Shweta Gajare1, Alhad Mulkalwar1
Volume 11, Number 1: 88-90
Received 29 07 2022; Rev-request 06 09 2022; Rev-recd 20 09 2022; Accepted 26 09 2022
This article summarizes the novel experiences of a team of medical interns posted at Chhatrapati Shivaji Maharaj International Airport, Mumbai in the midst of the COVID-19 Pandemic. The authors describe the protocols, guidelines, duties, and procedures that were to be followed while deputed to screen the incoming international passengers for possible exposure and symptoms of coronavirus. For the young healthcare workers in the early days of their internship, being a part of this team was no less than a roller coaster ride. From anxiety and excitement to fatigue and crippling exhaustion, the authors narrate their ordeal as young COVID warriors on duty.
Keywords: COVID-19; Airport; Screening; Quarantine; Internship (Source: MeSH-NLM).
“Passengers, May I Have Your Attention Please…” even in the wildest of our imaginations, we never would have guessed that this would be our first announcement as healthcare workers. After a gruesome final year of M.B.B.S., we were now ready to enter our hospital internship as doctors. While some may find it hard to equate interns with doctors, in our minds, we were no less than integral and indispensable pillars of the healthcare system. It was the time to don that prestigious white coat and apply, in practice, the five years of rigorous training that we had endured. However, little did we know that along with our clinical internship, this was also the beginning of a new global event with unprecedented ramifications - the COVID-19 pandemic, which would alter everything and anything we thought we knew.
It was as early as our third day of internship at the hospital when 15 interns from our batch were summoned by the Dean. Clueless as to what this was all about, we rushed to the office where we were informed that our team was to be a part of the delegation to the Chhatrapati Shivaji Maharaj International Airport, Mumbai to screen the incoming passengers in view of the ongoing pandemic. We collected our PPE (Personal Protective Equipment) and immediately departed for the Airport Health Organization (APHO). There was a surge of mixed feelings amongst us - the thrill of doing something important for the nation and the excitement of a novel experience as medical professionals, alongside the fear of fighting an unknown adversary. On the way to the airport, we were briefed about the safety guidelines, including the signs and symptoms and management protocols used by other countries at that time. As India had reported only a couple of cases by then, domestic protocols were still evolving. At the beginning of the pandemic, we had little data on all these characteristics of the SARS-CoV-2 virus. However, we resolved to face the challenge ‘head-on’ with the guidance of our mentors. We reported to the APHO and were handed our airport staff ID cards. After the documentation and other official formalities were completed, we were directed to the staff canteen for lunch where we got an opportunity to interact with interns and residents from other colleges who were also deputed at the airport for the same duty. We were then handed our schedules and briefed on the screening protocols to be followed and given instructions regarding management of passengers, positioning of stanchions and use of megaphones for crowd control at the arrival terminal of the airport.
Our work profile included the screening of all incoming international passengers and members of the cabin crew. Once all passengers on-board a particular flight were screened completely, we would then issue clearance to the airlines. There were multiple counters set at the arrival terminal for the screening, thereby ensuring a one-meter distance between the passengers and the Medical Officers (MO). Passengers were given in-flight self-health declaration forms by their respective airlines. They were asked to fill the forms during their journey and then submit the same at the screening counters. A copy of the form was to be kept by the MO for records and the original was given back to the passenger with the APHO stamp after clearing the screening procedure. All passengers were required to produce the APHO stamped health forms at the immigration counter, and failure to do so would impact the immigration process. The screening procedure consisted of recording the body temperature using a thermogun (infrared thermometer), identifying the basic symptoms of ILI (Influenza-like illness), making a note of any comorbidities, and asking about travel history to Wuhan, China within last 14 days, as this was the location of patient 0 and the known incubation period of coronavirus. Those passengers who were at a higher risk (positive travel history or greater than 60 years of age) or those who showed any symptoms were directly transferred to the nearest hospital for further work-up. By that time, India had banned all the flights from China to avoid any possible exposure to the virus. However, we were very apprehensive about the lack of information and studies on the infectivity and communicability of the virus. Also, constant news of the exponential spread of the infection across the world and failure of even the developed countries to contain the same was demoralizing. Assuring our worried and concerned families amidst this catastrophe was another Herculean task. It was like fighting a mysterious evil. Little did we know that this was no less than a forest fire. Almost every alternate day, the list of red countries (to check for travel history to countries with higher infection rates and/or increasing case load for high risk of exposure to COVID-19) became longer and longer. After China, many European countries were added to the list. Gradually, the issuance of new visas was suspended and those with old visas had to carry a negative COVID test report, which was to be conducted within 48 hours prior to the departure of the flight. Then, on March 11th, 2020, the World Health Organization declared the COVID-19 spread a pandemic.Figure 1.
Our Team of Doctors at Work at the International Arrival Terminal of CSI Airport, Mumbai.
With the escalating situation of pandemic and increasing mortality rates, the guidelines were frequently updated and we ensured to obey the new protocols. Initially, we used the health declaration forms and thermoguns to screen the passengers. Healthy international passengers who would clear the screening were stamped on the dorsum of hand, indicating that they were to mandatorily quarantine themselves. The stamp read ‘HOME QUARANTINE’ along with the date until which the person was to be quarantined. They were generally asked to be quarantined for 14 days at home, if possible, or at a government facility.Figure 2.
Appreciation Letter Received from the Airport Health Authority, Mumbai.
The last week of airport duty, which was also the week before the lockdown, was the busiest of all. The Government of India had declared a Pan-India lockdown beginning on March 24th, 2020 – this resulted in huge number of Indian citizens abroad making last minute reservations to return home. By then, we had started quarantining all passengers aged greater than 60 years old and those with any existing comorbidities for 24-48 hours at the nearest government facility for observation. All such passengers underwent Rapid Antigen Test or RT-PCR, as indicated, and were kept under observation until a negative report was produced. If positive, they were isolated and treated accordingly. This helped to reduce the mortality rate to a greater extent as many cases were detected in this screening process amongst the high-risk patients, facilitating early intervention and recovery.
The 12 hour night shift of March 22nd – 23rd was our last shift at the CSI Airport. It was a Sunday and India had already implemented a weekend curfew by then. The streets were deserted, which was a rare sight for the usually chaotic city. On arrival, a long queue of the passengers awaited us. All the flights were arriving at maximum capacity as it was the last day for entry into India before the international borders were to be closed. That night proved to be our most hectic duty as we screened an enormous number of passengers.
The next morning, at 8am, was the end of this riveting journey at CSI airport Mumbai and the end of Phase 1 of our internship or “The COVID Internship”! While returning from the airport, something did not feel right; it was if someone had stopped time. This was something that will never be forgotten - the only vehicle running on the roads of the busiest city was our bus! The city of dreams, known for its speed, was as calm as the adjoining sea. The police check points on the roads ensured enforcement of the lockdown. As fascinating as the experience was, we would never wish to relive it. Hopefully, we will not experience such a disaster again. Even if such a time comes, let us hope that we will have learnt from our prior mistakes and are able to mitigate accordingly.
The Authors have no funding, financial relationships or conflicts of interest to disclose.
Conceptualization; Data Curation; Formal Analysis; Funding Acquisition; Investigation; Methodology; Project Administration; Resources; Software; Supervision; Validation; Visualization; Writing - Original Draft Preparation; Writing – Review & Editing: SG, AM.
Cite as Gajare S, Mulkalwar A. “Passengers, May I Have Your Attention Please…” – The Airport Diaries of Young COVID-19 Warriors. Int J Med Stud. 2023 Jan-Mar;11(1):88-90.
Copyright © 2023 Shweta Gajare, Alhad Mulkalwar
This work is licensed under a Creative Commons Attribution 4.0 International License.
International Journal of Medical Students, VOLUME 11, NUMBER 1, October 2022