuous nursing
facilities. Several hospitals are there having specialization in treating and handling mentally
sick patients or in cancer patients or some are in treating children. These facilities are
provided either on an outpatient or inpatient basis. The combination of professionals required
by hospitals varies according to geographical locations, size or capital structure of the
organizations or on the basis of values, goals and management philosophies. As soon as
organization strives towards efficiencies, facilities starts to move towards outpatient basis
from inpatient basis.
 Nursing and residential Care: One more segment which work along with hospitals is the
facility of nursing and residential care. These services comprise “rehabilitation, inpatient
nursing and health-related personal care” to the people required it on constant basis, and not
having the need of hospital services. The other facilities of convalescing are related to assist
those, who required minimum support. In addition, the facilities related to residential care
offers 24 hours personal and social care to old age people, to children and to those who are
unable to care themselves.
 Offices of Physicians: Physicians and surgeons covers around 37 % of industry. They
either practice privately or in groups having specializations either in similar or different
fields. Though various practitioners are willing to work in groups so that they will be able to
reduce the overhead expenses and also get consultation with their colleagues. Nowadays

7
Surgeons and physicians showing interest in working on salary basis for big groups, for other
medical clinics, or for integrated health systems.
 Offices of Dentists: Dentist occupied around 20% of the industry. They provide
“preventative, cosmetic, or emergency care” to the patients required them. Some institutions
having specialization only in particular branch of Dentistry like Orthodontics or Periodontics.
 Offices of Health Practitioners: one important section of the system covers “Health
Practitioners”. The section comprises “the offices of optometrists, podiatrists, chiropractors,
occupational and physical therapists, psychologists, speech-language pathologists,
audiologists, dietitians, and other health practitioners”. The demand of these services is
somewhere related to the ability of payment of healthcare consumer either directly or through
insurance. The segment also covers the “offices of practitioners of alternate medicine, such as
homeopaths, hypnotherapists, acupuncturists and naturopaths”.
 Outpatient Care Centre: Other diversified establishments in this group contain health
maintenance organization, medical centres, Kidney dialysis centres, substance abuse centres,
outpatient mental health and freestanding surgical and emergency centres.
 Other Ambulatory Health Care Services: This segment is relatively small in comparison
to other segments of the industry. It covers “ambulance and helicopter transport services,
blood and organ banks, and other ambulatory health care services, such as pacemaker
monitoring services and smoking cessation programs”.
 Medical and Diagnostic Laboratories: These laboratories help the physicians by
providing diagnosing and analytical services to them or they provide these 42 facilities to
patients also on the prescription of Doctors. These organizations conduct blood tests,
ultrasounds, tomography scans, X-rays and other clinical investigations. These laboratories
accounts for provide lesser employment in the industry.

Health Care System

Public health care infrastructure in India
India has a mixed health-care system, inclusive of public and private health-care service
providers. However, most of the private health-care providers are concentrated in urban
India, providing secondary and tertiary care health-care services. The public health-care
infrastructure in rural areas has been developed as a three-tier system based on the population
norms and described below. The urban health system is discussed in the article on Urban
New-born.

Sub-Centres
A sub-centre (SC) is established in a plain area with a population of 5000 people and in
hilly/difficult to reach/tribal areas with a population of 3000, and it is the most peripheral and
first contact point between the primary health-care system and the community. Each SC is
required to be staffed by at least one auxiliary nurse midwife (ANM)/female health worker
and one male health worker (for details see recommended staffing structure under the Indian
Public Health Standards (IPHS)). Under National Rural Health Mission (NRHM), there is a
provision for one additional ANM on a contract basis.

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SCs are assigned tasks relating to interpersonal communication in order to bring about
behavioural change and provide services in relation to maternal and child health, family
welfare, nutrition, immunization, diarrhoea control and control of communicable diseases
programs. The Ministry of Health & Family Welfare is providing 100% central assistance to
all the SCs in the country since April 2002 in the form of salaries, rent and contingencies in
addition to drugs and equipment.

Primary health centres

A primary health centre (PHC) is established in a plain area with a population of 30 000
people and in hilly/difficult to reach/tribal areas with a population of 20 000, and is the first
contact point between the village community and the medical officer. PHCs were envisaged
to provide integrated curative and preventive health care to the rural population with
emphasis on the preventive and promotive aspects of health care. The PHCs are established
and maintained by the State Governments under the Minimum Needs Program (MNP)/Basic
Minimum Services (BMS) Program. As per minimum requirement, a PHC is to be staffed by
a medical officer supported by 14 paramedical and other staff. Under NRHM, there is a
provision for two additional staff nurses at PHCs on a contract basis. It acts as a referral unit
for 5-6 SCs and has 4-6 beds for in-patients. The activities of PHCs involve health-care
promotion and curative services.

Community health centre

Community health centres (CHCs) are established and maintained by the State Government
under the MNP/BMS program in an area with a population of 120 000 people and in
hilly/difficult to reach/tribal areas with a population of 80 000. As per minimum norms, a
CHC is required to be staffed by four medical specialists, that is, surgeon, physician,
gynaecologist/obstetrician and paediatrician supported by 21 paramedical and other staff. It
has 30 beds with an operating theatre, X-ray, labour room and laboratory facilities. It serves
as a referral centre for PHCs within the block and also provides facilities for obstetric care
and specialist consultations.

Government-funded Healthcare
Publicly funded government hospitals provide basic care only and often lack adequate
infrastructure. They can also be crowded and waiting times can be long. Government
hospitals are often understaffed, which is why a family member usually attends to the patient
during a hospital stay.
Though the cost of care is less at these government hospitals, the standard is inferior
compared to private hospitals, and in general western expats opt for private healthcare.

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COMPANY PROFILE
APOLLO HOSPITAL

APOLLO HOSPITAL:
Apollo Hospitals is widely recognized as the pioneer of private healthcare in India, and was
the country’s first corporate hospital. The Apollo Hospitals Group, which started as a 150-
bed hospital and today, operates 9200 beds across 64 hospitals. A forerunner in integrated
healthcare, Apollo has a robust presence across the healthcare spectrum. The Group has
emerged as the foremost integrated healthcare provider in Asia, with mature group companies
that specialize in insurance, pharmacy, consultancy, clinics and many such key touch points
of the ecosystem. The Apollo Group has touched the lives of over 45 million patients, from
121 countries.

Genesis
The first Apollo Hospital opened in Chennai, in 1983. It was borne out of the determination
to lead a complete transformation in Indian healthcare. Apollo’s Founder Chairman, Dr.
Prathap C Reddy was the driving force behind the inception. Credited as the architect of
modern Indian healthcare, Dr. Prathap C Reddy started Apollo with the mission of bringing
world-class healthcare to India, at a price point that Indians could afford! The backdrop to
this development was the hopelessly inadequate healthcare infrastructure prevalent in India,
at that time.

Game-changer
Apollo’s first innovation was its business model itself; before Apollo, only the very
privileged had the access to quality treatment, as they could afford to travel abroad. Apollo
introduced healthcare that matched best-in-class outcomes, but cost only a fraction of the

10
global prices. This led to a revolution with democratized treatment in our nation. This cost
consciousness continues to be a key building block in our healthcare strategy.

Clinical Excellence
This is not the only constant in the Apollo story. The Group is built on the bedrock of an
enduring value system, and continues to drive unwavering focus on key touchstones like
excellence, expertise, empathy and innovation.

Over the past three decades Apollo Hospitals’ transformative journey has forged a legacy of
excellence in Indian healthcare. The Group has continuously set the agenda and led by
example in the blossoming private healthcare space. One of Apollo’s significant contributions
has been the adoption of clinical excellence as an industry standard. Apollo pioneered the
concept – the group was the first to invest in the pre-requisites that led to international quality
accreditation like JCI and also developed centres of excellence in Cardiac Sciences,
Orthopaedics, Neurosciences, Emergency Care, Cancer and Organ Transplantation.

Apollo’s prowess in excellence comes from the habit to rigorously re-evaluate and reinvent.
Protocols are built, taken apart and built again to ensure that infection control are optimized
to extreme levels; stringent internal scoring systems are constructed with the sole objective of
ensuring the group matches up with the very best. Apollo’s initiatives like ACE@25 and
TASSC are indicators of the commitment to better global benchmarks in clinical excellence.

This focus on quality has become one of the group’s strongest credentials. It is the one of the
building blocks in the trust the Apollo brand name commands.

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Strong value system
Along with excellence the Apollo philosophy rests on the pillars of technological superiority,
a warm patient- centric approach, and a edge in forward-looking research. Apollo’s
spectacular success rests on sustained commitment and investments in each of these pillars.

Technology driven
At Apollo, healthcare systems leverage technology to build integrated healthcare delivery
models, which facilitate seamless electronic medical records, Hospital Information systems
and telemedicine-based health outreach initiatives, for enhanced access to medical care.
Another critical manifestation of widespread technology has been the amazing advancement
in medical equipment and Apollo has repeatedly pioneered the introduction of such
innovations in India. The future promises with revolutionary new products like the Proton
Beam Therapy. From leveraging new age mobility, to getting futuristic equipment Apollo has
always been ahead of the curve. Currently, the group believes in the tremendous potential of
robotics and is investing heavily in making it a real and robust option for all.

TLC
Apollo pioneered Tender Loving Care (TLC) and it continues to be the magic that inspires
hope, warmth and a sense of ease in the patients. Processes are relentlessly improved upon to
ensure maximum patient-centricity.

Road ahead
Apollo Hospitals has taken the spirit of leadership well beyond business metrics. It has
embraced the onus of keeping India, healthy. Taking cognizance of the undeniable fact that
India is reeling under the onslaught of Non-Communicable Diseases (NCD), the Apollo
Group has assumed the responsibility to educate, influence mindset. Increased focus on
tactical initiatives like personalized preventive healthcare bears testimony to this new thrust.
The Group has declared war on NCDs, and is leading the entire healthcare fraternity into this
battle.

Socially Conscious
Apollo Hospitals has always strongly believed in social initiatives that help transcend
barriers. In keeping with this, the group has started several impactful programmes in this
area. One among these initiatives is SACHI (Save a Child’s Heart Initiative) – a community
service initiative with the aim of providing quality paediatric cardiac care to children from
underprivileged sections of society suffering from heart diseases. Apollo also runs the SAHI
(Society to Aid the Hearing Impaired) initiative to help poor children with hearing
impairment, and the CURE Foundation which is focused on cancer screening, cure and
rehabilitation for those in need. In the area of Cancer care Apollo has also joined hands with
Yuvraj Singh’s YOUWECAN to organize large-scale cancer screenings. Apollo regularly
conducts comprehensive health screening camps across the nation. The Group runs the

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incredible successful Billion Hearts Beating campaign – a nationwide programme that has
awakened India to heart healthiness.

The Group continues to break new ground in adopting new technology. From leveraging new
age mobility, to getting futuristic equipment Apollo has always been ahead of the curve.
Currently, the group believes in the tremendous potential of robotics and is investing heavily
in making it a real and robust option for all. Apollo pioneered Tender Loving Care (TLC) and
it continues to be the magic that inspires hope, warmth and a sense of ease in the patients.

Apollo started out with the promise of bringing quality healthcare to India at a price point that
Indians could afford. The cost of treatment in Apollo was a tenth of the price in the western
world. Today as the group charts out its roadmap to take healthcare to a billion, the focus on
driving a strong value proposition remains constant.

Apollo Hospitals has taken the spirit of leadership well beyond business metrics. It has
embraced the onus of keeping India, healthy. India could soon become the heart disease
capital of the world if the surge of lifestyle diseases goes unchecked. Apollo Hospitals has its
agenda full in taking steps to avoid this. Recognizing that the risk of heart disease can be
significantly reduced, even reversed, Apollo Hospitals launched the pathbreaking Billion
Hearting Beating, a campaign that empowers Indians with the knowledge to fight the
common adversary – heart disease.

Apollo Hospitals has always strongly believed in social initiatives that help transcend
barriers. In keeping with this, the group has started several impactful programmes in this
area. One among these initiatives is SACHI (Save a Child’s Heart Initiative) – a community
service initiative with the aim of providing quality paediatric cardiac care and financial
support to children from underprivileged sections of society suffering from heart diseases.
Apollo also runs the SAHI (Society to Aid the Hearing Impaired) initiative to help poor
children with hearing impairment, and the CURE Foundation which is focused on cancer
screening, cure and rehabilitation for those in need. In the area of Cancer care Apollo has also
joined hands with Yuvraj Singh’s YOUWECAN to organize massive cancer screenings.
Apollo regularly conducts comprehensive health screening camps across the nation. The
Group actively leverages its telemedicine and mHealth capabilities to take its screening
programmes to even remote corners of the country.

Apollo’s remarkable story has captured India’s attention. For its service to the nation, the
Group was felicitated with the honour of a commemorative postage stamp bearing its name.
For his untiring pursuit of excellence in healthcare, Dr. Prathap C Reddy, was bestowed with
the second highest civilian award, the ‘Padma Vibhushan’, by the Government of India.

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Analysis of the study
Healthcare workers at the forefront of the war against coronavirus are not only facing the
daunting task of handling patients, but are also fighting to keep their own worries and
emotional stress at bay. A doctor from a leading Mumbai hospital, who is currently home
quarantined after he came in contact with a colleague who had coronavirus symptoms, said
these times are challenging for everyone, including the medical fraternity.

Even though his colleague tested negative for coronavirus, the doctor is not taking any
chances as he has aged parents and a six-month-old son at home. “I haven’t touched my baby
since the last one month. Yesterday was my wife’s birthday, but I could not participate in the
celebration since I am confined to a separate room in the house,” the doctor told PTI. He said
some of them at the frontline of the COVID-19 war are feeling exhausted and running out of
patience.

“Initially, we thought we would tide over the crisis. But now April is ending and there is no
sign of decrease in coronavirus cases. My colleagues haven’t met their families for last one
month,” he said. “The junior doctors, nurses and paramedics have really taken up this war
time as a challenge. We hope we are able to flatten the curve,” he said.
He said wearing the personal protection equipment (PPE) and masks for long hours is also no
mean task and makes them feel suffocated. The PPE comprises a gown, shoes, cap, N-95
mask, goggles and double gloves which are air tight. “Still, there is no guarantee of protection
against the virus,” he said.

14
Most hospitals here have separate coronavirus disease ward, ICU and a dedicated medical
team whose members work for five days and then are quarantined for seven days, he added.
A nurse, who is ward in-charge in a city hospital, was initially quite worried when she was
told last month that the medical facility will admit COVID-19 patients, and she and her team
will be working in the specially created ward.
“We were not mentally prepared and had heard about how serious the situation was in China.
I was more worried for my young team than my 15-year-old son and husband. What if I was
got infected while treating the patients?” she said, adding that they did not even know how to
wear the PPE. “I could not control my emotions in front of my senior doctor. He said I may
be excluded from the team as I was very sensitive. Later, he told me I can take up this
challenge by considering my own and my team’s safety first. He said the hospital trusts me I
can handle the situation,” she revealed.

The nurse said she then took it upon herself to stay emotionally strong. But, the fear of
whether she and her family would be safe continued to haunt her. “Fortunately, all patients
who have come to us so far are stable and not like what we had heard about China and other
countries,” she said. But, her inner struggles continued when she could not celebrate her
son’s 15th birthday on March 24, as the first COVID-19 patient got admitted to their hospital
that day.

15
“I felt sad and at the same time wondered if I was making my family and team unsafe. I felt I
was responsible for their safety. So, we sent our son to my parents’ home and me and my
husband maintained social distancing,” she said. But the emotional turmoil continued and one
day, after returning come, she cried. Her son consoled her, saying she was part of efforts
being made at the global level to fight the pandemic and should not be emotional.
“My son was proud of me. The next day, I joined the duty at my hospital and worked non-
stop for the next few days. My son would call me at night to enquire about me. Some nurses
did not report to work due to family pressure or fear of being isolated by society, but my
allowed me to work,” she said.
The nurse said they also faced problems when the cleaning staff stayed away from work after
the COVID unit was started. “We nurse had to clean the patients and also give them bed
pan,” she said. While she was all geared up for her work, she was earlier this month asked to
remain in institutional quarantine for 10 days after she came in contact with a ward boy who
tested positive for coronavirus.
“My test later came out negative. I felt God wanted me to continue my work. There is no fear
of coronavirus now,” the nurse said. She also expressed concern over fake content on
coronavirus circulating on social media. Revealing one such incident, she said the security
guard of her ward tested positive for coronavirus sometime back and was admitted to another
hospital.
A few days later, the security guard’s son came to her and showed a purported video of his
father’s death and the civic body preparing for the funeral. “I informed higher authorities of
my hospital to check and found the security guard was stable and doing well. This left me
wondering how people can think of preparing fake videos when the health workers and others
are working round-the-clock to contain the pandemic,” she said.

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FINDINGS
They are the possibility of being sources of infection, being isolated /quarantined, putting
family members and other staff at risk, fear of improper use of personal protective equipment.
Health workers are frustrated over the growing number of cases, but the emotional toll of
seeing the worst-case scenario turn into a reality on a daily basis is higher than the physical
exhaustion. Not only do healthcare workers suffer the anxiety of caring for the sick while
facing a shortage of PPE kits and changing medical protocols, but they also must forge a
calm companionship with their partners and children. The level of stress they put themselves
through daily is immense, and it should come as no surprise that their mental health is in
jeopardy.
Doctors across the world are being forced to make difficult decisions like choosing which
patients for ventilator access, a heart-breaking choice that may leave a lasting psychological
impact. Doctors are trying to keep up, but the leadership is just as confused as the ground
workers. They lack crucial information, face a shortage of essential equipment, and must
battle public panic. The last one, especially, takes many forms, from gossip and social
rejection to denial of essential services and physical assaults, all of which can compound their
mental burden.

SUGGESTIONS
Messages for healthcare workers
1. Feeling under pressure is a likely experience for you and many of your colleagues. It is
quite normal to be feeling this way in the current situation. Stress and the feelings
associated with it are by no means a reflection that you cannot do your job or that you
are weak. Managing your mental health and psychosocial well-being during this time is
as important as managing your physical health.
2. Take care of yourself at this time. Try and use helpful coping strategies such as ensuring
sufficient rest and respite during work or between shifts, eat sufficient and healthy food,
engage in physical activity, and stay in contact with family and friends. Avoid using
unhelpful coping strategies such as use of tobacco, alcohol or other drugs. In the long
term, these can worsen your mental and physical well-being. The COVID-19 outbreak is
a unique and unprecedented scenario for many workers, particularly if they have not
been involved in similar responses. Even so, using strategies that have worked for you in
the past to manage times of stress can benefit you now. You are the person most likely to
know how you can de-stress and you should not be hesitant in keeping yourself
psychologically well. This is not a sprint; it’s a marathon.
3. . Some healthcare workers may unfortunately experience avoidance by their family or
community owing to stigma or fear. This can make an already challenging situation far
more difficult. If possible, staying connected with your loved ones, including through
digital methods, is one way to maintain contact. Turn to your colleagues, your manager
or other trusted persons for social support – your colleagues may be having similar
experiences to you.
4. Use understandable ways to share messages with people with intellectual, cognitive and
psychosocial disabilities. Where possible, include forms of communication that do not
rely solely on written information.

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5. Know how to provide support to people who are affected by COVID-19 and know how
to link them with available resources. This is especially important for those who require
mental health and psychosocial support. The stigma associated with mental health
problems may cause reluctance to seek support for both COVID-19 and mental health
conditions. The mhGAP Humanitarian Intervention Guide includes clinical guidance for
addressing priority mental health conditions and is designed for use by general
healthcare workers.

Messages for team leaders or managers in health facilities

1. Keeping all staff protected from chronic stress and poor mental health during this
response means that they will have a better capacity to fulfil their roles. Be sure to keep
in mind that the current situation will not go away overnight and you should focus on
longer-term occupational capacity rather than repeated short-term crisis responses
2. Ensure that good quality communication and accurate information updates are provided
to all staff. Rotate workers from higher-stress to lower-stress functions. Partner
inexperienced workers with their more experienced colleagues. The buddy system helps
to provide support, monitor stress and reinforce safety procedures. Ensure that outreach
personnel enter the community in pairs. Initiate, encourage and monitor work breaks.
Implement flexible schedules for workers who are directly impacted or have a family
member affected by a stressful event. Ensure that you build in time for colleagues to
provide social support to each other.
3. Ensure that staff are aware of where and how they can access mental health and
psychosocial support services and facilitate access to such services. Managers and team
leaders are facing similar stresses to their staff and may experience additional pressure
relating to the responsibilities of their role. It is important that the above provisions and
strategies are in place for both workers and managers, and that managers can be role-
models for self-care strategies to mitigate stress
4. Manage urgent mental health and neurological complaints (e.g. delirium, psychosis,
severe anxiety or depression) within emergency or general healthcare facilities.
Appropriate trained and qualified staff may need to be deployed to these locations when
time permits, and the capacity of general healthcare staff capacity to provide mental
health and psychosocial support should be increased
5. Ensure availability of essential, generic psychotropic medications at all levels of health
care. People living with long-term mental health conditions or epileptic seizures will
need uninterrupted access to their medication, and sudden discontinuation should be
avoided.
6. Orient all responders, including nurses, ambulance drivers, volunteers, case identifiers,
teachers and community leaders and workers in quarantine sites, on how to provide basic
emotional and practical support to affected people using psychological first aid.

Company Vision

Apollo's vision for the next phase of development is to 'Touch a Billion Lives'.

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CONCLUSION
The novel coronavirus spread so rapidly that it has changed the rhythm of the globe. Whether
from the perspective of a single country or multilateral levels, the solidity of international
relations has been put under test. The most obvious consequences include economic
recession, a crisis of global governance, trade protectionism and increasing isolationist
sentiment. People-to-people, cultural and travel exchanges have all been restricted.
Nonetheless, this is just a tip of the iceberg.

After we overcome the pandemic, which will surely happen, we must carry out a
comprehensive evaluation of the world's ability to maintain stability when faced with similar
challenges in the future. We must also craft measures to cope with these challenges together.
But perhaps at the current phase, we can already draw some conclusions.

A pandemic is not new in human history. But what makes the COVID-19 pandemic special is
that it takes place in an unprecedented backdrop when the interconnectivity and
interdependence between people, between countries and between continents are so deep. The
achievements people have made in technology, intelligence and transportation make them
both physically and psychologically globalized.

The consequence is that problems in one country will become global ones. Long ago we
raised warnings, and we cannot underestimate the danger of multinational threats, from
terrorism to cybercrimes. 

Similarly, if one isolates oneself and relies on others to solve one's own problems, it is simply
impossible. The effect of the virus has clearly proved this. The pandemic reminds us that we
need to stay humble in the face of disasters. Any country or individual, regardless of their
geography, fortunes or political ambitions, is equal. The novel coronavirus crisis rips off all
fanciful illusions and superficial things and displays the lasting value of human life.

Not everybody was prepared for the test of the pandemic. Even under the current
circumstances, when global challenges are supposed to unite people and propel people to
even temporarily forget divergences, some still resort to exploitation. Not everyone can resist
the temptation of being selfish. Others also take advantage of the situation to play geopolitics
by chasing their own interests and revenge against their geopolitical rivals. Once bred in such
an environment, the virus will intensify conflicts and heighten unfair competition. 

As a result, some "man-made" consequences have been added to the natural effect caused by
the virus. These "man-made" consequences are a result of the zero-sum mentality that
humans, or precisely some humans, refuse to give up even when faced with common
disasters. Nonetheless, to overcome the visible consequences caused by COVID-19, countries
are urged to stay more united than ever and to gather all strengths and resources. 

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We have to admit that the COVID-19 pandemic has shown us examples that lack
humanitarianism. This may be due to the chaos caused by the spreading threat. However,
such lack of humanitarianism seems to be deep-rooted. This is because of some countries' and
their ruling elites' incurable egoism. Those who proclaim themselves as moral leaders with
democratic traditions did not unite all parties to seek mutual understanding. Instead, they
started to act according to the law of the jungle, regardless of etiquette rules and ethical
constraints. 

They blame China for the spread of the virus, or maliciously slander Russia because we have
provided assistance to some countries in response to their requests. They even raised absurd
allegations against Russia, accusing us of taking advantage of humanitarian and medical
assistance to strengthen geopolitical influence. They cared nothing about the severity of the
pandemic and issued a ban preventing people from seeking Russia's medical and
humanitarian assistance. This violates basic diplomatic rules and is insulting. 

Some Western countries are politicizing humanitarian issues and trying to use the pandemic
to punish the governments they dislike. If not, how could we explain that these Western
countries, which always talk about respecting human rights, do not want to give up their one-
sided economic sanctions on developing countries (at least before the global pandemic
situation is eased)? Indeed, such sanctions have weakened ordinary people's ability to
exercise their social and economic rights, causing serious difficulties in protecting residents'
health and hitting the most unprotected people.

Russia has always firmly opposed such an inhumane approach, and this is completely
unacceptable when humanity is facing a disaster. Because of this, at the virtual meeting
of G20 leaders on March 26, President Vladimir Putin proposed establishing "green corridors
free of trade wars and sanctions" that would ensure supplies of medication, food, equipment
and technology. 

It is very dangerous to try to use the current situation to sabotage the UN's basic principles.
To effectively resolve the problems faced by humanity, UN agencies should still be the main
coordination mechanism for multilateral cooperation. In view of this, people are deeply
concerned about the defamation of the World Health Organization (WHO). Most countries
agree that the WHO has been fighting at the forefront since the outbreak of the COVID-19.
Indeed, like all other multilateral institutions, the WHO should improve its work and adapt to
various new situations. But to achieve this, the WHO must not be undermined. All WHO
member states should maintain their constructive dialogues with each other, so as to jointly
formulate solutions to deal with the new challenges.

The pandemic has once again debunked the long-held myth in the West about the "end of
history," an all-powerful model of hyper-liberal development, based on the principles of
individualism, and a firm belief in the ability to solve all problems through the market alone.

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