#and they telepathically controlled him to pull their oxygen switch

[nitewrighter]

[call-me-emma]

Tests

Summary: Wally and Avery highly suspect that Emma has some special powers. But how can they be sure?

Pairings: OC / Wally West (platonic)

Warnings: none really

Word Count: Approx. 3800

A Note: Avery Yu belongs to @audreythetealovingcat @audreyandherocs

The drive to the Flash Museum was over before the fourth song on Emma's favorite Switchfoot cd started. The museum was laid out in a circular pattern, so they decided to just follow the circle, stopping at whatever looked interesting.

The first exhibit was dedicated to the various speedsters throughout history, with a small statue and name plaque for each; with Flash and Kid Flash at the center. The base depicted scenes from some of the battles each speedster had won and quotes from the grateful people they had helped, along with information about numerous charities they had worked with. Wally grinned as he read a quote from a little girl saying how Kid Flash was her favorite hero. Fortunately, neither of his friends noticed him tear up a touch; he remembered this little girl in particular.

Emma stared in awe at the polished bronze statues of Flash and Kid Flash towering above them. “I still can't get over the fact that this city has an actual museum to him. In Chicago, they pretty much either hated superheroes or were mostly neutral. It’s so different seeing people like, actually embrace Flash and Kid Flash.”

“How could they hate superheroes? All the good they do? And the people they save? I don’t get it,” Wally asked.

Emma shrugged. “I don’t get it either. It didn’t use to be like that, from what I can remember. When I was a real little kid we had a handful of superheroes, and the police loved them. They worked with them. But then something happened. I’m not sure what, my dad wouldn’t tell me. It was right before we moved here.”

Avery nodded. “So, is that why? Is that maybe why your father doesn’t seem to like metas?”

Emma shook her head. “I wish it was. But no. He’s always hated them. I don’t get it. He doesn’t like anything that’s different.”

Avery sensed Emma’s frustration bubbling to the surface in a prickling sensation on her skin and quickly redirected the conversation. “Well we’re here to enjoy the museum, and none of us feel that way. So let’s enjoy it while we’re here.”

The next exhibit mirrored the first, being dedicated to the Rogues Gallery. Now it was Emma’s turn to sense Avery’s mood shift. She could feel the girl’s visceral hatred for Vandal Savage. Emma had never really heard much about the evil immortal, so she had no reason to hate him so intensely herself. But she found her stomach knotting and her hands clenched into fists without her control. She heard herself making a low growling noise in the back of her throat as she stared at the hologram of Savage. She heard Avery’s voice in her mind as clearly as if she were speaking. A tirade of Chinese spilled from Avery’s mind; Emma was surprised to find she could make out a cuss word here and there. Taking her friend by the shoulders, she motioned to Wally it was time to move on.

As they passed the restaurant, Emma paused and tilted her head towards Wally. *Did he just?* She frowned. *He did.* She turned to face him and chuckled. “Wally. How can you possibly be hungry again already? We just got here!”

Wally raised his brows at Avery quickly,  then squinted at Emma. He hadn’t said anything. But he had been thinking about how good a pizza sounded.

Well, it is about lunch time, and it’s been a few hours since we ate breakfast. Avery tested Emma to see if she heard.

Sure enough, Emma did hear. She turned to Avery. “I guess you’re right. I didn’t realize it was this late already. Let’s eat while we’re here.”

Let’s share a pizza, Wally thought.

Emma didn’t even notice that Wally hadn’t said anything out loud. “That’s a good idea. Let’s get a pizza to share. How about.”

Sausage, Avery suggested telepathically.

“Sausage? Is that ok with yous guys?” She pulled out her wallet as she headed towards the counter to order. “What do you want to drink?”

Wally and Avery decided to keep their little impromptu test going and see how long they could continue their telepathic conversation with Emma.

Coke for me, Wally thought.

“Really, Wally? Coke? Not Mountain Dew? Ok.”

I’ll take a Sprite, Avery thought.

“Avery? Did you say you wanted a Sprite?” Emma ordered the pizza for them to share, and the drinks for her friends, with a root beer for herself.

As the three sat down at the table, Wally kept his face blank as he questioned Emma. “So, how’d you know we were hungry?”

Emma almost choked on her soda. So Wally hadn’t said anything out loud earlier; she had just heard him mentally. She recovered as quickly as possible. “Well, Wallman, when are you not hungry? I seriously don’t know where you put it all. ” She nudged him playfully.

“What can I say? I’m a growing boy. I’ve got a fast metabolism.” Wally shrugged. He looked at Avery. Either she really didn’t hear me, and it was a lucky guess, or she’s not ready to say anything yet. He was careful to keep his mind guarded so Emma didn’t accidentally hear. They weren’t quite sure how exactly her telepathy worked yet. So far it seemed to be sporadic, and outside of her control.

Wally, you know there’s no way she just made a lucky guess. Remember she straight up asked me if I’d said I wanted a Sprite. You and I both know I didn’t say anything out loud. So we at least know she has telepathic hearing. What we need to find out is if she can control it and if she can transmit thoughts as well as just hear them.

To prove her point, she turned to Emma. “How’d you know I wanted Sprite? I didn’t get a chance to answer.”

Emma’s face flashed from confused to slightly worried before she answered. “I just know you well, I guess. I know you like your lemons, so it makes sense you’d like lemon pop.”

“Huh. Yeah, you’re right.” Avery held back from saying anything more at this point.

Wally was biting his tongue to keep from saying anything to Emma yet as well. They still needed to test a few more things, and this was not a conversation either of them wanted to have with her in a public place. Wally knew his friend well enough to know this talk needed to happen somewhere she felt safe, and where she could ask questions without fear of anyone else hearing. Once they all finished eating the group headed to the next part of the museum.

Emma ran ahead of her friends to the next exhibit, which focused on the Speedforce. The display explained how the Speedforce worked and featured a simulator where visitors could experience a virtual Speedforce; similar to the zero gravity rides at the space museum. There was also a special set-up detailing how a normal person’s body would react to running at such high speeds. A treadmill hooked up tp next to a blood-pressure and heart rate monitor and a pulse oximeter let people see how their vital stats while running compared to Flash or Kid Flash’s. State of the art technology also measured how much sugar, oxygen they burned, along with hydration levels. Avery and Wally gave each other a look.

Should we have her try it? Avery asked.

Definitely. I’ve already noticed she does seem to be able to run faster and farther in gym class. Plus she seems stronger, so there’s a good chance these powers she has are physical too, and not just mental. Except, it might look suspicious if we have her try it and the two of us don’t. But I don’t think you should exert yourself like that, and me, well.

They were surprised to find that Emma had already eagerly stepped onto the treadmill. “What?” She shrugged at them. “I’m just curious. I’ve been working my butt off in Taekwondo lately, and it seems to be paying off.”

“Emma, are you sure? Just, be careful. The last thing we need is you having an asthma attack.” Avery told her worriedly. As much as she wanted to see if her friend really did have some sort of physical powers, she was concerned about her. She knew Emma had had asthma attacks from overexerting herself before, and that Emma had a tendency to push herself too hard. She glanced at Wally. Ok, we need to test this, but we need to watch her carefully. We pull the plug if she starts reaching for that inhaler.

Agreed.

“Don’t worry guys, I have my inhaler.” She waved it at them. “And I can handle a few minutes on a treadmill.” She pressed the start button, having hooked up all the monitors. She started off at a steady walking pace, gradually picking up to a full run.

The next thing she knew she was running faster than she’d ever been able to run before. Normally she hated running, but this. This felt so much different. Like she was flying. It was exhilarating. She was sprinting as fast as she could, and all she could feel was the adrenaline pumping through her veins. Her legs weren’t tired and cramping, her heart wasn’t racing, her forehead wasn’t covered in sweat that dripped into her eyes. Best of all, her lungs weren’t burning and her throat wasn’t constricting. She laughed with excitement as she cranked up the speed. Running had never been this effortless for her. She didn’t bother to glance down at the readout.

Wally’s eyes widened and his jaw dropped when he saw it. A few seconds ago when he’d looked she was going nearly 10 miles an hour. Now she was pushing 20. Her pulse rate had barely climbed and all her other stats looked just as good. He looked at Avery and pointed to the screen. She nodded. He knew Emma’s fastest mile time had only been about 14 minutes in gym class. Even that had been pushing it. She’d already gone five miles at her current speed. A quick mental word to Avery and he pulled the emergency switch on the treadmill, bringing it to a sudden stop.

Emma stared at Avery with a bewildered face. “Why'd you stop it? I feel great! I wanted to keep going!” she whined.

“Emma, you've already been on it for a while. There's a line forming,” she gestured behind them.  “And you were pushing yourself pretty hard. You don't feel it now, but you were going almost 20 miles an hour. Are you sure you feel ok?”

“20 miles an hour?” Emma shrieked in disbelief.

Wally looked around quickly and noticed the crowd staring at the same time Avery sensed them. He placed a hand on Emma's back while Avery took her by the hand and they led her to a quieter corner, away from the nosy throng.

“There's no way! I mean, yeah, I feel great, I've never been able to run like that before! Wow! That fast? Really? How long was I on it for? Dang, I don't even need my inhaler! I wish I could feel like this in class all the time!” She rambled.

“Emma, shhh. You've got to keep your voice down.” Wally reprimanded.

Emma hung her head and fidgeted with the hem on her shirt with one hand, clutching her arm with the other. “Sorry. I didn't mean to embarrass you guys. I'm sorry about that. I didn't think I was being that loud. It's just,” she trailed off

Avery took her hand gently, stilling her anxious fidgeting. “It's alright. You didn't embarrass us. You've got nothing to apologize for. We're your friends, we’re never going to be ashamed of you.”

Wally nodded. “Yeah, it's not that. You just need to be careful. You never know who might be listening. It could be dangerous if the wrong people hear you talking like that.”

“Who might be listening? What? I don’t get it. What are you guys talking about? It’s not like we know anyone here,” Emma asked.

Wally gripped her shoulders and turned her to face him directly. He spoke slowly and methodically. “Emma. Think about it.” He paused for a moment as he could see on her face that she was trying to decipher what they meant. “You were going on about how you’re suddenly able to run so fast for so long without feeling it. How you felt like you were flying.” He emphasized the last word. “Why might that not be a good idea to talk about so loudly? In this city, of all places?” Avery watched Emma’s face as her brows furrowed together and she squinted at the ground, biting the corner of her lip. Avery held back from giving her any hints. They needed Emma to figure this out on her own.

What are they talking about? It’s not like I was saying I actually was flying. Why are they so? In this city? What’s he?

Wally saw his friend’s eyes light up and the spark go off just as Avery felt the jolt of static when it finally dawned on Emma. She stood there in shock for a moment before her shoulders began to shake with laughter. She slapped her thigh with one hand, covering her mouth with the other.

She barely caught her breath to blurt out “Wait. You guys don’t think that I? I mean seriously! No, no, no! I do not! I mean, that would be awesome! But no! I’ve just been working my ass lately is all.” She leaned in close and whispered emphatically. “I. Do. Not. Have superpowers.” She added to herself I can’t.

Wally smiled at her excitement and sudden change of mood. That overflowing enthusiasm was one of the things he adored about his best friend. He had hoped for a moment that she might take hearing what he and Avery had to tell better than expected. Then he felt the strange shoving sensation in his mind when she declared she didn’t have powers. A light pressure settled on his head as if somebody was trying to stuff something inside that wouldn’t quite fit. He put his hands up in surrender. “Ok, ok. Say no more. We get it.”

Avery felt something drilling at her temples when Emma made her declaration. She immediately recognized the sensation of someone trying to get past her mental wall. For a split second the idea that Emma could possibly have powers seemed utterly ridiculous to her. She pulled her hand away abruptly and took a small step back as she realized what was happening. “Ok. Wally’s right. But you really should be careful.”

Emma nodded. “Ok, yeah. Yous guys are right.” Her eyes darted around, suddenly self-conscious. I’m being silly, she thought. Out loud she said, “Let’s just go see the next part.”

The group made their way through the museum without even until they came to a life-size statue of Gorilla Grodd with the title “Flash’s Telepathic Foe.” A short video showed the two mid-battle, followed by a brief description of how Grodd’s powers worked, and of course, a bit of how Flash managed to beat him. A case contained a model for the mind control headband Grodd sometimes used. A plaque detailing various theories about how telepathy worked stood next to it. It also gave a bit of information about a few other telepathic opponents, and some allies like Martian Manhunter and Miss Martian.

Emma stared intently at the plaque listing the theories. “So, I don’t get it. How does it work? The telepathy?”

Wally looked up from examining the model of Grodd’s headband. “Are you asking me to explain how telepathy works?”

“Yeah. How does it work? Like, I know most so-called psychics are just really good at reading people and stuff, but what about him?” She gestured to Martian Manhunter’s photo. “What about the real telepaths?”

“Well, there’s a few theories on how it works.” Wally started to explain.

“Just like? Is it science, or magic, or something else?” Emma prodded.

Avery spoke up. “Telepathy can be tricky to define and even harder to recognize. That’s partly because there are so many different types, and each individual telepath has different abilities. As for science or magic, that depends on the person. It can be magic based, but there are also some scientific elements to it.”

“And don’t forget, sometimes advanced science looks like magic until its able to be explained. For Martians, for example, scientists know that it’s something in their genetics that gives them their powers. To us humans, they look like superpowers. But for them, it’s just a normal part of their biology.”

“I think I get it, sort of. But now I just have other questions.” Emma stared at Avery bewildered.

“Hey, hey, don’t worry about it. It’s just one of those things you sort of take for what it is. Don’t overthink it.” Wally patted her arm.

“Hey look! Speaking of. Are you a telepath? Let’s try it. Maybe it can help explain it a bit. You always did learn best with interactive stuff.” Wally pointed excitedly at the sign hanging over a set of computers. “At the very least it could be fun.”

Nice. Avery encouraged Wally. We can see just how much she can control it.

“I don’t know.” Emma shifted her weight back and forth on her feet. Truthfully the little set up did look tempting. She had vehemently denied having powers, but she strongly suspected that wasn’t true. She felt fairly certain Wally and Avery were right about her new physical abilities. She feared there might also be some mental abilities, including possible telepathy. She glanced back at the computer and shrugged. “I mean, I guess. Why not?” She chuckled nervously. “It’s not like this thing is probably that accurate anyway”

Avery agreed to try the test with her first. They sat down as Avery carefully cleared her mind, letting down her barrier just enough to give Emma access without projecting anything herself. She clicked on the screen and selected a handful of images for the test. The idea was for one person to select the images and string them into a sentence, while the other person tried to figure out the sentence, or at least the images. Few people ever got it right, but everyone had fun trying. Emma took her seat across from Avery and waited for her signal to start.

Emma pursed her lips and made eye contact with Avery. She knew Avery like a sister. If she could see the images Avery had picked from, this would be a snap. She squinted at her friend for a few seconds before an image and a strange sensation came to her. She saw several long finger-like projections stretching out in front of her, reaching for Avery. A tickling sensation played at the back or her brain, working its way forward. The tickling became more intense and changed to more of a prickling, like thousands of tiny needles and Emma could just make out the outlines of several shapes. She closed her eyes, in part to ward off the growing pressure in her skull, in part to block out everything else and bring the shapes into focus.

Avery felt a slight pressure at her temples as Emma concentrated. She could see long tentacles coming towards her in her mind’s eye. They wrapped her head, surprisingly gentler than Avery expected. If she had her mental walls up, it would have been more uncomfortable, like somebody drilling at her temples. As it was, it felt like Emma was pulling her hair a bit too hard and tugging at her skull. Avery didn’t notice Emma rubbing at her forehead, but Wally did.

Despite her slowly growing headache, Emma kept focused on the images in her mind’s eye. She was so close to forming a full picture. Wally and Avery might have suggested trying the little test in good fun, but she had to know for sure. She leaned forward, craning her neck as if to see a movie screen. At the same moment, the pictures came into focus, a sound came to her. She opened her eyes and jumped in her seat.

“Um, I think I hear a dog barking?” She closed her eyes briefly again. “And, I think. It’s brown? I see a brown dog.”

Wally glanced from Avery’s screen to Emma, and back. He hadn’t expected results like this.

Emma rubbed her forehead again and squeezed her eyes shut tighter before she continued. “I see a school bus, and I think I hear kids on it. And, there’s one more. I hear, music? It’s, um, I think I see. Um, uh, oh! Is it an iPod? It’s blue.” She opened her eyes as she severed the link, causing Avery to stumble back in her chair a bit. She looked at Avery questioningly, waiting for confirmation. She knew it was strange that she’d actually seen images, let alone heard them. She also knew she should probably be acting like she hadn’t really seen or heard anything, that she should be hiding this. Especially if she really was a telepath. But a desperate curiosity got the better of her. She’d wondered for a few months now, and she knew she could trust Wally and Avery if she could trust anyone.

Avery hadn’t noticed the expectant look on her face while she recovered from the sudden release of pressure and put her psychic walls back up. She had, however, heard what Emma had said. What Emma had said had impressed, shocked, and slightly worried her. She was sure now that her friend was a telepath and a strong one at that.

Wally and Avery watched Emma with faces as passive as possible. “Emma,” Avery started slowly. “You got all of them.”

Sensing Emma’s growing worry, Wally attempted a joking tone o lighten the mood. “Hey, you did so well with this, maybe you can get me the answers to the next math test?”

Emma looked at Wally, then at Avery, expecting them to break out in full laughter. She knew that wouldn’t happen though. “C’mon Avery. What were they really? That’s not possible. There’s like, a million different combinations possible. There’s no way I could have guessed what you picked.” She gulped. “Unless..” Her breath quickened and her hands shook. “No, no, no. Please no.”

Avery answered slowly, carefully. “Emma. That was it. No joke. I don’t joke about matters like these.”

Emma took a small step back, eyes wide. “Matters like these?”

Wally placed a comforting hand on her shoulder. “Let’s go home, Emma. It’s getting late, and we need to talk.”

[hq-au]

(warning for NSFW content: nothing explicit/graphic, but it’s there)

So this is messy and uneven, but I’ve been working at this for a full month now and I’m not sure how much longer it’ll take before it’s fully satisfactory. I’m tired. (I also might expand this into an original work at some point in the future, idk)

Under Read-More for length

AU where Hinata is an explorer traversing the cosmos, a nomad mapping the uncharted wilds of space in his trusty, silver rocket.

On a barren desert planet, when he explores the landscape, he’s attacked by a shifting black mass that leaps out from the shadows of a sandstone stack. Before he can react it wraps around him, and as he struggles to pull it off it gets into his spacesuit and bonds to him. The alien winds around his face and he starts suffocating, before retracting moments later, allowing him to breathe again.

He rushes to his rocket to utilize his safety shower unit, and, walksuit half-undone, is about to douse himself with chemicals when he hears it speak.

A tense conversation follows in his mind, with the alien communicating telepathically. It tells him it’s weak, and needs to subsist on others to survive. Hinata knows what kind of alien this is, and is furious and scared. As his hand lays onto the tap toggle the alien pleads with him for a week, just a week. After that he can do what he wants, but it doesn’t want to die, not yet.

Hinata pauses, at the emotions it’s displaying. There’s an anguish and sincerity to it that catches him off-guard. He stops trying to turn the faucet, and, against his better judgment screaming at him, he starts thinking it over. Seeing an opening, the alien doubles its entreaties, until finally Hinata gives up and agrees, growling a frustrated sigh. He looks back at the faucet, and in a few seconds comes to a decision. “If you want to live,” he tells it, “Get inside my suit. Don’t come out.” Then he screws his helmet on again, and throws the tap.

It’s several hours later, and he hasn’t moved from where he sat down after finishing the sanitizing of his suit. He’s running on canned oxygen. His suit has vents and air filters he can switch to, but he’s worried about germs and other particles that the system may not know and recognize, or may slip past through sheer lack of size. There’s not much he can do inside the suit. He’s occupied himself first by uploading the data he’s captured so far of the planet, and then by running diagnostics on his ship. Everything is tip-top, as he likes to keep it. Much of it is run by switches and gauges, and the keyboards controlling the rest are glove-friendly in event of pressure loss. He can handle these things. But he’s already gone over nearly every procedure listed in the manual, and he’s got a long week ahead of him if this is what it’s going to be like. He’s bored and antsy. And he knows that, sooner or later, he’ll have to use the water closet. Unlike the entry passage, the seal on that door isn’t airtight or Clean, and he’s not sure how he’ll keep the rest of the ship free of contamination. He bounces his leg to vent some energy.

«You seem uncomfortable» the alien muses. "I'm fine," Hinata says, tersely. «You can change, if you want» the alien says. «I'm already on you.» "I'm worried about contamination!" Hinata snaps. Then he purses his lips in frustration, mentally cursing himself for giving that bit of info away. If the alien knows it could be a biohazard merely by virtue of its existence, there’s no telling what it might attempt. The alien though, for its part, seems to retreat at Hinata’s words, or maybe his musings, pulling back and receding from his mind. Hinata quashes the shadow of guilt that pangs in his chest, takes a deep breath, and continues bobbing his knee.

It’s been two days. Hinata has accepted, through lack of choice, that he won’t be able to keep his ship Clean and himself alive at the same time, and has given up on the endeavor. He’s not an android; he has needs. He’d boxed up what he could inside the few airtight containers he keeps aboard, and resigned himself to exposing the rest to contamination, or at any rate the possibility of it. He keeps inside his spacesuit as much as he can, but even that���s getting tedious, and he’s not sure how much longer he can bear it.

It’s night on the fourth day when the alien appears in his dreams. It has a humanoid shape, but the details are all wrong, and Hinata wants to scream, or throw up, from the uncanny valley effect. Maybe do both. “Why are you here?” he asks in terror. «I want to talk» it says, eyeing him with blank sockets and unknowable intentions. It wends toward him, and Hinata screams, primal, at it to leave. It then vanishes in a cloud of smoke, his subconscious takes over, and he spends the night’s remainder in more comforting sleep.

«Please» the alien begs. “It’s been a week,” Hinata says. «There’s nothing for me out there!» “A deal’s a deal!” He struggles to get dressed, the alien making it difficult for him. He manages to pull a shirt on over his head, and black tendrils squirm out from inside the sleeves, twisting and twitching in agitation. «Just a little more time!» it pleads. The alien wraps itself around his body a little tighter, caressingly, but the sensations caused by its movements, so liquid, so foreign, so alien, only nauseates him. “No, we agreed on a week, and that was bad enough as it is!” He tries to pull the black mass off himself, but, desperate to keep its foothold on him, it only stretches. “Get off me!” he shouts in aggravation. «But I’ll starve!» it blasts in his head, at a volume that makes him wince. «I can’t go yet!» Hinata finally manages to get his walk-suit on, and, sealing his helmet and respirator into place, stumbles into the entry passage, his movements made uneven as the thing winds itself around his ankles. In a desperate bid for survival, the alien begins thrashing about around him, and manages to work portions of its body through the seams of his suit. It quickly expands outward, tendrils flying through the air as it searches for purchase anywhere it can. It grabs onto the surfaces and corners of the entry passage, and Hinata finds himself struggling against a web. Inky ribbons of black wind and stretch around his limbs and do their damnedest to keep him immobile, pulling his arms back every time he reaches for the latch, and by the time he manages to overpower them and get it open, the creature’s managed to compromise the seal of his helmet. «I’m sorry» it says over and over again, as it cracks the glass for good measure. «I can’t go yet, I’m sorry!» Realizing that if he goes outside, he’ll now suffocate too, Hinata is momentarily stunned into motionless. Then with a fury he switches direction and flings himself toward the safety shower. The alien, reading his thoughts, panics and lets go of the walls, and contracts around him. The tendrils twist and braid around his limbs and snake inside his suit, searching for any way to impede his movement. One suddenly wraps around his groin, and Hinata gasps despite himself at the sensation, momentarily losing focus. The alien, not understanding what it did but seeing the opening, takes the chance to instantly bind him up, and he falls to the deck with a thud, his limbs all but hogtied. Hinata curses it out, thrashing impotently on the floor, until the alien realizes it can shut him up with a gag to his mouth, and then a thin film stretches taut across his face, slowly depriving him of oxygen until he blacks out.

He isn’t getting rid of the alien any time soon, he realizes. Hinata is furious, unsettled, and powerless in the situation. He doesn't know how much time its species needs to fully bond to a host organism, but he's sure a week isn't much less; he can feel the thing sinking its roots into him, embedding itself deeper into his body by the day. The alien’s now had 240 hours, give or take a few, to wriggle deep enough in him to ensure that, if it doesn't want off, it's probably not going to come off without a lengthy procedure at best. And the thing has made it pretty clear that it doesn't want off. Ironically, the alien’s demeanor has been one of timidity and placation, or at least of gestures of them---whatever its deeper-lying feelings are---and its attempts to placate him form a juxtaposition with its unrelenting, ever-tightening grip on his form so surreal that he, sometimes, almost thinks that he’s dreaming. «What is that?» the alien asks, bubbling up around his neck. “Ack!” Hinata chokes, and snaps at it. “Do you mind?!” The alien immediately shrinks away, but after a moment extends a portion of itself outward, hovering mid-air, craning for a look at the object in his hands. It asks again, though with a more hesitant tone of thought. “What, this?” Hinata asks, calming down. “It’s a book.” He’s on his knees and hands, rummaging through some of his older possessions in an effort to sort them out. He’d been hoping to find something specific and sentimental, but it doesn’t seem to be among the detritus. «What’s that?» the alien asks. Hinata’s lips parts to answer, when he realizes he has no idea how to explain something so rudimentary. His mind scrabbles for several seconds, then, at a loss for an answer, he gives a tired sigh, shuffles over to the captain’s chair, and pulls open an online dictionary on the ship’s computer.

Hinata stares at the ceiling above his bunk. Grey half-light swathes him gently, a combination of the planet's dawn and the UV filters and slats on the windows. He woke up half an hour earlier, but getting up would require an effort he hasn't wanted to make. Outside, the planet's sun is already bathing the rocky, windswept surface in light, though at its far-off distance hardly keeps the temperature above freezing. Hinata has kept the artificial Earth-environments system running on his ship since he first touched down. The planet turns slowly, the days are long. He needs to promote proper sleep cycles if he's to stay healthy and stave off exhaustion. Exhaustion leads to worse maladies, and maladies are hard to treat in space. He lies unmoving inside his bag and his sheets, swaddled up comfortingly to his neck in front, and his scalp behind, but he feels movement around him. He feels the alien bonded to him wriggling, subtly, shiftingly. So this is it? He thinks, staring blankly with half-lidded eyes. Is this my life? The cabin is silent, the winds outside drowned out with three layers of insulation in the hull. Hinata realizes he’s been holding his breath, and sucks in oxygen. He holds it five seconds, then exhales. This is is life now. His body is no longer his own. How will this affect his health? Will it affect his mind? He feels these and other questions being thought in his mind, in a disconnected fashion, but he can't bear to concentrate any hard on them. He is not alone, he is not in charge. The axis around which his entire universe has spun for so many years has suddenly, violently, and probably irreparably, shifted, and he doesn't know how to cope with the fact. Part of him wants to break down, while another wants to rage, but most of him just feels numb. The emotions he wants to feel are too big, too overwhelming, and for the moment shock has taken over, and he's detached from himself. On a mental level he knows he's in shock, but even that knowledge feels hazy and faraway, as if he's accessing it from another plane of existence, or from an altered state of consciousness. Moving his body would mean accepting and claiming it as his own, the body that, host to a new, living, entirely separate organism, is barely his. He can't bring himself to doing that, just yet, so he lies motionless and cocooned in his wool-silk blend sheets and his polyethylene sleep sack, and dissociates, staring wanly at that familiar sculpted ceiling. The metal above his head seems clearer somehow, the texture somehow more polished, more visceral. It's the same bulkhead he sees every morning and night, the same piece of plating he's been familiar with for the past nine years. There's nothing different about it, and to think so is absurd. Nevertheless, it looks clearer somehow, as if his eyesight has improved.

The alien proves itself insatiable. It started with a few simple questions; once Hinata had answered those, it was like a switch had been flipped, and he soon found himself in an onslaught of queries and questions in his mind, a veritable flood that he found himself having trouble even keeping his head above at times. He realizes the alien might have more raw intelligence than he has himself, which is an existentially daunting realization (as well as a rather depressing one on a personal level, if he’s being honest); regardless, it’s voracious, and the more it learns, the more it wants to know.

“How did you even end up on this planet?” Hinata asks, incredulously, one day, interrupting the alien’s latest stream of questions. He’s sitting in the cockpit, uploading the latest of his forays’ data onto the computers. He’d rooted around the day before until he’d found his old spare suit, almost from his cadet days, stowed away in a compartment, and has been using that for data capturing. He has a job to do, and nothing short of a life-or-death emergency is going to stop him. He watches the loading animations tick, as the data transfers, with bored detachment. The alien, taken aback at the question, falls into an uncharacteristic silence. «I was born here» it says. «No---!» it starts a split-second later, realizing its error. «I---....I don’t remember... .» The voice Hinata hears in his head takes on a dreamy, abstract quality, and he becomes momentarily unguarded in his surprise. Without acknowledging his change, the alien continues after a few moments. «I...I think I came here, on a host» it says after thinking, mentally reaching toward far-away memories. “And what happened to the host?” Hinata queries, feeling confused. «I don’t know...» it replies. «Don’t remember. It seems.....a long time ago..» Hinata pauses a moment, pursing his lips slightly. His mouth then parts, opening almost of its own accord. “How did you survive?” he asks. His voice, without even meaning to, comes out gentler than what he’s used in the entirety of their interactions so far. The alien pauses a second to think. «I hibernated» it says thoughtfully.

The alien asks about him a lot too. Hinata describes his childhood with his family in Japan; and then has to explain family units and how nations work after being asked what “family” and “Japan” are. When he talks about the language barriers he faced, when first arriving in the international, multicultural environment of outer space, and how hard it was to learn even passable English (not to mention Russian; he’s still not sure which was worse), the alien asks what “language” is, and he has to describe those as well. He relies on online thesauri and dictionaries more than he’s had to in years, and it’s frankly exhausting. Ironically, though, the one question he couldn’t answer was far from the most technically difficult: at one point the alien asks what “Sex” is, after a discussion about families; Hinata, having been single for years, can only splutter, and, face flushed, pull up an article for the alien to read, and then clamp his eyes shut in embarrassment.

The questions open up space between the two beings though, and begin bridging the gulf that existed between them. Slowly, Hinata begins to see the other as a person, of sorts, rather than a creature. A they rather than an it. With the new leeway, the alien makes attempts at becoming more cozy and familiar with him, testing the limits Hinata wants to keep, toeing the boundaries he tries to erect. It makes jokes and quips, and with its rudimentary understanding of human humor they fall flat as often as not, but in its attempts Hinata begins to understand that they have a wicked sense of humor. He’s not sure whether to even be amused or scandalized, half the time. He’s had to shut it down more than once, but the alien inevitably recoils whenever he shows real anger; it seems to enjoy teasing for the fun of it, and doesn’t truly mean to upset him.

There’s a bustle of activity in the cockpit. Hinata uploads the last of the data he’s captured to file storage, and then checks the displays for the fuel feed lines. Working. He starts up the injection feed, and hoses elsewhere get to work. «What are you doing?» the alien asks, noticing the unusual verve in the other’s movements. “I’ve finished mapping this region of the planet,” Hinata says. “I have to move on to the next quadrant.” He continues checking his displays, making sure his systems are working properly. His movements are quick, practiced, fluid; the product of years’ worth of experience. The manual procedures are long memorized by now, and their physical copies lie neglected in the cockpit’s storage compartment, kept around only for prudence’s sake. Hinata reaches up and checks the breakers, circuits and systems above his head, half standing from his seat to reach, head tilted as his gloved fingers hover an inch beneath the displays, halfway to the switches already---then, satisfied that everything’s in order, flicks the toggles one by one, with a practiced air. «What does that mean?» the alien asks, as he settles back into his seat. Hinata pauses in punching in new coordinates to his navigator. “Do you really not know that?” he asks. For gods’ sake, he arrived here in a spaceship. «No, I meant, What does it mean for “us”» Ah, he thinks. Hinata unlocks the final control column. “It means,” he says “That we’re going for a ride.” He shifts the engine column into gear, swiftly and with a flourish, and locks it into place, then steadies his grip on the yoke. The ship hums as the engines roar to life, and then, as he activates the thrusters for takeoff, that familiar warbling noise cants upward in pitch, evening out as it builds in frequency. The ship slowly rises into the air, its landing gear retracts, and then, as Hinata pushes the throttles forward, and, defying gravity, the ship accelerates, it sings.

His attempts to set ground rules are largely fruitless, and Hinata feels like he’s slowly suffocating. His several attempts at ridding himself of the alien entirely have failed as well, with its ability to read his thoughts hindering any chance he has of surprising it. It appears in his dreams, trying to reach out to him with attempts at human form, but though no longer terrifying, putting up with the alien during his days is horrible enough, and he always shouts it away.

He’s had to start taking iron supplements and vitamins, with the creature leeching off him, and the bottles are old supplies. Almost finished off. He’s going to have to restock soon, and Hinata’s not sure how or where he’s going to manage that without cutting into, and thus likely failing in, his present mission. The Alien asks him what the pills are when he takes them. He ignores it. He focuses on his work, and tries his best to tune the living bodysuit out.

It’s about two and half weeks after first contact when Hinata finally caves in to a more primal urge, and takes some time to himself one evening, after his work for the day is done. Too amped up to go to sleep, and too exhausted to accomplish anything worthwhile, he gives in to baser instincts, and sets to work. That’s when it decides to cut in. «What are you doing?» it asks. “Nothing,” Hinata says irritably. He grits his teeth and concentrates. «It doesn’t seem like nothing» the alien says, having the gall to actually sound smarmy. A few tendrils bubble into view, and cling thinly to his forearms. Hinata shudders, but otherwise ignores it, and picks up the pace. «Seriously, what are you doing.» Hinata keeps silent, only tightens his fist around himself, trying to physically distract himself. The alien keeps needling him though, and finally he shouts “Masturbating! God!” He growls in frustration. He waits for the alien to say something, anything more, but no comments are forthcoming, and after a moment, he goes back to work. A few moments pass in silence. «Is that related to sex?» It asks, on intuition. Oh, Jesus and Buddha both. “Yes!” Hinata shouts impatiently, then amends “Kind of!” He throws his free hand in the air in a gesture of frustration, then lets it fall to his lap with a smack. “I gave you that article to read!” «I can’t read your languages» it reminds him, dryly. His other hand stills, and then as the realization washes over him Hinata sighs in exasperation and pain. He wants to cry, just a little. There’s an ungodly pause, and then the creature breaks the silence with an even worse question: «Can I help?» The question is awful enough on its own, but what brings it to its surreal, horrifying apex is the tone it has attached: tinged with something like hunger. It’s a very specific emotion Hinata is familiar with, one that is so unsettlingly human that it makes him crack. “Go away!” he screams, “just leave me alone!” The alien retreats from him then, mentally at least, and disappears from view as well. Hinata doubts it’s left him entirely, but while he thinks he can feel the other’s presence, he can’t actively sense it. He pants and sucks in deep breathes, trying to regulate himself to a normal mode of breathing again, and, after a minute or two, he feels calm enough to continue where he’d left off. It’s start and stop for long while, his frustration cutting into his fantasies continually with worse images, but eventually he brings himself over the edge, and with release finally finds some semblance of sanity.

The alien makes a grand declaration one day, not long after, that it will study Hinata’s native tongue, and then makes an admirable attempt at it, considering it thinks mostly in concepts, has no knowledge of any alphabet, and needs each kanji it comes across explained to it. Hinata puts up with it for a little while, teaching him some basic words, and then his patience runs out and he says enough’s enough.

With the rudimentary knowledge it’s thus gained of Japanese though, the alien then names itself Kuroo, after its coloration. They have conversations a lot. Hinata takes to sleeping more to reduce the stress his body is under, working for two. Kuroo asks about Earth and its cultures, and the more it learns the more excited it gets. It practices the human form it projects in his consciousness, refining it with every new scrap of information it learns. The man Hinata sees in his dreams is devilishly handsome, with a tangled mess of jet-black hair and a roguish grin, is flirty and goadingly handsy, and, worst of all, underneath it all an absolute dork.

Hinata’s shoulder feels stiff. He must have slept on it wrong. He moves his hand to his shoulder to massage it, only to feel the wet, sticky embrace of Kuroo's body pooling over the bone beneath his shirt, having read his mind and beaten him to the punch. «Let me massage it» Kuroo says, pleadingly. Without waiting for an answer, it begins dragging its mass back and forth across the ridge and blade of Hinata’s shoulder, expanding and contracting, tightening and loosening, massaging and digging in. Kuroo's surprisingly good at it, it being its first time. “That's enough,” Hinata says, “I'll do it.” Kuroo says nothing, only bubbles in response, and starts massaging harder. “I said that's enough!” Hinata cries, and grabs at the black goo. He yanks hard, and the black puddle morphs into many long, sticky strands which fight against him, pulling taut in a desperate attempt to hold together. Several of the strands snap, and the remnants in Hinata’s palm curl up and wrap around his hand, pulling tight against the back and around his fingers, and squeezing tight. It feels disconcertingly like a hand is holding his own. A beat. The mass of black on his shoulder quivers for a moment, Kuroo hesitating, and then afterward a few strands rise up and slowly, gingerly wrap around Hianta’s hand and pull it down to his shoulder. A tendril coaxes at Hinata’s knuckles, and then he takes the hint and starts massaging his shoulder, like he’d meant to from the start, sighing in aggravation while he does so. «Good host, best host» Kuroo placates. «There there».

Kuroo’s presence has enveloped his life. The alien is cloying, and needling, pestering him for attention and annoying him when it doesn’t get it. And horrifyingly, Hinata finds he’s getting used to it.

It’s only temporary, Hinata thinks over and over, a chant to keep himself sane. Just until I find a place that’s safe to leave him. That rules out most planets, of course; pollution of alien ecosystems is the sin among cardinal sins, for those in his walk of life, and he takes his responsibilities seriously. He plans to keep him under watch until he can drop him off with some force of authority. And then, one day, he realizes that would be a death sentence; either to be carried out by an officer’s blaster, or else by some laboratory scientist’s electron scalpel.

The weeks turn into months. Hinata, finished with that barren dust-bowl, restocks at a depot and moves on to another planet. Then another. Unwilling to drop him off on some living, breathing planet where he could disrupt a foreign ecosystem, and unable to strand him on some dead rock without an environment to speak of, Hinata’s kept his passenger around. Kuroo’s presence has become routine, and an accepted part of his life. His silly goading and his inquisitiveness become familiar and comfortable, and enjoyable as ways to chase boredom off during their days.

Hinata wears his suit in most cases, when he leaves his ship. He’s never able to find out for certain if the alien is a contamination risk, as doing so would involve the kind of lengthy, scientific procedure requiring his removal from Hinata’s body entirely---a separation which might well kill them both---and, unwilling to risk Kuroo’s safety for some environmental peace of mind, has opted simply not to take chances. His occasional visits home are one of the few exceptions, and Hinata always, after reminding Kuroo to stay put inside him, makes sure he’s sanitized himself thoroughly before touching down. Wearing spacesuits on Earth attracts suspicion, but he takes every other precaution to compensate; his mother and sister are too dear and precious to him to risk bringing any illness upon them or their neighborhood.

True to his nature, Kuroo is very tactile, whenever Hinata allows it, and over time has kept Hinata company on more than a few lonely nights. One day, chatting with an acquaintance about the work he’s been doing while on-station, he’s asked if he’s lonely, and he realizes he’s not.

One day, Hinata realizes, Kuroo’s become something like a boyfriend.

Hinata sits in front of the control panels in boxers and a ratty tee, sipping coffee as he runs the standard diagnostics. A golden-yellow sunrise filters brightly through the retractable slats drawn down inside the cockpit, carving the flight deck in chiaroscuro on their latest planet. «You’re up early» Kuroo voices inside his head, «and looking pretty as ever.» “Good morning, Kuroo,” Hinata says with an amused sigh. Kuroo seeps out of his body in fractions, extending tendrils to look around. «What are you doing?» is the question posed. “Checking systems,” Hinata answers. «Nothing serious, I hope?» Kuroo asks. He pools his body onto Hinata’s chest, and Hinata can feel his weight settle over him. “Nah,” Hinata answers, “It’s all clean as a whistle.” He almost manages to sound humble about it. «So, nothing I can’t distract you from, then» Kuroo conjectures. A few ropy strands of his mass extend outward, and one pulls at the waistband of his underwear, while another inches downward inside. “I suppose not,” Hinata says nonchalantly, trying to appear blithe, pretending his act can’t be seen through by a creature that sees his mind. «Good» The strand around him thickens, and soon begins its gentle, interminable caresses. Hinata is stubborn, but his composure cracks soon enough, and the soft gasps and sighs he gives, in the soft blue glow of the displays that illuminate them both, is music to his lover’s ears.

[rustbonerp-blog]

THERE ARE TWO SLOTS FOR EACH CLASS A ABILITY

AFFLICTION:also called Affliction Inducing, Wound Infliction, Wound Inducing, Injury Infliction or Injury Inducing is the ability to inflict pain upon foes by pure force of will. The amount of pain will depend on the amount of control the individual has over the ability. It can go from a mild headache, to a torturous bone crushing pain throughout the entire body. One with this ability cannot induce sickness at all, although if the victim is put through too much pain, it can be enough to cause a heart attack, a stroke, paralysis and even death.

ALCHEMY: the ability to psychically turn one substance into another substance. One with this ability could do this one of two ways. The first version of this ability is Molecular Transmutation or Molecular Transmogrification, in which one rearranges the molecules of objects, transforming them into something that it is already similar to, such as water into hydrogen and oxygen. The second version is called Atomic Transmutation or Atomic Transmogrification, in which one rearranges the atoms of objects to turn a substance into another substance entirely, such as turning lead to gold or water to diamond.

ATMOKINESIS: also called Meteokinesis/Meteorokinesis or Atmosphere/Weather Manipulation is the ability to mentally manipulate the flux of the atmosphere at will, resulting in a change of weather patterns and formation of freak weather conditions. This ability allows generation of any natural weather condition, from fog and rain to thunderstorms, lightning, hailstorms, blizzards and hurricanes (and the calming or heightening of such conditions). At the higher bands, the user can even cause climate shifts (although sometimes one can only cause weather native to the area they are in).

CEREBROKINESIS: also known as Mind/Psychic Manipulation is the ability to psychically control the functions of the mind. Aside from the user’s telepathic abilities, one with this ability can, when actively concentrating, induce unconsciousness and exude a psychic signal which negates the part of the brain allowing those in the direct vicinity to use supernatural abilities.

CHRONOKINESIS: also called Horokinesis or Temporal/Time Manipulation is the superhuman ability to mentally alter the flow of time. With this ability, one could slow the passage of time, quicken it, stop it, or even travel through time. One with this power could even age or de-age any non-Time-Defiant subject one desires (by progressing or regressing the time-fields around biotic matter). Another faculty, however, entails the manipulation of time in a different way; the user would psychically alter the flow of time to instead affect subjects’, and/or one’s own speed.

CLAIRVOYANCE: also called Invisible Contact, is a form of extra-sensory perception wherein a person acquires knowledge of all sorts by visual means. This can include sight of that which is normally invisible, the past, the future, or simply from a location not relative to the user. If one saw a distant location (or came into contact with a map), they could also know where the location is, allowing them to find others. The user may also receive visual sensations (itchy/watery eyes, rapid blinking for no reason, etc.) with presence of psychic energy.

DEFLECTION: also called Reflection, Blocking or Riposting is the ability to physically or psychically dismiss and deflect whatever physical power is thrown directly toward the user. One with this ability usually makes no conscious effort to use this ability, as it is activated by a feeling of impending danger, which quickly causes projectiles or incoming impact to simply bounce off of the thin psychic aura generated by the user. Eventually, however, one with this ability could even consciously knock away impending dangers with phenomenal force.

DEGENERATION: is the ability to psychically deteriorate others. Old wounds are re-opened, all old afflictions return, and eventually the subject on whom it is inflicted will be dead, as the cells which keep repaired bodily materials together (bruises, scrapes, broken limbs) would be killed or even kept from healing damaged organs at a normal rate. This psychic ability can slow down the healing process, stop it, or reverse it completely.

DEHYDRATION: or Desiccation is the ability to pull water or moisture out of any subject capable of storing the former (usually via the hands), either to just make them thirsty or pull all of the water out, so they die from the lack of moisture. One with this ability either stores the moisture or simply disperses it from the body of the foe (although both are possible); sometimes one with this ability can even decide which liquids specifically to drain out of said subject, so as to help remove poison from an ally or the like.

GYROKINESIS: also called Gravitokinesis or Barokinesis is the ability to mentally manipulate gravity, allowing one to increase or decrease the effects of it around any desired area, to make objects extremely lighter, heavier or to even crush things by compressing them with intense gravity. One this ability can even shift his center of gravity and defy it, by walking up walls, jumping up to extreme heights, gravitating objects and subjects to/away from him and the like.

HELIOKINESIS: is the ability to mentally manipulate solar energy. This makes the person endowed with this ability capable of performing a special type of photosynthesis, rendering his own personal gravity field and generating nearly-perpetual energy, along with generating and manipulating stellar and solar energies in other forms. Their body is even capable of generating geomagnetic storms and solar winds, or even induce solar flares, should their power be strong enough.

ILLUSION CASTING: is the ability to mentally distort subjects' perceptions of reality. This could be done either by bending light so objects and subjects appear different (or nonexistent), by projecting a false image or sensation to the subject’s mind, or by covering an object, subject or an area of space with illusory energy to make things appear different than what they actually are (or to give the illusion of the presence of nonexistent things). This can even affect individual senses and cause foes to perceive things that are otherwise imaginary [for example, one could give the illusion that a foe was high off of the ground, thus inducing vertigo in the foe, or cause the subject to experience intense (but imaginary) pain, etc.].

INDUCED RADIOACTIVITY: also known as Radiokinesis or Induced Radioactivity is the superhuman ability to generate and manipulate various types and amounts of radiation. One with this ability could generate an EMP, ultraviolet, nuclear or various other types of radiation. One with this ability could withstand it, absorb it and induce anywhere from an explosion of combustible radiation, to a nuclear mushroom cloud. This ability could even be used to manipulate radio waves to simulate broadcasts.

INTUITIVE APTITUDE: is the ability to psychically see and/or understand the anatomy of any system and how it works. One with this ability could even detect what each part does in a machine, so that they can almost-instinctively figure out how to work any device. You do not take abilities from others.

INVULNERABILITY: also known as Indestructibility or Invincibility is the ability to resist all forms of damage. One with this ability has a subliminal aura that surrounds his cells which keeps them from being damaged from impact, or the person's body has cells which absorb all manners of concussion from blows that would otherwise cause extreme damage, even fatality. Sometimes, however, it can also be used to resist any sort of assault on the body, from mental/telepathic abilities, to physical concussive force, even poisons and illnesses, until nothing short of divinity can do damage to this person. It is possible that one with this ability could die of old age, though.

KINETIC ABSORPTION: the ability to absorb the kinetic energy out of any impact; this can be used to slow down opponents, or absorb kinetic energy and slow down a fall that would otherwise kill you. One with this power could even lessen the blow of any object hurled at him and withstand the force of any blow, as it would provide no force after the kinetic energy has been taken from it. Sometimes that absorbed energy can even be sent back at the foe or converted into strength or sustenance.

MAGNETOKINESIS: or Magnetic/Magnetism Manipulation is the ability to mentally alter magnetic fields in order to increase, decrease or redirect the flow of magnetic energy. With little concentration, the user could move/manipulate magnetic metals (even using the power of magnetism to attract/repel them). One with this ability could even reverse the polarity of magnetic fields, (sometimes) deactivate magnetism in normally-magnetic metals or disorient users of Magnetoception, by shifting fields of magnetic flux.

METEMPSYCHOSIS: also known as Mind Transfer or Mind Switching/Swapping is the ability to psychically “switch” the minds of two or more beings. Either the user causes himself and the subject to trade minds, or he causes two or more other people to switch minds, or he projects his consciousness into the mind of one who is unconscious, dead or weak-minded (sometimes inanimate objects, like dolls or electronics). The latter would let one work through another’s body as though it were his (and the other body is left inert/“dead”, so other souls can take over the user's actual body). The user may only be able to switch the minds of others.

NECROKINESIS also known as corpse manipulation. One with this ability can reanimate corpses and dead beings, making them able to move and react, though this is not to be confused with bring them back to life, which they cannot do. They are under the user's control, because the corpses are mindless, and they cannot move, fight, or otherwise act at all without the user’s active attention.

OSTEOKINESIS: Characters with the ability to manipulate the bones in their own bodies. This includes, but is not limited to, the generation of new bone mass, projecting bones out from the skin or rearranging one's own bones.

PERSPICUITY: also known as Psychic Static, Psychic Shield, Mental Protection or Mental Immunity is resistance to all psychic penetration. One with this ability is immune to Illusion or Deception, contact by Telepathy/Empathy or Hypnotism (and psychics can’t dominate them). If foes tried to hear the mind of such an individual, they only hear static (or nothing at all); if they tried to dominate or implant thoughts into the mind of the user, the attempt would fail.

PHOTOKINESIS: also called Lumokinesis, Luminokinesis or Photon/Light Manipulation is the ability to mentally alter light particles so that one might be able to generate, manipulate and intensify light at will. This ability can be used to increase one’s vision range, bend light around oneself (to turn invisible), perhaps bend light to cast optical illusions, and even fire offensive lasers, rays or bolts of light, of varying heat and intensity (from heat rays to freeze rays), or just concussive light beams.

POWER ACTIVATION: also called Power Manifestation or (Power) Manifestation Inducing is the ability to jump-start latent superhuman powers in others. One with this ability simply opens the part of the mind or accesses the DNA that allows the activation of superhuman abilities and faculties within that subject. They cannot bestow abilities; they only release or activate those which are inherently present in the subject's DNA. Used offensively, they can cause abilities to act on their own, or can cause a subject to use their powers when they don't want to (this is called Power Liberation).

POWER BOOSTING: called Power Augmentation or Power Amplification is the ability to psychically strengthen and intensify the powers of a nearby superhuman. This could be used to jumpstart latent superhuman powers, or strengthen normally weak abilities. One with this ability could even strengthen the ability of one person to a point where they cannot control them and cause harm to themselves and others around them (called Power Feedback or another version of Power Liberation). Most times it can also be used in reverse, so that either increase or decrease of abilities is possible.

PSIONIC BLASTS: is the generation and emission of beams or rays of intense psionic energy, usually very hot and/or capable of melting, but sometimes the energy is simply concussive and forceful.

PSIONIC MENTAL OVERLAND: also called Psionic Rush or Mental Bombardment is the ability to psionically duplicate knowledge and use it to inundate the mind of another, resulting in headaches, memory loss, or loss of consciousness. In extremely unique cases, this ability may allow blows from the user to create mental stress in addition to physically inflicted pain. Long-term use of this ability on an individual subject could finally lead to brain diseases such as tumors or cerebral hemorrhage.

PUPPETRY: also called another version of Mirroring, Psychic Control, Psychic/Psionic Puppetry or (more colloquially) Psychic/Psionic Puppet Strings- the ability to create a psychic/psionic link between the user’s motion and living subjects’ motion. The subjects can still resist, but the user controls the subjects’ bodies (and power use, if the subject has powers) as though they weren’t resisting, moving their limbs by making hand gestures similar to controlling a puppet (hence the ability’s name). Rarely, the subject can even be manipulated as though by Telekinesis (slung around, levitated, etc.)

RAPID CELLULAR REGENERATION: Accelerated Regeneration, Regeneration, Regenerative Healing or a Healing Factor is the ability to regenerate at a superhumanly quick rate. One with this ability regenerates as an automatic response to injury, and usually does so within less than a minute (though over a minute is not uncommon). The user can also regenerate normally unregenerated body parts. The user can even sometimes still function as vital organs regenerate. In some cases, the ability even results in the stunting of aging/development if it is employed too many times.

REALITY BENDING: also known as Reality Warping, (Situation) Realization, Canonization or (more colloquially) Projection, is the immensely powerful superhuman psychic ability to literally alter what is currently true about reality, even to the point of inducing normally-impossible events.

SEISMOKINESIS: also called Vibrokinesis or Tremor/Vibration Manipulation is the ability to mentally generate and alter vibrations. This ability can range from causing using vibration on a smaller scale, like shattering glass, vibrating the air to produce sounds or, at the higher bands, causing seismic tremors. One with this power could even release concussive waves of strong vibration to affect subjects in various ways, such as knocking foes down or launching vibrations into the ears of foes, causing disorientation.

TECHNOPATHY: or Cyberpathy is the psychic ability to sense and control the functions of electronic devices requiring only physical or mental contact with the device, to potentially override security codes and infiltrate an installation with ease by manipulating any electronic device, or sense the presence of electronics (even artificial intelligence).

TECTOKINESIS: is the ability to psychically manipulate the plate tectonics. One with this ability could induce or negate several terrene natural disasters, such as earthquakes, volcanic eruptions, mudslides (even tsunamis). One with this ability may even be able to manipulate geothermal energy and/or magma and lava.

TELEKINESIS: also called Psychokinesis, Telergy or Psychergy is the ability for a person to psychically influence tangible matter with the intangible mind. Those gifted with telekinesis are able to move physical items and at their strongest even levitate, by lifting their own matter and even manipulate matter and energy on a sub-atomic scale.

TERRAKINESIS: or Geokinesis is the ability to mentally manipulate earth. With this ability, one could hurl rock, dirt or minerals at foes with only the power of their minds, create fissures, sinkholes, mudslides or form said rock, mud and soil into constructs, like walls or projectiles. One could even absorb any rock debris or necessary minerals out of desired subjects to use them for oneself. Another faculty of this ability is Geogenesis/Terragenesis in which one can generate earth and sediment.

THERMOKINESIS: is the ability to mentally manipulate the motion of molecules, thus changing temperature in the immediate vicinity. This can range from controlling body temperature (called Body Temperature Manipulation or Body Temperature Control) to generating mass heat waves or massive cold fronts. This ability does not change the weather immediately, it only changes how hot or cold things are, sometimes resulting in changing the weather.

UMBRAKINESIS: also called Sciakinesis, Scotokinesis or Shadow/Darkforce/Darkness Manipulation is the ability to mentally generate and manipulate darkness (deactivated photons, not the absence of light). One with this ability can even deactivate and/or repulse photons or travel through shadows by converting deactivated photons into a dark version of a portal. One with this power could surround foes in pitch black clouds of lightless space, turn deactivated photons into constructs or shoot bolts of solid darkness at foes

VITAKINESIS: Occasionally known as healing touch. The ability to control the flow of life of oneself and others. Life may only be stolen through direct skin-to-skin contact, and the flow of life is slowed by a mask of fabric or other thicker, sturdier materials. One with this ability has the capacity of absorbing the life force of another being into oneself and utilize to prolong one's longevity or the longevity of others, should the life be pushed into another individual. One with this ability will also heal semi-automatically, and can force themselves to heal fully, depending on the life force they have stored.

[jimfromsales]

Free will (Steve imagine)

Hey all!  This is a prompt from the lovely @these-midnight-memories, she asked if I could write one about helping Steve break the prisoners out of Tony’s prison.  Finally got around to it!!! And again, thank you to @nymphadora-blurryface, @thepotatopuff, @elvencantation and @purplekitten30 for giving me the strength :D  I actually love this one, I hope you guys do too, and let me know what you think!

Also, @evansfanficweekly, does my story qualify?  I think it does, but let me know :)  There is a link to this post in my Masterlist in my bio.

Word count:  2158 (sorry not sorry)

Warnings: None, as always :)

Breathe, I remind myself.  I can’t get scared.  If I get scared, I’ll make a mistake and then they’ll catch me again.  Emphasis on again.  My bones still ache from my desperate leap out of the moving van the first time I was captured.  They put me in a different car after that, away from everyone else.  I had hoped that they would, it gave me cover to switch places with my guard.

    That’s right, guard.  Singular.  Even after I jumped out of a moving vehicle, they still thought I wasn’t a threat.  I think that when they phoned Tony to ask him what to do with the crazy blonde, he told them I could just go in a different car because “I wasn’t the kind of person to try to escape twice.”  I appreciated that, I really did.  It just makes this all the more difficult.  

    I straighten my uniform, suck in a big gulp of oxygen, and turn the corner into the hollow corridor.  I have to move fast before I involve too many people in this.

I’m hoping that some of them won’t recognize my face, and that the other ones will be smart enough to not clearly remember where they know me from.

One woman passes me, her eyes set dead ahead.  I watch her from out of the corner of my eye, my body tingling with dread and anticipation as I wait.  When her eyes flicker to me for a split second, I do it.  Her eyes glaze as I take control over her and telepathically command her to lead me to the prisoners.  She turns on her heel and I follow her as far down as her level of entry allows.  Then I send her to get me a coffee and find someone to take me down to the next level, and so on.

The whole process takes about two hours, and once I am at the bottom I’ve got four coffees in hand.

Setting them down, I pull out my emergency sleeping pills (which tend to come in very handy in a number of emergencies, including and not limited to:  knocking out Spiderman while he’s panting on the ground with his mouth wide open, knocking out Bucky when he’s freaking out, and knocking out Tony when he’s being annoying.)

I slip a pill into each of the cups, closing the lids carefully over them afterwards. I wouldn’t want to spill any of my “special” coffee.

Steeling my courage, I thump four coffee cups down on four desks.  I wait to see if they’re going to drink them on their own, and to my relief, three of them do.

With a shaky breath, I turn to face the fourth person.  They hold a hand up to me as their other writes furiously on a piece of paper.  I wait for them to finish.  Once they’ve completed the note, they turn to face me, picking up their coffee and taking a sip as they do.  I exhale in relief.

“What?” They ask, a hint of annoyance in their tone.

“Nothing.  Just let me know if you need anything.”  I turn to exit the room and run right into Tony Stark.

He looks as surprised to see me as I am to see him, but I’m sure my heart sinks more.  I’m done for.  I refuse to use my power on Tony, absolutely refuse.  Even if we’re fighting for different sides, I can’t.

My power is mind control.  I hate it.  A different person might consider it a gift, but not me.  The thing about controlling someone else’s mind is that all that cool stuff that happens when they obey your every order doesn’t seem so cool when you have to watch the free will vanish from their eyes when you do it.  It’s why I use it as minimally as possible, and never on my friends.

Tony stares at me for a minute, both of us contemplating what we’re going to do. My only option is engaging him in hand to hand combat, but I don’t feel confident in my ability to win.

He snaps from his frozen pose and the man behind him, I assume his bodyguard, steps into the room, locking the door behind them.

“Who is this?” The man asks, addressing the whole room.

Only the man who drank his coffee last responds, and he only mumbles something incoherent.

Tony watches me, a suspicious glint in his eye.  I sneak him a pleading look.

“She’s an old friend,” Tony says, glaring at me as he speaks.  He brushes past me, walking into the prison, and though the doors close behind him, I can hear him apologizing to the captives (albeit in a rather shift-the-blame-off-myself manner).

I wait, unsure whether I should leave now or continue with my plan. 

Tony comes out again a minute later and gives me a slight smile.  “Let’s go,” he says to his companion.  They exit together, Tony picking up his pace as he notices the barely conscious guards slowly drooping in their seats.

Thank you Tony, I think.

No problem, he returns.

I step into the brightly lit room as the last guard’s head hits their desk, and look around.  Everyone- all my friends- are locked in separate cells.

No one looks up when the door opens, but when my footsteps echo on the floor, Clint raises his eyes to meet mine.

“Sarah,” he says softly, his face lighting up.

“How do I get you out of these?” I ask urgently.  The others take notice of my existence as I speak, and each one presses themselves to the glass to say hello.

Clinton nods towards the keypads glued to the front of each cell door.  “Those need to be decoded or have a fingerprint put on them.”

“Okay.”  I go back into the room with the guards and drag one back to Clint.  I’m hoping that I can use their fingerprint to unlock the cells.

Just as I press their thumb to the keypad, a siren begins blaring and the lights go out, leaving only the red security beams on for light.

“Sarah, get out of here,” Sam says, and the others nod in agreement.

I shake my head and am about to respond when I hear movement on the other side of the door.  My heart rate elevates and I silently press myself against the wall closest to the door.

The door slides open and a man steps into the room.  Before he has time to react, I slam into him with all my might, which isn’t much, but should at least knock him off balance.  He yells and grabs me, pinning me down with one arm.  

“Stop you guys!”  Sam’s voice freezes the man’s arm, which is about to slam down on me, and gives me the chance to head-butt the stranger to try and get away.

“Ow!”  His head is much thicker than I anticipated.

“Sarah?”  A familiar voice comes from the man.

“Steve?”  It is him.  He grabs me and wraps me in a big hug.  

“Sarah, you okay?  What’re you trying to beat me up for?”

I laugh.  “Sorry.  You okay?”

He grins and pulls me back to look at me.  “Are you kidding?  You’re practically a stick!”

He looks around at everyone else.  “Sorry you all got caught.  I’m gonna get you out, don’t worry.”  He pauses.  “Who’s this guy?”  He asks, pointing at a slightly dazed looking man in the cell next to Wanda.

“He’s the one I hypnotized into believing that I was the guard and he was the prisoner,” I admit sheepishly.

“That’s amazing!”  Steve laughs.  He turns to Sam.  “Hey man.”

“Hey man, what’s up?”

“Hopefully you soon.”

Sam grins at Steve.  “You got a plan to get us out of here?”

Steve glances at me.  “Did you have any ideas?”

I shake my head.  “Nothing besides dragging the security over here to check if any of their fingerprints could unlock the cells.  But an alarm went off right after I tried the first one.  Was that from you or from me?”

“Me.  Sorry.  Good idea though, let’s see if any of them work.”

Steve presses the limp guard’s thumb to every keypad and one of them unlocks.  Antman’s cell.  Which is great, except that Antman is fairly useless without his suit.

“Okay, so every cell is activated by a different fingerprint.  Let’s get to it.”

It takes two minutes to get everyone out; all four guards had the fingerprint to someone’s cell.  It wouldn’t have taken as long except that after Steve called me a stick I wouldn’t let him help me carry the person I was struggling with.    The only person left in a cell at the end was the man who I had hypnotized, and I wrote a note on his cell to alert the next person that came down here that he wasn’t actually one of us.    The six of us make our way up the stairs, Wanda in the front - she can do mind control too- and me in the back.  Steve gives me a wry smile.    “I know you don’t like controlling people, Sarah, but we sure do appreciate it.”    “I know,” I say, mustering up a fake smile back.    To her credit, Wanda takes care of all the people we run into the whole way up.  At least, until we reach the top.    There are two helicopters positioned on the roof for us to get into, creating a blizzard of wind as their propellers spin.    Steve gestures towards them and yells for us to run.    Wanda darts off first, followed by Clint and Antman.  The first helicopter takes off.    Sam sprints towards the other one and jumps in.  My pulse races as I leg it for the helicopter.  I reach the door as I hear the sound of a gun being cocked behind me.

I freeze, and then slowly turn around to see a man standing about ten feet away from Steve, pointing a gun at his forehead.

“Sarah,” Steve says quietly, keeping his eyes locked on the man in front of him.

My hands begin to tremble.  The man yells for all of us to freeze, to get out of the helicopter and freeze.  My jaw clenches shut and I feel something shifting inside of me.  Wanda is gone in the other helicopter, so it’s up to me to stop this.

I take a step towards Steve and the man.  “Freeze!”  He yells angrily, his finger twitching on the trigger as he speaks.

“Put the gun down.”  It is not a request.

“Step back!” He screams at me.

“Put the gun down.”  Steve is watching me, a nervous look beginning to dawn in his eye.

“If you don’t step back, I’m gonna shoot him!”  The man’s eyes are wild, his expression one of panic.  He’s going to be in huge trouble over our escape, he’s going to be fired, he’s going to-

He’s going to shoot my friend.

In one motion I rip through his mind, his scream of pain falling on deaf ears as as the words I’m gonna shoot him ring through my head.

It has only been a few seconds, but it feels like an eternity has gone by when Steve’s voice cuts through my rage.

“Sarah, stop!”

The man has pressed the gun to his own neck and is looking at his possessed hand fearfully.

I do not move my position, but Steve does.

He picks me up and carries me to the helicopter, buckling me in and making a protective sandwich around me using himself and Sam.

“Let’s go!” He yells to the pilot, who nods and immediately lifts us off the ground. I watch the man, gun pressed to his throat, until finally the rage holding me together snaps and he drops the gun and collapses onto the tarmac below.  I didn’t make him pull the trigger.

Steve and Sam both press themselves into me as my whole body begins to tremble.

“Hey, you got us out of there, we’re safe now.”  Steve’s words break through my shock and I begin to cry out of sheer exhaust.

“I almost killed someone, Steve.”  I manage to say through my tears.

He nods. “But you didn’t, even though you had every opportunity to.”

I suck in a deep breath, and he leans forward to look me in the eyes.  “Sarah, you didn’t kill anyone.  Not only did you not kill anyone, you used your power to safely rescue the team without hurting anyone with your power.  And you used your power to help us even though you feel terrible when you use it.  So please don’t feel guilty about something you didn’t do.”

I nod slowly and whisper “okay.”  My heart rate begins to slow, my breathing becomes even.  Steve bundles me into him, and I slowly drift off to sleep, tucked in between two of the people that I love the most.

[brajeshupadhyay]

It's 8 pm. The streets of Chennai are dead. The checkpoints have multiplied for this 12-day lockdown, so have the cops on the street. Every vehicle is being stopped, scanned, questioned. Near the Rajiv Gandhi Government General Hospital (RGGGH), one of the four main facilitates which is treating COVID-19 patients in Chennai, this reporter saw an MTC bus leaving with a few healthcare workers. All of them looked like they were about to pass out. As we parked next to the canteen, this reporter spotted a doctor in blue scrubs and a green mask, walking with her head bowed down. In 2017, this reporter had interviewed a bunch of newly-christened ‘doctors’ at this very spot. Three of them had animatedly spoken about throwing themselves headlong into the profession, in spite of the various drawbacks. Opposite the parkin, a board read: new PG Hostel. Wonder how many of the 42 PG doctors from Madras Medical College, who had tested positive for COVID-19 almost two weeks ago, stayed there. Meanwhile, the reporter's friend’s cousin got out of the car and was waiting to catch a glimpse of her husband, who had tested positive a few days ago. He had almost recovered from fever when he experienced a bout of breathlessness and had to be rushed back to the facility. Since he has been at the COVID facility inside the RGGGH campus. She was bringing him a change of clothes, some medicines and was seeing him for the first time since he was admitted at the facility. They exchanged a few nervous words, as my friend and I tried to look away. The COVID Outpatient Block is two towers away from where we stood in Tower 1. These towers have a raised entrance, which makes the reception visible from the road, as well. As we started driving past the campus, I looked at the bright lights coming from the tower. Nothing poetic came to my mind but the dead silence, which is unusual to the hospital because usually it is bustling owing to Chennai Central Railway Station which is located right across the road. The jarring lights coming from the COVID Outpatient Blocks, only added to the general uneasiness that one had started to feel in Chennai. Rajiv Gandhi Government General Hospital in Chennai The COVID-19 Outpatients Block at the RGGG Hospital is built like a wedding hall. It has huge steps leading up to a hall-like reception. On either side are ramps. Ambulances stop at the right corner, from where patients can be wheeled in. Before you enter, there is an assistance kiosk outside labelled ‘May I Help You’. Those entering were made to sanitise their hands at the kiosk. The healthcare workers, manning the kiosk, also answer questions if you are confused. This kiosk though is not manned at all times. While we were there, a few people had to look around for help. Diagonally opposite the kiosk is a space to wash hands. Inside the hall, there are rows of chairs, all placed at a distance of 4-5 feet, facing a reception area. Patients have to wait their turn to make their entry at the reception, following which doctors on duty will assess the patients. Some have attendees helping them, while most of them are there by themselves. There are huge windows on either side of the entrance. This is where the family and friends of those who’ve gone inside are waiting. Pushpa, a resident of Thideer Nagar in Besant Nagar, was here with her husband K*, who was diagnosed with blood cancer in September 2019. He was just about to commence radiation therapy at Cancer Institute in Adyar when another patient at the institute was tested positive for COVID-19. Since April, as many as seven patients and three healthcare workers from the institute had tested positive. All the patients from that ward were told to test themselves for COVID 19 before seeking further therapy. K’s first test was negative but a second test confirmed their worst fears. After this, K was advised to seek help from RGGGH. "Now, they have said even though he is not showing any symptoms, he will be taken to an isolation ward for 14 days as he is a cancer patient," said his brother Suresh. Pushpa is worried that postponing radiation therapy will adversely impact K. "We already pushed it by three months. Now I am not sure when we can actually get to it," she said. As Pushpa continues to tell her story while waiting for the ambulance which would take K to the isolation facility, a doctor in a blue PPE darts out, a nurse in a green PPE at her heels, signalling for a stretcher. "Why isn’t it here yet, it's been half an hour," the doctor asked the nurse. “No ma’am, I’ll get it, just a moment," the nurse said before signalling furiously to a group of healthcare workers standing 100 meters away, next to a few stretchers. Two of them, with a face mask and no PPE, hauled it across the ramp, while the doctor looked around, clicking her feet. While waiting for the stretcher, the doctor glanced over to this reporter, and almost as if reading the reporter's mind she quickly looked away before there was a question. It was almost a telepathic no. Close to a month of tailing healthcare workers on COVID duty across the state will teach you to steer clear of them when they were working. Interrupting the nurses or the doctors on duty inside the OP was out of the question. "You need to understand that everybody is in a lot of tension. There is a lot of work. Just during my eight-hour shift, more than 600 people trickle in," said Palanisamy*, a contract worker from Korukpet, who was overseeing security arrangements outside the OP. "It wasn’t so much in the beginning, but now it is 24/7. This place doesn’t sleep anymore,” he added, explaining that asymptomatic patients from RGGGH were sent to facilities outside, whereas those with moderate to severe symptoms were housed within the hospital. "People are scared. Look at his face, can’t you see panic in it," he remarked, pointing at a middle-aged man who walked past us. “There is no reason to panic, we are very much in control. The uncertainty is going to be there because we don’t know how this pandemic will turn out but that doesn’t mean one should panic,” Dr K Narayansamy, Director of the Hepatology Department at MMC, said. He was recently appointed the Dean of MMC and Rajiv Gandhi Government General Hospital after the former Dean Dr R Jayanthi went on leave until further notice. MMC and RGGGH have been through choppy waters in the past few months, with many doctors, PGs, nurses and healthcare workers testing positive for COVID-19. It seemed a little ironic to be sitting inside a building with a possibly high viral load but being told that RGGGH is dealing with the pandemic head-on, minus the panic. Asking about F's experience, a COVID-19 positive patient who had told this reporter that he was turned away from RGGGH when he had shown up there with his results. F had said that he was denied admission due to lack of beds in the hospital. Dr Narayanswamy says that it must have been a misunderstanding. "We’ve close to 1,000 beds, half of them equipped with oxygen supply. We are constantly upping our capacity, there is no way anybody would have said there are no beds," Narayanswamy said, explaining that doctors make an assessment of patients in the OP block. If a person shows moderate to severe symptoms, they are admitted to the COVID care unit. If they don’t, they are sent to isolation wards outside RGGGH for observation. "This is how we ensure that facilities are available to those who are in actual need, without burning it all out," added Narayanswamy. Eventually, F was admitted to RGGGH and is at the moment, stable. F said he is happy with the facilities now and feels that he is well taken care of. Whether or not his problem was a wrong assessment of the patient’s symptoms or if the patient had misunderstood the doctor, what was told to him doesn’t seem easy to figure out. This problem though has been mentioned by many doctors on duty. Some of them, across several districts in Tamil Nadu, said that they assess ILI (Influenza-Like Illness) symptoms in patients and to ensure that the system isn’t overburdened, admit those who absolutely need hospital care. If not, they are told to rest and recover at home. A few patients are also not very forthcoming which hinders the process further. But since the decision largely rests on discretion, as there are no guidelines set in stone, there is room for error. *** Kilpauk Medical College Hospital, Chennai The waiting area outside the COVID OP Block in Kilpauk Medical College Hospital (KMCH) was an open space, like a sit out in a park. It had an enclosure on top but was open otherwise. Ambulances were lining up right in front of the waiting area, from where patients were being taken into the OP. The ones waiting their turn had worry written all over their faces. Approaching a young woman seated alone, the reporter asked her in Tamil, "Neenga positive patient ah (Have you been tested positive)?" She first shook her head and then nodded. She introduced herself as C* from Nepal. The reporter switched to Hindi and asked her if she wanted to speak to her. She said yes, and pulled out a piece of paper from her bag. She pointed to the section which said ‘POSITIVE’. "I don’t know where they are going to take me," she said. C has been living with her son in Chennai for more than a year now. The lockdown had been a drag as she was out of work. But she had managed until she developed a fever a few days prior. Though her fever subsided, she tested positive for COVID-19. So, she packed up, told her son to stay home and set out for Kilpauk Medical Hospital. “What will they do now, how long will I have to wait here?” she asked. She had two young teens to keep her company. Their uncle, who was on dialysis, had tested positive for COVID-19. "He is in there, getting it done. They usually do it on the arm, but this time they are going through his neck,” one of them said explaining the process of dialysis. Two rows away, an individual who was waiting his turn, spat onto his side. Everybody looked, a few hissed. Twenty-four hours later, C had been allotted a room at a COVID isolation facility in Pulianthope. She was first lodged at a facility within KMCH, and then the next day transferred. It has been three days and she seems okay. The problem that patients seem to face at government facilities is only at the beginning. Stricken by panic in the beginning, most patients are confused and need reassuring. Healthcare workers, however, seem overworked and not in a position to do so. *** Government Order 174 issued by the former health secretary Beela Rajesh, dated April 3 of 2020 reads: “1. In the G.O. read above, the Government has notified the list of designated Government Hospitals for treatment of COVID-19 patients. Further, treatment for COVID-19 is being offered in all Government Medical College Hospitals, District Head Quarters Hospitals and Key Sub-District Hospitals completely free of cost. 2. It has been brought to the notice of the Government that certain patients/public desire to have treatment for COVID-19 in Private Hospitals also. 3. Considering the spread of CoronaVirus Disease (COVID-19) in the State, the Government have decided to include the Private Hospitals in the State for treatment to COVID-19 patients to prevent the spread of this communicable disease. 4. Accordingly, the willing patients are hereby informed that they may approach the Private Hospitals listed in the Annexure to this order to receive treatment for COVID-19, at their own cost. The hospitals are directed to follow the treatment protocol prescribed by the Government of India from time to time.” Of the 22 hospitals listed on this Government Order, the number of private players catering to COVID-19 patients in and around Chennai has increased to 45 in a period of two months. Yet, there is uncertainty regarding the functioning of these hospitals. First, a few videos emerged saying that these hospitals are charging exorbitant and unaffordable rates. This was followed by another government order, which capped the price for private hospitals. For non-critical cases, the cost was to be capped at Rs 5,000 per day. For critical cases, the cost was fixed at Rs 10,000 to Rs 15,000 depending on whether the patient required ICU and ventilator facility. Another video by a news anchor and television actor S Varadharajen went viral, where he claimed that a friend of his, who had severe breathing problems and fever, was unable to secure a bed for himself at either a government or a private hospital. Health Minister Vijay Bhasker immediately got into a damage control mode and announced his team was making all efforts to ensure that facilities are adequate. "There are 75,000 beds in Tamil Nadu and 5,000 in Chennai alone," he announced a day after the video went viral. Provisions of IPC, the Epidemic Diseases Act and the Disaster Management Act were invoked against Varadharajen for the offence of ‘falsifying information to create panic.’ Two weeks since and all the damage control later, the feeling of panic in Chennai is far from gone. A flurry of transfers, including that of the health secretary hasn’t helped matters. '‘Mismanagement' is the word on the street and the rumour mills have become difficult to track. It's mostly hearsay as very few "go on record" to say anything. The fear among doctors and bureaucrats keeps them from speaking out aloud. But statements by those leading the state are hard to miss. For instance, chief minister E Palaniswami’s transition from "our positive cases will be zero in a few days" to "God alone knows when this will end." "Strong leadership and a clear line of command is crucial to managing any public health emergency. When people are clueless as to who to turn to for a decision, you know there is a problem," said Dr Aiswarya Rao, public health consultant and former joint director of Tamil Nadu State Aids Control Society (TANSACS). In April, there were multiple teams comprising bureaucrats who were put in charge of managing the situation. Then came the appointment of another committee. There was also the health secretary who was issuing directions on one side, while the ministers did their own thing. This is pretty much how April and May went by for Chennai. Even after the appointment of Dr J Radhakrishnan, who has managed to control multiple crises in Tamil Nadu, this crisis seemed all over the place. His reinstatement as health secretary seems to have given many within the department hope. What about frontline workers in Chennai? The basic fear, reiterated both private and government healthcare workers, doctors, nurses and technicians, is the fear of exposure. April witnessed many protests by government doctors and nurses in Chennai, demanding basic preventive protective equipment and post-duty quarantine facilities, after a bunch of them tested positive at RGGGH. In a few weeks, healthcare workers at Government Stanley Medical Hospital tested positive. While government doctors have to work irrespective of fear of exposure, the same isn’t the case with private practitioners. Many private establishments have sought help from the government stating that they are not able to take on the costs required to operate a COVID-19 facility. Sanitary workers organised a strike this week after one of them died following exposure to COVID-19 positive patients. While the government has been saying that it is meeting these demands, how the government hopes to sustain meeting these demands remain unknown. So does the expenditure over COVID-19 so far. During his interaction with Prime Minister Narendra Modi, Palaniswami sought a grant of Rs 9,000 crore and a sanction of Rs 3,000 crore for medical equipment during a pandemic. An official statement by the chief minister also said that 2.75 crore triple-layer face masks, 38.85 lakh N-95 masks, 21 lakh PPE kits and 15.45 lakh RT-PCR testing kits have been ordered by the Tamil Nadu government. There is no official figure on how much the government has spent on personal protective equipment. The biggest challenge for the government continues to be how it will bring about some level of accountability from private hospitals in the middle of this pandemic, which doesn’t seem like will abate any time soon. Many non-COVID patients have spoken out about how cumbersome it has become to get private hospitals to cater to them, even under serious circumstances like deliveries. The norm at every private hospital since April has been that almost all procedures only after a COVID 19 clearance. Two months since the lockdown, yet private hospitals have not figured their way out, and that's worrisome. Many seem to be treading the safer path by staying away. But senior doctors say that media trying to put the entire blame on private hospitals is unfair. "The costs are high, the usual patient load less. We are doing what we can to keep the hospitals running with the bare minimum," said a private practitioner, "When will the government step in and help out?" Real situation at private hospitals listed as COVID-19 designated centres Firstpost looked at the Tamil Nadu live dashboard and spoke to all the 45 hospitals (four from Chengalpattu and Kanchipuram districts) listed under Chennai district. Of these 45, many of the hospitals are already operating at full capacity. Doctors at some of these hospitals said "that isn’t the case but don’t want to say anything further." In the case of some hospitals, authorities said there were no beds available anymore. Even though in some cases the live dashboard says the opposite. Some of them tailor their answers after asking a routine set of questions, which are common to all: How old is the patient? Are they obese? Do they have any existing conditions or co-morbidities? Do they’ve breathlessness? A positive answer to the fourth question brings forth this answer: “We are out of ventilators” or “Where are you at the moment? Okay, then go to the closest government facility, that would be the safest for you.” Here is a brief of what Firstpost found The Live Dashboard says these hospitals are running at full capacity: Apollo Hospital, Be Well Hospital, Bharathiraja Hospital, CSI Kalyani General Hospital, Dr Kamakshi Memorial Hospital, Dr Mehta’s Hospital, Fortis Malar Hospital, Kauvery Hospital, Lifeline Hospitals, Maya Nursing Home, Venkateshwara Hospital, Noble Hospital, Panimalar Hospital, Prashanth Hospital, MIOT Hospital, Medway Hospital. For other hospitals, the dashboard, as on 22 June (some updated on 21 June) say has 1,865 beds, 89 ICU beds and 71 ventilators. Here are the responses of the hospitals, when contacted regarding beds: Apollo Hospitals: No beds Sri Ramachandra Medical College Hospital, Porur: Dashboard says 184 beds are available, hospital authorities said there are no beds. Bharath Medical College: Dashboard shows as having 60 + 2 ICU beds. Authorities said that they aren’t admitting any patients as they don’t have the staff or the resources to handle the situation. Be Well Kilpauk: Asked if the patient has insurance. Then said beds are available, will quote fees only after consultation with the doctor. Chettinad Hospital: Dashboard says 161 empty beds at the hospital whereas the hospital authorities say that there are no beds available. Kanchi Kamakoti Child Trust Hospital: Facility available for children. Aysha Hospital: Will assess the patients and admit according to need. If oxygen is stable, patients can home quarantine and recover. Gleneagles Global Health City: Authorities said patient can come for a check up, cannot confirm if there is a bed. Mint Hospital: Said beds available at the cost of Rs 35,000 per day. Vijaya Hospital: No beds, if there is a discharge and a slot opens, can contact. Cost Rs 30,000 to 40,000 a day. With ventilator will cost Rs 70,000 a day. Tagore Medical College: Beds are available, costs are Rs 12000/day for asymptomatic patients, Rs 14000 with oxygen support, Rs 21000 if ventilator is used. Sundaram Medical College: Full, there are patients waiting in the ER. St Thomas Hospital: There are beds but they will decide after it's communicated how serious the patient is. SRM Medical College: Dashboard says 103 beds + 3 ICU beds is incorrect, they are running at full capacity. Sathya Sai Medical College: Not a super speciality, can only admit mild cases as they don’t have resources to take care of severe cases. Will cost Rs 15,000 to 20,000 a day. Balaji Hospital: Can only admit mild cases as ICU beds are full. SIMS hospital: Full, can’t admit. National Hospital: Overflowing, government hasn’t updated dashboard. Muthu Hospital: Beds are available, cost will be communicated after assessing the patient. Meenakshi Medical College: Not admitting private patients at the moment, only admitting patients from government hospitals. Karpaga Vinayaga Medical Science & Research Facility: Beds available; Rs 5,000/ day is the base amount, exclusive of oxygen support or investigation/scan charges. Melmaruvathur Aadhiparasakthi Medical College: Is a Trust Hospital, all charges will come up to Rs 10,000/day GLB Hospital: Beds available, will cost Rs 35,000/day Appasamy Hospital: 1 bed available, will cost Rs 23,000/day. *** J Radhakrishnan IAS, the newly reinstated health secretary says that the health department is pushing its limits to ensure that facilities are coping with the increase in numbers. “We are increasing beds in government hospitals for people who depend on us. Many non-COVID beds are lying vacant, as most aren’t coming for routine procedures, so we are constantly in the process of switching that dormant lot to our COVID bed strength. We’ve added 25 percent of those beds into COVID care,” he told Firstpost. The health department is also trying to create a call centre for access to private facilities, in addition to 104 services, so that they can cross monitor, Radhakrishnan explains. “We held an open meeting with private hospitals, and the estimate of beds with them is 5000. We are attempting to provide dynamic data of these beds, in order to facilitate a smoother process for COVID patients”, he adds. When I inform him that many of the hospitals aren’t admitting patients even if they have beds, he says, “Close to 170 hospitals are registered with us for treating patients. If they are not admitting COVID patients or even non-COVID cases, we will take action against them under the Clinical Establishments (Registration and Regulation) Act of 2010.” *Names withheld to protect the identities of COVID-19 patients

http://sansaartimes.blogspot.com/2020/06/scared-patients-overflowing-hospitals_23.html

[brajeshupadhyay]

Scared patients, overflowing hospitals and overworked doctors​: It's time Tamil Nadu govt got its act together in Chennai

It's 8 pm. The streets of Chennai are dead. The checkpoints have multiplied for this 12-day lockdown, so have the cops on the street. Every vehicle is being stopped, scanned, questioned.

Near the Rajiv Gandhi Government General Hospital (RGGGH), one of the four main facilitates which is treating COVID-19 patients in Chennai, this reporter saw an MTC bus leaving with a few healthcare workers. All of them looked like they were about to pass out. As we parked next to the canteen, this reporter spotted a doctor in blue scrubs and a green mask, walking with her head bowed down. In 2017, this reporter had interviewed a bunch of newly-christened ‘doctors’ at this very spot. Three of them had animatedly spoken about throwing themselves headlong into the profession, in spite of the various drawbacks.

Opposite the parkin, a board read: new PG Hostel. Wonder how many of the 42 PG doctors from Madras Medical College, who had tested positive for COVID-19 almost two weeks ago, stayed there.

Meanwhile, the reporter's friend’s cousin got out of the car and was waiting to catch a glimpse of her husband, who had tested positive a few days ago. He had almost recovered from fever when he experienced a bout of breathlessness and had to be rushed back to the facility. Since he has been at the COVID facility inside the RGGGH campus. She was bringing him a change of clothes, some medicines and was seeing him for the first time since he was admitted at the facility. They exchanged a few nervous words, as my friend and I tried to look away.

The COVID Outpatient Block is two towers away from where we stood in Tower 1. These towers have a raised entrance, which makes the reception visible from the road, as well. As we started driving past the campus, I looked at the bright lights coming from the tower. Nothing poetic came to my mind but the dead silence, which is unusual to the hospital because usually it is bustling owing to Chennai Central Railway Station which is located right across the road. The jarring lights coming from the COVID Outpatient Blocks, only added to the general uneasiness that one had started to feel in Chennai.

Rajiv Gandhi Government General Hospital in Chennai

The COVID-19 Outpatients Block at the RGGG Hospital is built like a wedding hall. It has huge steps leading up to a hall-like reception. On either side are ramps. Ambulances stop at the right corner, from where patients can be wheeled in. Before you enter, there is an assistance kiosk outside labelled ‘May I Help You’.

Those entering were made to sanitise their hands at the kiosk. The healthcare workers, manning the kiosk, also answer questions if you are confused. This kiosk though is not manned at all times. While we were there, a few people had to look around for help. Diagonally opposite the kiosk is a space to wash hands. Inside the hall, there are rows of chairs, all placed at a distance of 4-5 feet, facing a reception area. Patients have to wait their turn to make their entry at the reception, following which doctors on duty will assess the patients. Some have attendees helping them, while most of them are there by themselves.

There are huge windows on either side of the entrance. This is where the family and friends of those who’ve gone inside are waiting.

Pushpa, a resident of Thideer Nagar in Besant Nagar, was here with her husband K*, who was diagnosed with blood cancer in September 2019. He was just about to commence radiation therapy at Cancer Institute in Adyar when another patient at the institute was tested positive for COVID-19. Since April, as many as seven patients and three healthcare workers from the institute had tested positive.

All the patients from that ward were told to test themselves for COVID 19 before seeking further therapy. K’s first test was negative but a second test confirmed their worst fears. After this, K was advised to seek help from RGGGH.

"Now, they have said even though he is not showing any symptoms, he will be taken to an isolation ward for 14 days as he is a cancer patient," said his brother Suresh. Pushpa is worried that postponing radiation therapy will adversely impact K. "We already pushed it by three months. Now I am not sure when we can actually get to it," she said. As Pushpa continues to tell her story while waiting for the ambulance which would take K to the isolation facility, a doctor in a blue PPE darts out, a nurse in a green PPE at her heels, signalling for a stretcher.

"Why isn’t it here yet, it's been half an hour," the doctor asked the nurse. “No ma’am, I’ll get it, just a moment," the nurse said before signalling furiously to a group of healthcare workers standing 100 meters away, next to a few stretchers. Two of them, with a face mask and no PPE, hauled it across the ramp, while the doctor looked around, clicking her feet. While waiting for the stretcher, the doctor glanced over to this reporter, and almost as if reading the reporter's mind she quickly looked away before there was a question. It was almost a telepathic no.

Close to a month of tailing healthcare workers on COVID duty across the state will teach you to steer clear of them when they were working. Interrupting the nurses or the doctors on duty inside the OP was out of the question.

"You need to understand that everybody is in a lot of tension. There is a lot of work. Just during my eight-hour shift, more than 600 people trickle in," said Palanisamy*, a contract worker from Korukpet, who was overseeing security arrangements outside the OP. "It wasn’t so much in the beginning, but now it is 24/7. This place doesn’t sleep anymore,” he added, explaining that asymptomatic patients from RGGGH were sent to facilities outside, whereas those with moderate to severe symptoms were housed within the hospital. "People are scared. Look at his face, can’t you see panic in it," he remarked, pointing at a middle-aged man who walked past us.

“There is no reason to panic, we are very much in control. The uncertainty is going to be there because we don’t know how this pandemic will turn out but that doesn’t mean one should panic,” Dr K Narayansamy, Director of the Hepatology Department at MMC, said. He was recently appointed the Dean of MMC and Rajiv Gandhi Government General Hospital after the former Dean Dr R Jayanthi went on leave until further notice.

MMC and RGGGH have been through choppy waters in the past few months, with many doctors, PGs, nurses and healthcare workers testing positive for COVID-19. It seemed a little ironic to be sitting inside a building with a possibly high viral load but being told that RGGGH is dealing with the pandemic head-on, minus the panic.

Asking about F's experience, a COVID-19 positive patient who had told this reporter that he was turned away from RGGGH when he had shown up there with his results. F had said that he was denied admission due to lack of beds in the hospital. Dr Narayanswamy says that it must have been a misunderstanding. "We’ve close to 1,000 beds, half of them equipped with oxygen supply. We are constantly upping our capacity, there is no way anybody would have said there are no beds," Narayanswamy said, explaining that doctors make an assessment of patients in the OP block. If a person shows moderate to severe symptoms, they are admitted to the COVID care unit. If they don’t, they are sent to isolation wards outside RGGGH for observation. "This is how we ensure that facilities are available to those who are in actual need, without burning it all out," added Narayanswamy.

Eventually, F was admitted to RGGGH and is at the moment, stable. F said he is happy with the facilities now and feels that he is well taken care of.

Whether or not his problem was a wrong assessment of the patient’s symptoms or if the patient had misunderstood the doctor, what was told to him doesn’t seem easy to figure out. This problem though has been mentioned by many doctors on duty. Some of them, across several districts in Tamil Nadu, said that they assess ILI (Influenza-Like Illness) symptoms in patients and to ensure that the system isn’t overburdened, admit those who absolutely need hospital care. If not, they are told to rest and recover at home. A few patients are also not very forthcoming which hinders the process further. But since the decision largely rests on discretion, as there are no guidelines set in stone, there is room for error.

***

Kilpauk Medical College Hospital, Chennai

The waiting area outside the COVID OP Block in Kilpauk Medical College Hospital (KMCH) was an open space, like a sit out in a park. It had an enclosure on top but was open otherwise. Ambulances were lining up right in front of the waiting area, from where patients were being taken into the OP.

The ones waiting their turn had worry written all over their faces. Approaching a young woman seated alone, the reporter asked her in Tamil, "Neenga positive patient ah (Have you been tested positive)?" She first shook her head and then nodded. She introduced herself as C* from Nepal. The reporter switched to Hindi and asked her if she wanted to speak to her. She said yes, and pulled out a piece of paper from her bag. She pointed to the section which said ‘POSITIVE’. "I don’t know where they are going to take me," she said.

C has been living with her son in Chennai for more than a year now. The lockdown had been a drag as she was out of work. But she had managed until she developed a fever a few days prior. Though her fever subsided, she tested positive for COVID-19. So, she packed up, told her son to stay home and set out for Kilpauk Medical Hospital.

“What will they do now, how long will I have to wait here?” she asked. She had two young teens to keep her company. Their uncle, who was on dialysis, had tested positive for COVID-19. "He is in there, getting it done. They usually do it on the arm, but this time they are going through his neck,” one of them said explaining the process of dialysis. Two rows away, an individual who was waiting his turn, spat onto his side. Everybody looked, a few hissed.

Twenty-four hours later, C had been allotted a room at a COVID isolation facility in Pulianthope. She was first lodged at a facility within KMCH, and then the next day transferred. It has been three days and she seems okay.

The problem that patients seem to face at government facilities is only at the beginning. Stricken by panic in the beginning, most patients are confused and need reassuring. Healthcare workers, however, seem overworked and not in a position to do so.

***

Government Order 174 issued by the former health secretary Beela Rajesh, dated April 3 of 2020 reads:

“1. In the G.O. read above, the Government has notified the list of designated Government Hospitals for treatment of COVID-19 patients. Further, treatment for COVID-19 is being offered in all Government Medical College Hospitals, District Head Quarters Hospitals and Key Sub-District Hospitals completely free of cost.

2. It has been brought to the notice of the Government that certain patients/public desire to have treatment for COVID-19 in Private Hospitals also.

3. Considering the spread of CoronaVirus Disease (COVID-19) in the State, the Government have decided to include the Private Hospitals in the State for treatment to COVID-19 patients to prevent the spread of this communicable disease.

4. Accordingly, the willing patients are hereby informed that they may approach the Private Hospitals listed in the Annexure to this order to receive treatment for COVID-19, at their own cost. The hospitals are directed to follow the treatment protocol prescribed by the Government of India from time to time.”

Of the 22 hospitals listed on this Government Order, the number of private players catering to COVID-19 patients in and around Chennai has increased to 45 in a period of two months. Yet, there is uncertainty regarding the functioning of these hospitals.

First, a few videos emerged saying that these hospitals are charging exorbitant and unaffordable rates. This was followed by another government order, which capped the price for private hospitals. For non-critical cases, the cost was to be capped at Rs 5,000 per day. For critical cases, the cost was fixed at Rs 10,000 to Rs 15,000 depending on whether the patient required ICU and ventilator facility.

Another video by a news anchor and television actor S Varadharajen went viral, where he claimed that a friend of his, who had severe breathing problems and fever, was unable to secure a bed for himself at either a government or a private hospital. Health Minister Vijay Bhasker immediately got into a damage control mode and announced his team was making all efforts to ensure that facilities are adequate. "There are 75,000 beds in Tamil Nadu and 5,000 in Chennai alone," he announced a day after the video went viral. Provisions of IPC, the Epidemic Diseases Act and the Disaster Management Act were invoked against Varadharajen for the offence of ‘falsifying information to create panic.’

Two weeks since and all the damage control later, the feeling of panic in Chennai is far from gone. A flurry of transfers, including that of the health secretary hasn’t helped matters. '‘Mismanagement' is the word on the street and the rumour mills have become difficult to track. It's mostly hearsay as very few "go on record" to say anything. The fear among doctors and bureaucrats keeps them from speaking out aloud. But statements by those leading the state are hard to miss. For instance, chief minister E Palaniswami’s transition from "our positive cases will be zero in a few days" to "God alone knows when this will end."

"Strong leadership and a clear line of command is crucial to managing any public health emergency. When people are clueless as to who to turn to for a decision, you know there is a problem," said Dr Aiswarya Rao, public health consultant and former joint director of Tamil Nadu State Aids Control Society (TANSACS).

In April, there were multiple teams comprising bureaucrats who were put in charge of managing the situation. Then came the appointment of another committee. There was also the health secretary who was issuing directions on one side, while the ministers did their own thing. This is pretty much how April and May went by for Chennai. Even after the appointment of Dr J Radhakrishnan, who has managed to control multiple crises in Tamil Nadu, this crisis seemed all over the place. His reinstatement as health secretary seems to have given many within the department hope.

What about frontline workers in Chennai?

The basic fear, reiterated both private and government healthcare workers, doctors, nurses and technicians, is the fear of exposure. April witnessed many protests by government doctors and nurses in Chennai, demanding basic preventive protective equipment and post-duty quarantine facilities, after a bunch of them tested positive at RGGGH.

In a few weeks, healthcare workers at Government Stanley Medical Hospital tested positive. While government doctors have to work irrespective of fear of exposure, the same isn’t the case with private practitioners. Many private establishments have sought help from the government stating that they are not able to take on the costs required to operate a COVID-19 facility. Sanitary workers organised a strike this week after one of them died following exposure to COVID-19 positive patients.

While the government has been saying that it is meeting these demands, how the government hopes to sustain meeting these demands remain unknown. So does the expenditure over COVID-19 so far.

During his interaction with Prime Minister Narendra Modi, Palaniswami sought a grant of Rs 9,000 crore and a sanction of Rs 3,000 crore for medical equipment during a pandemic. An official statement by the chief minister also said that 2.75 crore triple-layer face masks, 38.85 lakh N-95 masks, 21 lakh PPE kits and 15.45 lakh RT-PCR testing kits have been ordered by the Tamil Nadu government. There is no official figure on how much the government has spent on personal protective equipment.

The biggest challenge for the government continues to be how it will bring about some level of accountability from private hospitals in the middle of this pandemic, which doesn’t seem like will abate any time soon.

Many non-COVID patients have spoken out about how cumbersome it has become to get private hospitals to cater to them, even under serious circumstances like deliveries. The norm at every private hospital since April has been that almost all procedures only after a COVID 19 clearance. Two months since the lockdown, yet private hospitals have not figured their way out, and that's worrisome.

Many seem to be treading the safer path by staying away. But senior doctors say that media trying to put the entire blame on private hospitals is unfair. "The costs are high, the usual patient load less. We are doing what we can to keep the hospitals running with the bare minimum," said a private practitioner, "When will the government step in and help out?"

Real situation at private hospitals listed as COVID-19 designated centres

Firstpost looked at the Tamil Nadu live dashboard and spoke to all the 45 hospitals (four from Chengalpattu and Kanchipuram districts) listed under Chennai district.

Of these 45, many of the hospitals are already operating at full capacity. Doctors at some of these hospitals said "that isn’t the case but don’t want to say anything further." In the case of some hospitals, authorities said there were no beds available anymore. Even though in some cases the live dashboard says the opposite. Some of them tailor their answers after asking a routine set of questions, which are common to all:

How old is the patient? Are they obese? Do they have any existing conditions or co-morbidities? Do they’ve breathlessness?

A positive answer to the fourth question brings forth this answer: “We are out of ventilators” or “Where are you at the moment? Okay, then go to the closest government facility, that would be the safest for you.”

Here is a brief of what Firstpost found

The Live Dashboard says these hospitals are running at full capacity: Apollo Hospital, Be Well Hospital, Bharathiraja Hospital, CSI Kalyani General Hospital, Dr Kamakshi Memorial Hospital, Dr Mehta’s Hospital, Fortis Malar Hospital, Kauvery Hospital, Lifeline Hospitals, Maya Nursing Home, Venkateshwara Hospital, Noble Hospital, Panimalar Hospital, Prashanth Hospital, MIOT Hospital, Medway Hospital.

For other hospitals, the dashboard, as on 22 June (some updated on 21 June) say has 1,865 beds, 89 ICU beds and 71 ventilators. Here are the responses of the hospitals, when contacted regarding beds:

Apollo Hospitals: No beds

Sri Ramachandra Medical College Hospital, Porur: Dashboard says 184 beds are available, hospital authorities said there are no beds.

Bharath Medical College: Dashboard shows as having 60 + 2 ICU beds. Authorities said that they aren’t admitting any patients as they don’t have the staff or the resources to handle the situation.

Be Well Kilpauk: Asked if the patient has insurance. Then said beds are available, will quote fees only after consultation with the doctor.

Chettinad Hospital: Dashboard says 161 empty beds at the hospital whereas the hospital authorities say that there are no beds available.

Kanchi Kamakoti Child Trust Hospital: Facility available for children.

Aysha Hospital: Will assess the patients and admit according to need. If oxygen is stable, patients can home quarantine and recover.

Gleneagles Global Health City: Authorities said patient can come for a check up, cannot confirm if there is a bed.

Mint Hospital: Said beds available at the cost of Rs 35,000 per day.

Vijaya Hospital: No beds, if there is a discharge and a slot opens, can contact. Cost Rs 30,000 to 40,000 a day. With ventilator will cost Rs 70,000 a day.

Tagore Medical College: Beds are available, costs are Rs 12000/day for asymptomatic patients, Rs 14000 with oxygen support, Rs 21000 if ventilator is used.

Sundaram Medical College: Full, there are patients waiting in the ER.

St Thomas Hospital: There are beds but they will decide after it's communicated how serious the patient is.

SRM Medical College: Dashboard says 103 beds + 3 ICU beds is incorrect, they are running at full capacity.

Sathya Sai Medical College: Not a super speciality, can only admit mild cases as they don’t have resources to take care of severe cases. Will cost Rs 15,000 to 20,000 a day.

Balaji Hospital: Can only admit mild cases as ICU beds are full.

SIMS hospital: Full, can’t admit.

National Hospital: Overflowing, government hasn’t updated dashboard.

Muthu Hospital: Beds are available, cost will be communicated after assessing the patient.

Meenakshi Medical College: Not admitting private patients at the moment, only admitting patients from government hospitals.

Karpaga Vinayaga Medical Science & Research Facility: Beds available; Rs 5,000/ day is the base amount, exclusive of oxygen support or investigation/scan charges.

Melmaruvathur Aadhiparasakthi Medical College: Is a Trust Hospital, all charges will come up to Rs 10,000/day

GLB Hospital: Beds available, will cost Rs 35,000/day

Appasamy Hospital: 1 bed available, will cost Rs 23,000/day.

***

J Radhakrishnan IAS, the newly reinstated health secretary says that the health department is pushing its limits to ensure that facilities are coping with the increase in numbers. “We are increasing beds in government hospitals for people who depend on us. Many non-COVID beds are lying vacant, as most aren’t coming for routine procedures, so we are constantly in the process of switching that dormant lot to our COVID bed strength. We’ve added 25 percent of those beds into COVID care,” he told Firstpost.

The health department is also trying to create a call centre for access to private facilities, in addition to 104 services, so that they can cross monitor, Radhakrishnan explains.

“We held an open meeting with private hospitals, and the estimate of beds with them is 5000. We are attempting to provide dynamic data of these beds, in order to facilitate a smoother process for COVID patients”, he adds. When I inform him that many of the hospitals aren’t admitting patients even if they have beds, he says, “Close to 170 hospitals are registered with us for treating patients. If they are not admitting COVID patients or even non-COVID cases, we will take action against them under the Clinical Establishments (Registration and Regulation) Act of 2010.”

*Names withheld to protect the identities of COVID-19 patients

via Blogger https://ift.tt/3dlGnMp

[brajeshupadhyay]

Scared patients, overflowing hospitals and overworked doctors​: Time Tamil Nadu govt got its act together in Chennai

It's 8 pm. The streets of Chennai are dead. The checkpoints have multiplied for this 12-day lockdown, so have the cops on the street. Every vehicle is being stopped, scanned, questioned.

Near the Rajiv Gandhi Government General Hospital (RGGGH), one of the four main facilitates which is treating COVID-19 patients in Chennai, this reporter saw an MTC bus leaving with a few healthcare workers. All of them looked like they were about to pass out. As we parked next to the canteen, this reporter spotted a doctor in blue scrubs and a green mask, walking with her head bowed down. In 2017, this reporter had interviewed a bunch of newly-christened ‘doctors’ at this very spot. Three of them had animatedly spoken about throwing themselves headlong into the profession, in spite of the various drawbacks.

Opposite the parkin, a board read: new PG Hostel. Wonder how many of the 42 PG doctors from Madras Medical College, who had tested positive for COVID-19 almost two weeks ago, stayed there.

Meanwhile, the reporter's friend’s cousin got out of the car and was waiting to catch a glimpse of her husband, who had tested positive a few days ago. He had almost recovered from fever when he experienced a bout of breathlessness and had to be rushed back to the facility. Since he has been at the COVID facility inside the RGGGH campus. She was bringing him a change of clothes, some medicines and was seeing him for the first time since he was admitted at the facility. They exchanged a few nervous words, as my friend and I tried to look away.

The COVID Outpatient Block is two towers away from where we stood in Tower 1. These towers have a raised entrance, which makes the reception visible from the road, as well. As we started driving past the campus, I looked at the bright lights coming from the tower. Nothing poetic came to my mind but the dead silence, which is unusual to the hospital because usually it is bustling owing to Chennai Central Railway Station which is located right across the road. The jarring lights coming from the COVID Outpatient Blocks, only added to the general uneasiness that one had started to feel in Chennai.

Rajiv Gandhi Government General Hospital in Chennai

The COVID-19 Outpatients Block at the RGGG Hospital is built like a wedding hall. It has huge steps leading up to a hall-like reception. On either side are ramps. Ambulances stop at the right corner, from where patients can be wheeled in. Before you enter, there is an assistance kiosk outside labelled ‘May I Help You’.

Those entering were made to sanitise their hands at the kiosk. The healthcare workers, manning the kiosk, also answer questions if you are confused. This kiosk though is not manned at all times. While we were there, a few people had to look around for help. Diagonally opposite the kiosk is a space to wash hands. Inside the hall, there are rows of chairs, all placed at a distance of 4-5 feet, facing a reception area. Patients have to wait their turn to make their entry at the reception, following which doctors on duty will assess the patients. Some have attendees helping them, while most of them are there by themselves.

There are huge windows on either side of the entrance. This is where the family and friends of those who’ve gone inside are waiting.

Pushpa, a resident of Thideer Nagar in Besant Nagar, was here with her husband K*, who was diagnosed with blood cancer in September 2019. He was just about to commence radiation therapy at Cancer Institute in Adyar when another patient at the institute was tested positive for COVID-19. Since April, as many as seven patients and three healthcare workers from the institute had tested positive.

All the patients from that ward were told to test themselves for COVID 19 before seeking further therapy. K’s first test was negative but a second test confirmed their worst fears. After this, K was advised to seek help from RGGGH.

"Now, they have said even though he is not showing any symptoms, he will be taken to an isolation ward for 14 days as he is a cancer patient," said his brother Suresh. Pushpa is worried that postponing radiation therapy will adversely impact K. "We already pushed it by three months. Now I am not sure when we can actually get to it," she said. As Pushpa continues to tell her story while waiting for the ambulance which would take K to the isolation facility, a doctor in a blue PPE darts out, a nurse in a green PPE at her heels, signalling for a stretcher.

"Why isn’t it here yet, it's been half an hour," the doctor asked the nurse. “No ma’am, I’ll get it, just a moment," the nurse said before signalling furiously to a group of healthcare workers standing 100 meters away, next to a few stretchers. Two of them, with a face mask and no PPE, hauled it across the ramp, while the doctor looked around, clicking her feet. While waiting for the stretcher, the doctor glanced over to this reporter, and almost as if reading the reporter's mind she quickly looked away before there was a question. It was almost a telepathic no.

Close to a month of tailing healthcare workers on COVID duty across the state will teach you to steer clear of them when they were working. Interrupting the nurses or the doctors on duty inside the OP was out of the question.

"You need to understand that everybody is in a lot of tension. There is a lot of work. Just during my eight-hour shift, more than 600 people trickle in," said Palanisamy*, a contract worker from Korukpet, who was overseeing security arrangements outside the OP. "It wasn’t so much in the beginning, but now it is 24/7. This place doesn’t sleep anymore,” he added, explaining that asymptomatic patients from RGGGH were sent to facilities outside, whereas those with moderate to severe symptoms were housed within the hospital. "People are scared. Look at his face, can’t you see panic in it," he remarked, pointing at a middle-aged man who walked past us.

“There is no reason to panic, we are very much in control. The uncertainty is going to be there because we don’t know how this pandemic will turn out but that doesn’t mean one should panic,” Dr K Narayansamy, Director of the Hepatology Department at MMC, said. He was recently appointed the Dean of MMC and Rajiv Gandhi Government General Hospital after the former Dean Dr R Jayanthi went on leave until further notice.

MMC and RGGGH have been through choppy waters in the past few months, with many doctors, PGs, nurses and healthcare workers testing positive for COVID-19. It seemed a little ironic to be sitting inside a building with a possibly high viral load but being told that RGGGH is dealing with the pandemic head-on, minus the panic.

Asking about F's experience, a COVID-19 positive patient who had told this reporter that he was turned away from RGGGH when he had shown up there with his results. F had said that he was denied admission due to lack of beds in the hospital. Dr Narayanswamy says that it must have been a misunderstanding. "We’ve close to 1,000 beds, half of them equipped with oxygen supply. We are constantly upping our capacity, there is no way anybody would have said there are no beds," Narayanswamy said, explaining that doctors make an assessment of patients in the OP block. If a person shows moderate to severe symptoms, they are admitted to the COVID care unit. If they don’t, they are sent to isolation wards outside RGGGH for observation. "This is how we ensure that facilities are available to those who are in actual need, without burning it all out," added Narayanswamy.

Eventually, F was admitted to RGGGH and is at the moment, stable. F said he is happy with the facilities now and feels that he is well taken care of.

Whether or not his problem was a wrong assessment of the patient’s symptoms or if the patient had misunderstood the doctor, what was told to him doesn’t seem easy to figure out. This problem though has been mentioned by many doctors on duty. Some of them, across several districts in Tamil Nadu, said that they assess ILI (Influenza-Like Illness) symptoms in patients and to ensure that the system isn’t overburdened, admit those who absolutely need hospital care. If not, they are told to rest and recover at home. A few patients are also not very forthcoming which hinders the process further. But since the decision largely rests on discretion, as there are no guidelines set in stone, there is room for error.

***

Kilpauk Medical College Hospital, Chennai

The waiting area outside the COVID OP Block in Kilpauk Medical College Hospital (KMCH) was an open space, like a sit out in a park. It had an enclosure on top but was open otherwise. Ambulances were lining up right in front of the waiting area, from where patients were being taken into the OP.

The ones waiting their turn had worry written all over their faces. Approaching a young woman seated alone, the reporter asked her in Tamil, "Neenga positive patient ah (Have you been tested positive)?" She first shook her head and then nodded. She introduced herself as C* from Nepal. The reporter switched to Hindi and asked her if she wanted to speak to her. She said yes, and pulled out a piece of paper from her bag. She pointed to the section which said ‘POSITIVE’. "I don’t know where they are going to take me," she said.

C has been living with her son in Chennai for more than a year now. The lockdown had been a drag as she was out of work. But she had managed until she developed a fever a few days prior. Though her fever subsided, she tested positive for COVID-19. So, she packed up, told her son to stay home and set out for Kilpauk Medical Hospital.

“What will they do now, how long will I have to wait here?” she asked. She had two young teens to keep her company. Their uncle, who was on dialysis, had tested positive for COVID-19. "He is in there, getting it done. They usually do it on the arm, but this time they are going through his neck,” one of them said explaining the process of dialysis. Two rows away, an individual who was waiting his turn, spat onto his side. Everybody looked, a few hissed.

Twenty-four hours later, C had been allotted a room at a COVID isolation facility in Pulianthope. She was first lodged at a facility within KMCH, and then the next day transferred. It has been three days and she seems okay.

The problem that patients seem to face at government facilities is only at the beginning. Stricken by panic in the beginning, most patients are confused and need reassuring. Healthcare workers, however, seem overworked and not in a position to do so.

***

Government Order 174 issued by the former health secretary Beela Rajesh, dated April 3 of 2020 reads:

“1. In the G.O. read above, the Government has notified the list of designated Government Hospitals for treatment of COVID-19 patients. Further, treatment for COVID-19 is being offered in all Government Medical College Hospitals, District Head Quarters Hospitals and Key Sub-District Hospitals completely free of cost.

2. It has been brought to the notice of the Government that certain patients/public desire to have treatment for COVID-19 in Private Hospitals also.

3. Considering the spread of CoronaVirus Disease (COVID-19) in the State, the Government have decided to include the Private Hospitals in the State for treatment to COVID-19 patients to prevent the spread of this communicable disease.

4. Accordingly, the willing patients are hereby informed that they may approach the Private Hospitals listed in the Annexure to this order to receive treatment for COVID-19, at their own cost. The hospitals are directed to follow the treatment protocol prescribed by the Government of India from time to time.”

Of the 22 hospitals listed on this Government Order, the number of private players catering to COVID-19 patients in and around Chennai has increased to 45 in a period of two months. Yet, there is uncertainty regarding the functioning of these hospitals.

First, a few videos emerged saying that these hospitals are charging exorbitant and unaffordable rates. This was followed by another government order, which capped the price for private hospitals. For non-critical cases, the cost was to be capped at Rs 5,000 per day. For critical cases, the cost was fixed at Rs 10,000 to Rs 15,000 depending on whether the patient required ICU and ventilator facility.

Another video by a news anchor and television actor S Varadharajen went viral, where he claimed that a friend of his, who had severe breathing problems and fever, was unable to secure a bed for himself at either a government or a private hospital. Health Minister Vijay Bhasker immediately got into a damage control mode and announced his team was making all efforts to ensure that facilities are adequate. "There are 75,000 beds in Tamil Nadu and 5,000 in Chennai alone," he announced a day after the video went viral. Provisions of IPC, the Epidemic Diseases Act and the Disaster Management Act were invoked against Varadharajen for the offence of ‘falsifying information to create panic.’

Two weeks since and all the damage control later, the feeling of panic in Chennai is far from gone. A flurry of transfers, including that of the health secretary hasn’t helped matters. '‘Mismanagement' is the word on the street and the rumour mills have become difficult to track. It's mostly hearsay as very few "go on record" to say anything. The fear among doctors and bureaucrats keeps them from speaking out aloud. But statements by those leading the state are hard to miss. For instance, chief minister E Palaniswami’s transition from "our positive cases will be zero in a few days" to "God alone knows when this will end."

"Strong leadership and a clear line of command is crucial to managing any public health emergency. When people are clueless as to who to turn to for a decision, you know there is a problem," said Dr Aiswarya Rao, public health consultant and former joint director of Tamil Nadu State Aids Control Society (TANSACS).

In April, there were multiple teams comprising bureaucrats who were put in charge of managing the situation. Then came the appointment of another committee. There was also the health secretary who was issuing directions on one side, while the ministers did their own thing. This is pretty much how April and May went by for Chennai. Even after the appointment of Dr J Radhakrishnan, who has managed to control multiple crises in Tamil Nadu, this crisis seemed all over the place. His reinstatement as health secretary seems to have given many within the department hope.

What about frontline workers in Chennai?

The basic fear, reiterated both private and government healthcare workers, doctors, nurses and technicians, is the fear of exposure. April witnessed many protests by government doctors and nurses in Chennai, demanding basic preventive protective equipment and post-duty quarantine facilities, after a bunch of them tested positive at RGGGH.

In a few weeks, healthcare workers at Government Stanley Medical Hospital tested positive. While government doctors have to work irrespective of fear of exposure, the same isn’t the case with private practitioners. Many private establishments have sought help from the government stating that they are not able to take on the costs required to operate a COVID-19 facility. Sanitary workers organised a strike this week after one of them died following exposure to COVID-19 positive patients.

While the government has been saying that it is meeting these demands, how the government hopes to sustain meeting these demands remain unknown. So does the expenditure over COVID-19 so far.

During his interaction with Prime Minister Narendra Modi, Palaniswami sought a grant of Rs 9,000 crore and a sanction of Rs 3,000 crore for medical equipment during a pandemic. An official statement by the chief minister also said that 2.75 crore triple-layer face masks, 38.85 lakh N-95 masks, 21 lakh PPE kits and 15.45 lakh RT-PCR testing kits have been ordered by the Tamil Nadu government. There is no official figure on how much the government has spent on personal protective equipment.

The biggest challenge for the government continues to be how it will bring about some level of accountability from private hospitals in the middle of this pandemic, which doesn’t seem like will abate any time soon.

Many non-COVID patients have spoken out about how cumbersome it has become to get private hospitals to cater to them, even under serious circumstances like deliveries. The norm at every private hospital since April has been that almost all procedures only after a COVID 19 clearance. Two months since the lockdown, yet private hospitals have not figured their way out, and that's worrisome.

Many seem to be treading the safer path by staying away. But senior doctors say that media trying to put the entire blame on private hospitals is unfair. "The costs are high, the usual patient load less. We are doing what we can to keep the hospitals running with the bare minimum," said a private practitioner, "When will the government step in and help out?"

Real situation at private hospitals listed as COVID-19 designated centres

Firstpost looked at the Tamil Nadu live dashboard and spoke to all the 45 hospitals (four from Chengalpattu and Kanchipuram districts) listed under Chennai district.

Of these 45, many of the hospitals are already operating at full capacity. Doctors at some of these hospitals said "that isn’t the case but don’t want to say anything further." In the case of some hospitals, authorities said there were no beds available anymore. Even though in some cases the live dashboard says the opposite. Some of them tailor their answers after asking a routine set of questions, which are common to all:

How old is the patient? Are they obese? Do they have any existing conditions or co-morbidities? Do they’ve breathlessness?

A positive answer to the fourth question brings forth this answer: “We are out of ventilators” or “Where are you at the moment? Okay, then go to the closest government facility, that would be the safest for you.”

Here is a brief of what Firstpost found

The Live Dashboard says these hospitals are running at full capacity: Apollo Hospital, Be Well Hospital, Bharathiraja Hospital, CSI Kalyani General Hospital, Dr Kamakshi Memorial Hospital, Dr Mehta’s Hospital, Fortis Malar Hospital, Kauvery Hospital, Lifeline Hospitals, Maya Nursing Home, Venkateshwara Hospital, Noble Hospital, Panimalar Hospital, Prashanth Hospital, MIOT Hospital, Medway Hospital.

For other hospitals, the dashboard, as on 22 June (some updated on 21 June) say has 1,865 beds, 89 ICU beds and 71 ventilators. Here are the responses of the hospitals, when contacted regarding beds:

Apollo Hospitals: No beds

Sri Ramachandra Medical College Hospital, Porur: Dashboard says 184 beds are available, hospital authorities said there are no beds.

Bharath Medical College: Dashboard shows as having 60 + 2 ICU beds. Authorities said that they aren’t admitting any patients as they don’t have the staff or the resources to handle the situation.

Be Well Kilpauk: Asked if the patient has insurance. Then said beds are available, will quote fees only after consultation with the doctor.

Chettinad Hospital: Dashboard says 161 empty beds at the hospital whereas the hospital authorities say that there are no beds available.

Kanchi Kamakoti Child Trust Hospital: Facility available for children.

Aysha Hospital: Will assess the patients and admit according to need. If oxygen is stable, patients can home quarantine and recover.

Gleneagles Global Health City: Authorities said patient can come for a check up, cannot confirm if there is a bed.

Mint Hospital: Said beds available at the cost of Rs 35,000 per day.

Vijaya Hospital: No beds, if there is a discharge and a slot opens, can contact. Cost Rs 30,000 to 40,000 a day. With ventilator will cost Rs 70,000 a day.

Tagore Medical College: Beds are available, costs are Rs 12000/day for asymptomatic patients, Rs 14000 with oxygen support, Rs 21000 if ventilator is used.

Sundaram Medical College: Full, there are patients waiting in the ER.

St Thomas Hospital: There are beds but they will decide after it's communicated how serious the patient is.

SRM Medical College: Dashboard says 103 beds + 3 ICU beds is incorrect, they are running at full capacity.

Sathya Sai Medical College: Not a super speciality, can only admit mild cases as they don’t have resources to take care of severe cases. Will cost Rs 15,000 to 20,000 a day.

Balaji Hospital: Can only admit mild cases as ICU beds are full.

SIMS hospital: Full, can’t admit.

National Hospital: Overflowing, government hasn’t updated dashboard.

Muthu Hospital: Beds are available, cost will be communicated after assessing the patient.

Meenakshi Medical College: Not admitting private patients at the moment, only admitting patients from government hospitals.

Karpaga Vinayaga Medical Science & Research Facility: Beds available; Rs 5,000/ day is the base amount, exclusive of oxygen support or investigation/scan charges.

Melmaruvathur Aadhiparasakthi Medical College: Is a Trust Hospital, all charges will come up to Rs 10,000/day

GLB Hospital: Beds available, will cost Rs 35,000/day

Appasamy Hospital: 1 bed available, will cost Rs 23,000/day.

***

J Radhakrishnan IAS, the newly reinstated health secretary says that the health department is pushing its limits to ensure that facilities are coping with the increase in numbers. “We are increasing beds in government hospitals for people who depend on us. Many non-COVID beds are lying vacant, as most aren’t coming for routine procedures, so we are constantly in the process of switching that dormant lot to our COVID bed strength. We’ve added 25 percent of those beds into COVID care,” he told Firstpost.

The health department is also trying to create a call centre for access to private facilities, in addition to 104 services, so that they can cross monitor, Radhakrishnan explains.

“We held an open meeting with private hospitals, and the estimate of beds with them is 5000. We are attempting to provide dynamic data of these beds, in order to facilitate a smoother process for COVID patients”, he adds. When I inform him that many of the hospitals aren’t admitting patients even if they have beds, he says, “Close to 170 hospitals are registered with us for treating patients. If they are not admitting COVID patients or even non-COVID cases, we will take action against them under the Clinical Establishments (Registration and Regulation) Act of 2010.”

*Names withheld to protect the identities of COVID-19 patients

via Blogger https://ift.tt/2Z0mqpl

[brajeshupadhyay]

It's 8 pm. The streets of Chennai are dead. The checkpoints have multiplied for this 12-day lockdown, so have the cops on the street. Every vehicle is being stopped, scanned, questioned. Near the Rajiv Gandhi Government General Hospital (RGGGH), one of the four main facilitates which is treating COVID-19 patients in Chennai, this reporter saw an MTC bus leaving with a few healthcare workers. All of them looked like they were about to pass out. As we parked next to the canteen, this reporter spotted a doctor in blue scrubs and a green mask, walking with her head bowed down. In 2017, this reporter had interviewed a bunch of newly-christened ‘doctors’ at this very spot. Three of them had animatedly spoken about throwing themselves headlong into the profession, in spite of the various drawbacks. Opposite the parkin, a board read: new PG Hostel. Wonder how many of the 42 PG doctors from Madras Medical College, who had tested positive for COVID-19 almost two weeks ago, stayed there. Meanwhile, the reporter's friend’s cousin got out of the car and was waiting to catch a glimpse of her husband, who had tested positive a few days ago. He had almost recovered from fever when he experienced a bout of breathlessness and had to be rushed back to the facility. Since he has been at the COVID facility inside the RGGGH campus. She was bringing him a change of clothes, some medicines and was seeing him for the first time since he was admitted at the facility. They exchanged a few nervous words, as my friend and I tried to look away. The COVID Outpatient Block is two towers away from where we stood in Tower 1. These towers have a raised entrance, which makes the reception visible from the road, as well. As we started driving past the campus, I looked at the bright lights coming from the tower. Nothing poetic came to my mind but the dead silence, which is unusual to the hospital because usually it is bustling owing to Chennai Central Railway Station which is located right across the road. The jarring lights coming from the COVID Outpatient Blocks, only added to the general uneasiness that one had started to feel in Chennai. Rajiv Gandhi Government General Hospital in Chennai The COVID-19 Outpatients Block at the RGGG Hospital is built like a wedding hall. It has huge steps leading up to a hall-like reception. On either side are ramps. Ambulances stop at the right corner, from where patients can be wheeled in. Before you enter, there is an assistance kiosk outside labelled ‘May I Help You’. Those entering were made to sanitise their hands at the kiosk. The healthcare workers, manning the kiosk, also answer questions if you are confused. This kiosk though is not manned at all times. While we were there, a few people had to look around for help. Diagonally opposite the kiosk is a space to wash hands. Inside the hall, there are rows of chairs, all placed at a distance of 4-5 feet, facing a reception area. Patients have to wait their turn to make their entry at the reception, following which doctors on duty will assess the patients. Some have attendees helping them, while most of them are there by themselves. There are huge windows on either side of the entrance. This is where the family and friends of those who’ve gone inside are waiting. Pushpa, a resident of Thideer Nagar in Besant Nagar, was here with her husband K*, who was diagnosed with blood cancer in September 2019. He was just about to commence radiation therapy at Cancer Institute in Adyar when another patient at the institute was tested positive for COVID-19. Since April, as many as seven patients and three healthcare workers from the institute had tested positive. All the patients from that ward were told to test themselves for COVID 19 before seeking further therapy. K’s first test was negative but a second test confirmed their worst fears. After this, K was advised to seek help from RGGGH. "Now, they have said even though he is not showing any symptoms, he will be taken to an isolation ward for 14 days as he is a cancer patient," said his brother Suresh. Pushpa is worried that postponing radiation therapy will adversely impact K. "We already pushed it by three months. Now I am not sure when we can actually get to it," she said. As Pushpa continues to tell her story while waiting for the ambulance which would take K to the isolation facility, a doctor in a blue PPE darts out, a nurse in a green PPE at her heels, signalling for a stretcher. "Why isn’t it here yet, it's been half an hour," the doctor asked the nurse. “No ma’am, I’ll get it, just a moment," the nurse said before signalling furiously to a group of healthcare workers standing 100 meters away, next to a few stretchers. Two of them, with a face mask and no PPE, hauled it across the ramp, while the doctor looked around, clicking her feet. While waiting for the stretcher, the doctor glanced over to this reporter, and almost as if reading the reporter's mind she quickly looked away before there was a question. It was almost a telepathic no. Close to a month of tailing healthcare workers on COVID duty across the state will teach you to steer clear of them when they were working. Interrupting the nurses or the doctors on duty inside the OP was out of the question. "You need to understand that everybody is in a lot of tension. There is a lot of work. Just during my eight-hour shift, more than 600 people trickle in," said Palanisamy*, a contract worker from Korukpet, who was overseeing security arrangements outside the OP. "It wasn’t so much in the beginning, but now it is 24/7. This place doesn’t sleep anymore,” he added, explaining that asymptomatic patients from RGGGH were sent to facilities outside, whereas those with moderate to severe symptoms were housed within the hospital. "People are scared. Look at his face, can’t you see panic in it," he remarked, pointing at a middle-aged man who walked past us. “There is no reason to panic, we are very much in control. The uncertainty is going to be there because we don’t know how this pandemic will turn out but that doesn’t mean one should panic,” Dr K Narayansamy, Director of the Hepatology Department at MMC, said. He was recently appointed the Dean of MMC and Rajiv Gandhi Government General Hospital after the former Dean Dr R Jayanthi went on leave until further notice. MMC and RGGGH have been through choppy waters in the past few months, with many doctors, PGs, nurses and healthcare workers testing positive for COVID-19. It seemed a little ironic to be sitting inside a building with a possibly high viral load but being told that RGGGH is dealing with the pandemic head-on, minus the panic. Asking about F's experience, a COVID-19 positive patient who had told this reporter that he was turned away from RGGGH when he had shown up there with his results. F had said that he was denied admission due to lack of beds in the hospital. Dr Narayanswamy says that it must have been a misunderstanding. "We’ve close to 1,000 beds, half of them equipped with oxygen supply. We are constantly upping our capacity, there is no way anybody would have said there are no beds," Narayanswamy said, explaining that doctors make an assessment of patients in the OP block. If a person shows moderate to severe symptoms, they are admitted to the COVID care unit. If they don’t, they are sent to isolation wards outside RGGGH for observation. "This is how we ensure that facilities are available to those who are in actual need, without burning it all out," added Narayanswamy. Eventually, F was admitted to RGGGH and is at the moment, stable. F said he is happy with the facilities now and feels that he is well taken care of. Whether or not his problem was a wrong assessment of the patient’s symptoms or if the patient had misunderstood the doctor, what was told to him doesn’t seem easy to figure out. This problem though has been mentioned by many doctors on duty. Some of them, across several districts in Tamil Nadu, said that they assess ILI (Influenza-Like Illness) symptoms in patients and to ensure that the system isn’t overburdened, admit those who absolutely need hospital care. If not, they are told to rest and recover at home. A few patients are also not very forthcoming which hinders the process further. But since the decision largely rests on discretion, as there are no guidelines set in stone, there is room for error. *** Kilpauk Medical College Hospital, Chennai The waiting area outside the COVID OP Block in Kilpauk Medical College Hospital (KMCH) was an open space, like a sit out in a park. It had an enclosure on top but was open otherwise. Ambulances were lining up right in front of the waiting area, from where patients were being taken into the OP. The ones waiting their turn had worry written all over their faces. Approaching a young woman seated alone, the reporter asked her in Tamil, "Neenga positive patient ah (Have you been tested positive)?" She first shook her head and then nodded. She introduced herself as C* from Nepal. The reporter switched to Hindi and asked her if she wanted to speak to her. She said yes, and pulled out a piece of paper from her bag. She pointed to the section which said ‘POSITIVE’. "I don’t know where they are going to take me," she said. C has been living with her son in Chennai for more than a year now. The lockdown had been a drag as she was out of work. But she had managed until she developed a fever a few days prior. Though her fever subsided, she tested positive for COVID-19. So, she packed up, told her son to stay home and set out for Kilpauk Medical Hospital. “What will they do now, how long will I have to wait here?” she asked. She had two young teens to keep her company. Their uncle, who was on dialysis, had tested positive for COVID-19. "He is in there, getting it done. They usually do it on the arm, but this time they are going through his neck,” one of them said explaining the process of dialysis. Two rows away, an individual who was waiting his turn, spat onto his side. Everybody looked, a few hissed. Twenty-four hours later, C had been allotted a room at a COVID isolation facility in Pulianthope. She was first lodged at a facility within KMCH, and then the next day transferred. It has been three days and she seems okay. The problem that patients seem to face at government facilities is only at the beginning. Stricken by panic in the beginning, most patients are confused and need reassuring. Healthcare workers, however, seem overworked and not in a position to do so. *** Government Order 174 issued by the former health secretary Beela Rajesh, dated April 3 of 2020 reads: “1. In the G.O. read above, the Government has notified the list of designated Government Hospitals for treatment of COVID-19 patients. Further, treatment for COVID-19 is being offered in all Government Medical College Hospitals, District Head Quarters Hospitals and Key Sub-District Hospitals completely free of cost. 2. It has been brought to the notice of the Government that certain patients/public desire to have treatment for COVID-19 in Private Hospitals also. 3. Considering the spread of CoronaVirus Disease (COVID-19) in the State, the Government have decided to include the Private Hospitals in the State for treatment to COVID-19 patients to prevent the spread of this communicable disease. 4. Accordingly, the willing patients are hereby informed that they may approach the Private Hospitals listed in the Annexure to this order to receive treatment for COVID-19, at their own cost. The hospitals are directed to follow the treatment protocol prescribed by the Government of India from time to time.” Of the 22 hospitals listed on this Government Order, the number of private players catering to COVID-19 patients in and around Chennai has increased to 45 in a period of two months. Yet, there is uncertainty regarding the functioning of these hospitals. First, a few videos emerged saying that these hospitals are charging exorbitant and unaffordable rates. This was followed by another government order, which capped the price for private hospitals. For non-critical cases, the cost was to be capped at Rs 5,000 per day. For critical cases, the cost was fixed at Rs 10,000 to Rs 15,000 depending on whether the patient required ICU and ventilator facility. Another video by a news anchor and television actor S Varadharajen went viral, where he claimed that a friend of his, who had severe breathing problems and fever, was unable to secure a bed for himself at either a government or a private hospital. Health Minister Vijay Bhasker immediately got into a damage control mode and announced his team was making all efforts to ensure that facilities are adequate. "There are 75,000 beds in Tamil Nadu and 5,000 in Chennai alone," he announced a day after the video went viral. Provisions of IPC, the Epidemic Diseases Act and the Disaster Management Act were invoked against Varadharajen for the offence of ‘falsifying information to create panic.’ Two weeks since and all the damage control later, the feeling of panic in Chennai is far from gone. A flurry of transfers, including that of the health secretary hasn’t helped matters. '‘Mismanagement' is the word on the street and the rumour mills have become difficult to track. It's mostly hearsay as very few "go on record" to say anything. The fear among doctors and bureaucrats keeps them from speaking out aloud. But statements by those leading the state are hard to miss. For instance, chief minister E Palaniswami’s transition from "our positive cases will be zero in a few days" to "God alone knows when this will end." "Strong leadership and a clear line of command is crucial to managing any public health emergency. When people are clueless as to who to turn to for a decision, you know there is a problem," said Dr Aiswarya Rao, public health consultant and former joint director of Tamil Nadu State Aids Control Society (TANSACS). In April, there were multiple teams comprising bureaucrats who were put in charge of managing the situation. Then came the appointment of another committee. There was also the health secretary who was issuing directions on one side, while the ministers did their own thing. This is pretty much how April and May went by for Chennai. Even after the appointment of Dr J Radhakrishnan, who has managed to control multiple crises in Tamil Nadu, this crisis seemed all over the place. His reinstatement as health secretary seems to have given many within the department hope. What about frontline workers in Chennai? The basic fear, reiterated both private and government healthcare workers, doctors, nurses and technicians, is the fear of exposure. April witnessed many protests by government doctors and nurses in Chennai, demanding basic preventive protective equipment and post-duty quarantine facilities, after a bunch of them tested positive at RGGGH. In a few weeks, healthcare workers at Government Stanley Medical Hospital tested positive. While government doctors have to work irrespective of fear of exposure, the same isn’t the case with private practitioners. Many private establishments have sought help from the government stating that they are not able to take on the costs required to operate a COVID-19 facility. Sanitary workers organised a strike this week after one of them died following exposure to COVID-19 positive patients. While the government has been saying that it is meeting these demands, how the government hopes to sustain meeting these demands remain unknown. So does the expenditure over COVID-19 so far. During his interaction with Prime Minister Narendra Modi, Palaniswami sought a grant of Rs 9,000 crore and a sanction of Rs 3,000 crore for medical equipment during a pandemic. An official statement by the chief minister also said that 2.75 crore triple-layer face masks, 38.85 lakh N-95 masks, 21 lakh PPE kits and 15.45 lakh RT-PCR testing kits have been ordered by the Tamil Nadu government. There is no official figure on how much the government has spent on personal protective equipment. The biggest challenge for the government continues to be how it will bring about some level of accountability from private hospitals in the middle of this pandemic, which doesn’t seem like will abate any time soon. Many non-COVID patients have spoken out about how cumbersome it has become to get private hospitals to cater to them, even under serious circumstances like deliveries. The norm at every private hospital since April has been that almost all procedures only after a COVID 19 clearance. Two months since the lockdown, yet private hospitals have not figured their way out, and that's worrisome. Many seem to be treading the safer path by staying away. But senior doctors say that media trying to put the entire blame on private hospitals is unfair. "The costs are high, the usual patient load less. We are doing what we can to keep the hospitals running with the bare minimum," said a private practitioner, "When will the government step in and help out?" Real situation at private hospitals listed as COVID-19 designated centres Firstpost looked at the Tamil Nadu live dashboard and spoke to all the 45 hospitals (four from Chengalpattu and Kanchipuram districts) listed under Chennai district. Of these 45, many of the hospitals are already operating at full capacity. Doctors at some of these hospitals said "that isn’t the case but don’t want to say anything further." In the case of some hospitals, authorities said there were no beds available anymore. Even though in some cases the live dashboard says the opposite. Some of them tailor their answers after asking a routine set of questions, which are common to all: How old is the patient? Are they obese? Do they have any existing conditions or co-morbidities? Do they’ve breathlessness? A positive answer to the fourth question brings forth this answer: “We are out of ventilators” or “Where are you at the moment? Okay, then go to the closest government facility, that would be the safest for you.” Here is a brief of what Firstpost found The Live Dashboard says these hospitals are running at full capacity: Apollo Hospital, Be Well Hospital, Bharathiraja Hospital, CSI Kalyani General Hospital, Dr Kamakshi Memorial Hospital, Dr Mehta’s Hospital, Fortis Malar Hospital, Kauvery Hospital, Lifeline Hospitals, Maya Nursing Home, Venkateshwara Hospital, Noble Hospital, Panimalar Hospital, Prashanth Hospital, MIOT Hospital, Medway Hospital. For other hospitals, the dashboard, as on 22 June (some updated on 21 June) say has 1,865 beds, 89 ICU beds and 71 ventilators. Here are the responses of the hospitals, when contacted regarding beds: Apollo Hospitals: No beds Sri Ramachandra Medical College Hospital, Porur: Dashboard says 184 beds are available, hospital authorities said there are no beds. Bharath Medical College: Dashboard shows as having 60 + 2 ICU beds. Authorities said that they aren’t admitting any patients as they don’t have the staff or the resources to handle the situation. Be Well Kilpauk: Asked if the patient has insurance. Then said beds are available, will quote fees only after consultation with the doctor. Chettinad Hospital: Dashboard says 161 empty beds at the hospital whereas the hospital authorities say that there are no beds available. Kanchi Kamakoti Child Trust Hospital: Facility available for children. Aysha Hospital: Will assess the patients and admit according to need. If oxygen is stable, patients can home quarantine and recover. Gleneagles Global Health City: Authorities said patient can come for a check up, cannot confirm if there is a bed. Mint Hospital: Said beds available at the cost of Rs 35,000 per day. Vijaya Hospital: No beds, if there is a discharge and a slot opens, can contact. Cost Rs 30,000 to 40,000 a day. With ventilator will cost Rs 70,000 a day. Tagore Medical College: Beds are available, costs are Rs 12000/day for asymptomatic patients, Rs 14000 with oxygen support, Rs 21000 if ventilator is used. Sundaram Medical College: Full, there are patients waiting in the ER. St Thomas Hospital: There are beds but they will decide after it's communicated how serious the patient is. SRM Medical College: Dashboard says 103 beds + 3 ICU beds is incorrect, they are running at full capacity. Sathya Sai Medical College: Not a super speciality, can only admit mild cases as they don’t have resources to take care of severe cases. Will cost Rs 15,000 to 20,000 a day. Balaji Hospital: Can only admit mild cases as ICU beds are full. SIMS hospital: Full, can’t admit. National Hospital: Overflowing, government hasn’t updated dashboard. Muthu Hospital: Beds are available, cost will be communicated after assessing the patient. Meenakshi Medical College: Not admitting private patients at the moment, only admitting patients from government hospitals. Karpaga Vinayaga Medical Science & Research Facility: Beds available; Rs 5,000/ day is the base amount, exclusive of oxygen support or investigation/scan charges. Melmaruvathur Aadhiparasakthi Medical College: Is a Trust Hospital, all charges will come up to Rs 10,000/day GLB Hospital: Beds available, will cost Rs 35,000/day Appasamy Hospital: 1 bed available, will cost Rs 23,000/day. *** J Radhakrishnan IAS, the newly reinstated health secretary says that the health department is pushing its limits to ensure that facilities are coping with the increase in numbers. “We are increasing beds in government hospitals for people who depend on us. Many non-COVID beds are lying vacant, as most aren’t coming for routine procedures, so we are constantly in the process of switching that dormant lot to our COVID bed strength. We’ve added 25 percent of those beds into COVID care,” he told Firstpost. The health department is also trying to create a call centre for access to private facilities, in addition to 104 services, so that they can cross monitor, Radhakrishnan explains. “We held an open meeting with private hospitals, and the estimate of beds with them is 5000. We are attempting to provide dynamic data of these beds, in order to facilitate a smoother process for COVID patients”, he adds. When I inform him that many of the hospitals aren’t admitting patients even if they have beds, he says, “Close to 170 hospitals are registered with us for treating patients. If they are not admitting COVID patients or even non-COVID cases, we will take action against them under the Clinical Establishments (Registration and Regulation) Act of 2010.” *Names withheld to protect the identities of COVID-19 patients

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