Whether it’s closing laptops, putting on pyjamas, reading a book or browsing Netflix, many would be calling it a day.
That’s not the case for Samir Gupta, respirologist and clinician-scientist at St Michael’s Hospital. For him, 10 p.m. marks the beginning of hours of additional work, when WhatsApp messages and questions start to flood in:
Should they take steroids?
Are those drugs safe?
Is that the right treatment?
Can you check the photo attachment of CT scans?
How about the photo attachment of hospital reports?
Over the past three weeks, Gupta has stayed up into the early hours of the morning, answering questions from family and friends in India; family who, in recent weeks, have become his patients and 18 of whom have tested positive for COVID-19. Even more friends and acquaintances are battling the virus.
Gupta has become a hub for knowledge and medical advice following the surge in cases in India, creating what he calls his “night job.”
In a country that has seen record high cases, reaching more than 400,000 infections a day, Gupta is one of the many Indo-Canadians trying to piece together the mess that has spiraled out of control.
“What’s happening is they’re not getting the help and advice they need so they’re turning to wherever they can,” says Gupta. “In this case, when you have a family member who is a respirologist who does COVID work, obviously I’m the person who is going to help them.”
Amanpreet (Preet) Brar, general surgery resident at the University of Toronto, notes that many Indo-Canadian doctors are struggling to combat the surge in cases locally, such as those now hitting vulnerable communities in Brampton and Scarborough.
“You just feel like you’re simultaneously dealing with two waves,” says Brar. “You’re trying to help people (back home), you’re trying to do your best, but also you’re trying to protect your loved ones here also, so it’s definitely very stressful.”
While immigrants have often struggled with their duty to help family and relatives abroad before the pandemic, usually financially, Brar notes that this outbreak has put substantial additional pressure on Indo-Canadian doctors of all trades and specialties as they are consulted for what could be life-saving information.
“Once (family friends) know I’m a physician, even though I’m actually a surgery resident, I get asked to provide input for what can be done at home,” says Brar. “It’s very difficult because you don’t know what tests have been done, you don’t know what information you’re getting because you’re not there physically to see the person. It puts you in a very difficult position because you do want to help.”
Prabhat Jha, director of the Centre for Global Health Research at St. Michael’s Hospital and professor of Epidemiology at the Dalla Lana School of Public Health, describes the situation in India as “a perfect storm that occurred.”
“Between September and now, India should have been preparing for a second wave. Instead, what it had was a fair amount of hubris saying ‘Oh well, aren’t we clever we’re not going to get a second wave’… So just the emergency footing – getting more oxygen, beds, nurses, everything lined up – was not done.”
Jha notes that deep-seated inequality in health care is a major contributor to this crisis.
“The elites of course will be able to effectively bring a hospital to their home, so they’ll have their own private oxygen tanks and so forth, but the common person in India has just so little recourse,” says Jha. “This was all avoidable.”
Gupta says trust is an important factor that explains why Indo-Canadian doctors are being called upon by family and friends in India. He says that not only do most Indians not have access to care or advice, but there is growing anxiety and a lack of trust in the medical system.
“That’s culminated in me being sort of the go-to for my family,” says Gupta. “There’s enough stress with what’s happening here but it’s a whole other stress because first, it’s your own loved ones, it’s your own family… I always think in the back of my mind, ‘If (my family) can’t handle this, what’s going to happen to the vast majority of Indians?’ They just have nowhere to go.”
Gupta notes that his cousin, among the first to contract COVID-19 in his family, called up to 30 hospitals before getting a bed. The cousin was then informed that he needed to supply a ventilator because the hospital was unable to provide one.
“We had to scramble and figure out how to get a ventilator on the black market,” recounts Gupta. “It was like bring your own ventilator … it’s just brutal.”
Gupta says this case was an example of how the lack of supplies limits how, and to what extent, he, as a doctor, can help his family.
“There are a lot of things that we would do (in Canada) that they can’t do right now,” says Gupta.
He notes that he feels there are a number of front-line Indo-Canadians dealing with the same struggles. They are trying to offer limited advice to family-turned-patients, who they cannot assess in person.
“I think there are a lot of us that are facing this; I can only tell from social media which one of my colleagues is going through this,” says Gupta.
In the early mornings before leaving for work, Gupta checks back online into WhatsApp, asking his own final questions.
What happened overnight?
Did they desaturate?
Any new complications?
What’s the status?
What’s their oxygen requirement?
“Then I get a break for the day to do my day of work,” says Gupta. “So, I feel like I’m running a parallel ward with my Indian family members.”