My recent COVID hospitalization experience in Indian government free hospital, as a single simple-living sadhaka (spiritual aspirant); Vital role of Oxygen in treating some COVID gasping cases

Minor update on 22 March 2023

While I am on a convalescence break from my social media writing work, I felt that I should write this post on my COVID hospitalization experience as a single (unmarried) simple-living spiritual aspirant, as it may be useful to some readers. An earlier post on this was a short one: Very grateful to Government General Hospital, Anantapur, Andhra Pradesh for very good and free treatment for my COVID health emergency, https://ravisiyer.blogspot.com/2022/02/very-grateful-to-government-general.html , 14th Feb. 2022.

The COVID pandemic has been a great spiritual test, IMHO, both at personal level and at community level. At personal level, if one gets infected with COVID then one becomes an infection-risk or infection-threat for others. 

From a spiritual point of view, at least for me, being an infection-risk to others was (and still is but less so as COVID is not so scary a disease as it was in 2020) quite a disturbing thing, especially in early days of the COVID pandemic when the world, including India, was struggling to handle the pandemic. So I felt that the right spiritual thing for me to do, was to follow all norms including masking and social distancing, and also take the vaccine shots when they became available.

Over time, I took both the COVID vaccine shots. So that part got done well.

But the masking and social distancing part was challenging as many people in the area where I live were not following those norms! If they came to my flat/door then I would request them to mask if they were unmasked. But while walking on the street outside, I could not really tell them to mask if they were not masked, as they might get offended. Further, I realized that there were some who were unmasked out of choice as they felt masking is not good for their health. I had to respect their choice.

I particularly wanted to avoid becoming hospitalized due to COVID as I live alone and getting people to support me when hospitalized for COVID would be challenging. Given that I had some breathing related issues to start with, I was more susceptible to have serious COVID issues if infected. Further, in the initial period of the pandemic in India when many health care workers even lost their lives to COVID, I felt I would be posing a significant risk to the medical staff who treat me in a COVID hospital.

So I decided to use the pandemic period as a period of spiritual seclusion limiting my visits outside my flat to an absolute minimum. I had also temporarily stopped (from June 2020 as that was around the period when the pandemic really hit places like Puttaparthi in rural India) using my maid's services and was doing all the cleaning and other flat work myself.

For food, I would usually use home delivery services where the delivery person would either hang the food parcel/bag on the door, or if he were handing it over to me, would mask up before doing that.

While it was physically taxing to do all the home work myself, it also was good from a spiritual sadhaka (aspirant) perspective as it promoted self-reliance. The solitude was also helpful to me as I was able to explore some spiritual practices in a better way.

I was able to do all this from June 2020 onwards till end 2021, a period of one and a half years. Being a retired from commercial work person gave me more liberty to lead such a life of relative seclusion. 

But 2022 brought serious health challenges for me. First the heart attack which is covered to some extent in this post: Very grateful to Bhagavan Sri Sathya Sai Baba Super hospital and General hospital in Puttaparthi for wonderful and free medical care they provided me for cardiac related health emergency, https://ravisiyer.blogspot.com/2022/02/very-grateful-to-bhagavan-sri-sathya.html . While in hospital for heart attack, a 14 day period, the medical staff there followed masking (I think N95 mask and an additional mask) and other COVID protection protocols and I too used to wear a mask, but I had to interact with quite a few persons and while I was having food I would not be having a mask on. I should also mention that I was tested for COVID in the initial period of this hospital stay and the result was negative.

Once discharged from the hospital, I had to have people helping me at home as I was in no position to do home work myself. So I interacted with lot of people though I usually took the precaution of wearing a double mask. However, while eating food, I would be unmasked.

There was also a trip to a Bangalore hospital to consult with a nephrologist in end January at which time Bangalore was having many cases of COVID.

So, perhaps inevitably, I contracted COVID with symptoms like fever appearing around the time I returned to Puttaparthi from Bangalore hospital visit.

I home-isolated myself and took Paracetamol/Dolo 650 for few days and also consulted with a local Puttaparthi doctor through a friend (all over phone). The fever was gone after 3 to 4 days but I had cough with sputum.

Early morning 31st January, I was having difficulty breathing. If I recall correctly, when I checked my saturation rate it was 90 or so, and then it dropped to around 85. I got into gasping. I called up a friend who sent a friend of his to take me to a hospital in Puttaparthi.

In the hospital, they did a rapid test for COVID and the result was positive. They advised that I should be taken to Government General Hospital, Anantapur (GGH-ATP).

I was taken in an ambulance from Puttaparthi to GGH-ATP. I was alone in the patient area of the ambulance as naturally there was fear that if anybody came with me in the ambulance patient area, they could get infected. Besides me, there was only the driver of the ambulance who was in the front side of the ambulance.

An oxygen cylinder was connected to me but I don't really know how much oxygen I was getting from it. It did not help resolve my gasping in any way. But perhaps I was getting some oxygen which prevented my gasping from getting worse - I don't know for sure.

The ambulance bed on which I was lying down was of quite small width. One side of it was flush to the ambulance frame/chassis but the other side was not protected by any safety stand/grill. So I had to hold fast to one end of the ambulance bed with one hand, and also hold on to the window bottom part with other hand, so that I would not fall off the bed onto the ambulance floor, as the ambulance went over some bumpy roads at times!

It was quite a spiritual test! The ride in the ambulance seemed to be very long for me. But I was told later that it was for around one and a half hours.

Once we got into the GGH-ATP area, we were quickly joined by my friend who had come in a car from Puttaparthi. My friend did the big bureaucratic work of filling out all the paperwork at the government hospital, which took around an hour. For this hour long period I was gasping in the ambulance!

Eventually the paperwork for admission to COVID ICU of the hospital got over, and a nurse took me in a wheelchair into the COVID ICU. From that point on, I was overwhelmed with the good treatment I got from the nurses and doctors there. Primarily, the nurses and doctors showed ***no fear*** in dealing with me. They were masked (probably N95 mask and an additional mask) but had little or no additional PPE (Personal Protection Equipment). That did not deter them from tending very well to me as a patient. It was as if they were dealing with a NON-COVID patient! Really! I was amazed and very awed by the courage and dedication of these medical staff of GGH-ATP to treat COVID patients there including me, so well, without any fear! It was an inspiring thing for me to see. 

Most of the doctors were young and there was a good mix of male and female doctors. Perhaps some of them were doing their M.D. They reminded me of my visits to Kasturba hospital, Mumbai in late 1970s and 1980 perhaps, where my elder sister was doing her M.B.B.S. internship. She and her fellow interns were young doctors then. These young doctors of GGH-ATP in 2022 reminded me of my sister and her fellow doctors in late 1970s and 1980 perhaps.

As soon I was admitted into the COVID ICU, I was given profuse oxygen supplied through oxygen pipes. Within a short period of time (perhaps half an hour), my gasping problem had gone. While I still had some breathlessness, it was much, much lesser than when I was having the gasping problem.

I think in early or mid 2020 itself, I had read about the importance of oxygen to treat COVID patients. Oxygen concentrator machines were being donated by countries that could spare them to countries which were in the grip of a COVID wave and did not have enough oxygen concentrators and other oxygen facilities. I had read about oxygen facilities (generation plants, I guess) being vital for COVID treatment centers that were coming up in India, including in my Anantapur district in Andhra Pradesh state of India.

Now I directly experienced how profuse Oxygen at COVID ICU, Anantapur Govt. Gen. Hospital resolved my problem. They did give me some injections too (antibiotic I think) but I think the main treatment was Oxygen!

I continued to use Oxygen off and on for perhaps 2 days and later I was off Oxygen completely, and 3 and a half days after admission i.e. on 3rd Feb., I was discharged from GGH-ATP. In between, I was moved from COVID ICU to a general COVID ward, where too the doctors and nurses fearlessly treated the COVID patients.

One big challenge I faced in GGH-ATP was that I did not have a reliable attendant. The hospital staff expected me to have an attendant. Almost all, if not all, the other patients had relatives as their attendants. The relatives attended on their COVID patient kin wearing only a mask or double-mask. To me who was experiencing a COVID hospital for the first time, it felt as if it was a normal, non-COVID hospital ward, excepting for masking/double-masking (but then even normal hospitals have their medical staff masked/double-masked now)! Seeing all this removed any thoughts I had about COVID hospitals being strange and somewhat fearful places. Yes, COVID was a very infectious disease but if one gets it and gets hospitalized, at least in 2022 in GGH-ATP, it was a routine disease that was handled by the medics in a confident way.

I must say that, quite surely, this would not have been the case in second half of 2020 in GGH-ATP as all the medics there grappled with the then new and scary COVID disease, and the danger it presented to medics who treated COVID patients. But in early 2022, at least what I saw and experienced directly in GGH-ATP, was that these medics had figured out how to confidently and fearlessly treat COVID patients. I think that is an awesome achievement by GGH-ATP medics and I salute them for this achievement.

Back to my attendant issue. As it was a COVID hospital, my friends in Puttaparthi were naturally fearful of doing attendant type services for me there. I completely understand that as they too have their families and loved ones and so they too need to be careful.

But the hospital needed an attendant for every patient! The solution was arranged by my friend after discussion with some person(s), through a paid attendant whom we paid Rs.1000 a day. He would not be there all the time and many times when he was needed he would not be around. But the hospital staff were willing to adjust to that and so we managed somehow.

I also saw that the COVID ICU had good equipment including good hospital beds. Next to me was a patient on a ventilator. There were some other ventilator machines in the ICU ward I was in, which had 6 patient-beds if I recall correctly. PM-CARES (an Indian central/federal govt. initiative) was written on some of these ventilators (perhaps all of them). I think this COVID ICU benefited from both Indian central government and Andhra Pradesh state government funding specially for COVID, and, as a patient, I benefited from some of this equipment (oxygen facility, for example and perhaps good patient bed too).

One person died in the ICU ward I was in, while I was there. So it was not as if COVID was not a deadly disease. But even that did not really create great fear among other patients, I think. 

I should mention here that most attendants were young. I think people have understood that young people typically do not get too badly affected even if they catch COVID, especially if they are double dose vaccinated.

Another notable thing was the camaraderie among patients and their relatives in the general COVID ward. The general ward had less serious patients and so I think people were more relaxed. I was in one room with 3  patient beds. I got to chat with and know the attendant-relatives of the two patients next to me. They even helped me when my paid attendant was missing.

Yes, when a patient would have a coughing fit, people would get a little concerned about infection spread, even if patients were masked and relative-attendants were masked. But they were not too scared! Somehow, the fear of COVID, in GGH-ATP was not so pronounced. 

I also saw that some young people like my paid attendant, were willing to attend on COVID patients for good money.

After coming back to my flat in Puttaparthi, I was in home isolation for a week, but with two young persons (one changed over this period) helping me out in my flat as I needed such help then. We would all be double-masked and I paid them decent money for their services.

It was good to understand that if I paid decent money, I could get attendant type services even in Puttaparthi, while I was in COVID home isolation. This I had not known earlier. This makes handling such situations much easier for single people like me.

My friend arranged an oxygen concentrator to be kept temporarily at my home. I used it once or twice and benefited from it in terms of my slight breathlessness then coming down.

I also explored using Oxygen canisters (3 or 4 puffs at a time) for temporary benefit from breathlessness.

I was glad to know that even oxygen cylinders could be obtained on rent from persons in Puttaparthi. Note that oxygen canister can provide only few puffs of oxygen at a time, as if it is used continuously it will get over in a few minutes. But oxygen cylinders can provide oxygen continuously for some hours, based on their capacity and how much oxygen is supplied for a particular time interval (I think that is measured in litres (per some time measure, I guess) and there is a knob and associated dial showing how much litres (per some time measure) are being supplied).

A big takeaway from me after this COVID gasping experience is that oxygen supply is the vital thing for some COVID gasping/acute breathlessness cases. Oxygen concentrators and oxygen cylinders are very useful in such cases. Further, in Puttaparthi, there are people who provide this on rent (or some are free). Oxygen canisters (e.g. OXYZONE Natural OXYGEN in Portable Can (12 Litre) 250 Sprays, https://www.amazon.in/gp/product/B08M3SPMQ9/ ) may be of some limited use, to tide over a short period, if oxygen concentrator or oxygen cylinder are not available.

Another point is that, as of now, it seems that Andhra Pradesh government directives are that all COVID hospitalization cases in Anantapur district should be referred to Anantapur Govt. Gen. Hospital. Note that Anantapur has some private hospitals too that treat COVID hospitalization cases. But moving a patient who is gasping for breath from Puttaparthi to Anantapur has some challenges. The journey is 1.5 hours and if patient is being admitted to GGH-ATP hospital, add 1 hour for procedure/paperwork before admission to hospital, during which patient will be in ambulance. Note that private hospitals in Anantapur that treat COVID patients may admit COVID patients right away. In case of GGH-ATP, 2.5 hours totally is the period between patient being shifted from Puttaparthi to GGH-ATP COVID ward. During this time, the patient should have good oxygen supply or else the patient could even die in the ambulance. I could have died in the ambulance and I was ready for that eventuality. No panic. I viewed it as a spiritual test. But in my case, I am single and do not have dependents, and so I am ready for death anytime. In most other cases, patients will have dependents and there may be other reasons for them to want to stay alive. Therefore, those arranging for such patients (COVID gasping or other acute breathlessness cases) to be taken from Puttaparthi to Anantapur should ensure that enough oxygen supply is provided in the ambulance for the 2.5 hours period (for GGH-ATP). 

When I checked with a Puttaparthi private ambulance service provider about what would the right oxygen supply for COVID gasping cases, he said that doctors tell the ambulance personnel how much oxygen should be supplied to patient in the ambulance and they provide that much. I don't know what would be right oxygen supply setting in the ambulance oxygen cylinder for COVID gasping cases.

Another Puttaparthi private ambulance service provider said that if required, double oxygen cylinder can be provided.

Yet another Puttaparthi private ambulance service provider said that a technician comes along with the patient in the ambulance with the technician checking patient's (vital) signs on (attached) monitor and the technician sets the oxygen supply to suitable level. Note that this ambulance service is expensive.

I paid Rs.7500 for the ambulance I used (from Puttaparthi to Anantapur). I was told that for COVID cases, as there is more sanitization work involved (and perhaps the risk factor), during COVID surge period, such charges are normal.

I should also mention that I was happy that I was admitted to GGH-ATP instead of a private hospital. I feel that as a single, simple-living sadhaka (spiritual aspirant), the govt. free hospital was the right one in this case. Not only did I get good medical treatment, I don't think I was over-medicated. Private hospitals where one does not know the doctors/owner, carry the risk nowadays of over-medication so as to increase the money earned (bill) from the patient.

There were some non-medical challenges in the GGH-ATP hospital but which was expected in a free govt./municipal hospital in Anantapur (or most places in India, I guess). As a spiritual aspirant, I viewed them as small spiritual challenges and was not really bothered by them.

This was the first time in my adult life at least (and probably even my childhood) that I have been admitted in a municipal/government (free) hospital. I found it to be a very interesting and largely positive experience.

I wondered how it would be for sannyasis and sannyasinis who did not have much money with them, if they contract COVID and need hospitalization. How could they get an attendant? Who would bring them to the hospital and do the paperwork needed before they could get admitted to the government hospital? After they are discharged, who would help them manage their home isolation at a time when their health is still not fully OK (and would they have a home in which they could get isolated)? I could not get any reasonable answers in my mind to these questions. I think that such sannyasis and sannyasinis may have to manage without hospitalization! Perhaps they may even die! But then such challenges, I think, have been the norm for sannyasis and sannyasinis (and monks  & nuns from other religions who do not have much money) over the ages. It is not easy to be such a sannyasin or sannyasini!

I am deeply grateful to Andhra Pradesh state government led by Hon'ble Chief Minister Jagan Mohan Reddy garu and Indian central government led by Hon'ble Prime Minister Narendra Modiji, who fund the COVID wards of Government General Hospital Anantapur (state government also administers the hospital). I am deeply grateful to the doctors, nurses and other staff of Government General Hospital Anantapur for their very good treatment of my COVID gasping problem. 

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Associated Facebook post: https://www.facebook.com/ravi.s.iyer.7/posts/3339169252966295 , has some comment exchanges. Given below is part of one comment I made on it:

Yes, Swami is always with us. In fact, at Anantapur Govt. Gen. Hospital, the paid attendant would get me food from a Sathya Sai Seva group that provides free food daily in or near Anantapur Govt. Gen. Hospital. So I was eating Sai prasad (Sai blessed food) for lunch and dinner during most of my short stint in Ananatpur govt. hospital. ... I was so happy to be able to enjoy that Sai prasad! So Swami also shows us how He is with us, while we are facing these challenges.

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