While you might have watched numerous educational videos on the Covid-19 pandemic, and are up to date with the rising case numbers worldwide, it’s difficult to experience, from the comfort of your own home, what it must be like on the front line of this crisis, unless you or a loved one have personally been affected by it.
The truth is, since the first case of the Covid-19 pandemic was reported in Wuhan, China last November, the world has never been the same. In fact, U.N. Secretary-General Antonio Guterres recently said the coronavirus outbreak is the world’s worst crisis since World War II. There’s no doubt then, that those who are dealing with the virus and its effects first-hand, including doctors, nurses, professional healthcare workers and many others, have been tirelessly working to help those in need and do whatever they can to flatten the curve and save lives.
We had the chance to speak to two healthcare professionals, from both the public and private healthcare sectors, to find out how they’ve been coping with the Covid-19 pandemic and what it’s been like working in this time. Here, they share their insights, triumphs and fears…
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Doctors in the front line of the Covid-19 pandemic
Dr Caroline Corbett MBBch (Wits), DA(SA), FCA(SA)
Dr Corbett is a Specialist Anaesthetist with 14 years of training in the state sector, both with the 2 Military Hospital in Cape Town and the Wits academic circuit, and with 10 years’ experience in private practice.
Dr Mzamo Jakavula (MBChB)
Dr Mzamo Jakavula is a medical doctor with 12 years’ experience in the field. He’s currently a registrar (doctor in training to be a specialist) in Psychiatry and is based at the Emergency Psychiatry unit at Groote Schuur Hospital, Cape Town.
On the stress surrounding the Covid-19 pandemic
“Despite having trained and worked in South Africa for my entire career, this was not something for which we were ever prepared. We’ve faced the threats of HIV and TB – amongst others, we cope with the ever present threat of overwhelming trauma that burdens our clinical units daily, as well as the constant limitations of infrastructural, pharmaceutical and human resources, but nothing has ever presented all these threats in one. This impending crisis is truly nothing like anything we’ve been faced with before. It’s just terrifying.” Dr C
“Personally, we’re taking a lot of strain because we work in high pressure environments, particularly those of us working in large tertiary institutions which were busy even before this pandemic hit. There’s also the strain of worrying because you fear you might get infected and expose your family to the virus. But, on the other hand, the support you get from your loved ones is what gets you through this period.” Dr J
Preparing for the outbreak
“This virus took everyone by surprise- from the World Health Organisation (WHO) to our own public health experts in the country, down to the healthcare workers on the ground. Initially, I got a sense that there was a lot of confusion, and that no one believed the impact this virus would have on the world, as it turned from just a few cases in China into a global pandemic. I feel that the lack of foresight and the sluggish approach to react by many countries in a way contributed to the poor containment of the rapid spread of the virus.” Dr J
“In SA, we’ve been monitoring the pandemic since its inception and when its highly contagious nature was made evident, all authorities were alerted. Though we may be resource constrained, we’re blessed with highly experienced teams of clinical health professionals, epidemiologists, and microbiologists who have all been working closely with the government to start mobilising our resources early. We have a vulnerable and demographically unique population, and fortunately these factors were considered in the planning of the swift response we’ve already seen from government and the healthcare sector.” Dr C
The plan of action
“As a wife and mother of two young children, I’m extremely careful that I shower before going home, keep hand sanitiser in my car, wear my mask and gloves when necessary, and know how to use my personal protective equipment (PPE) so that I neither get ill; nor accidentally bring the virus home to my family through poor hand hygiene. We must all do our part to weather this storm, whether you’re doing it by staying safely at home or by not bringing the virus into your home from work (after lockdown). We must all continue to try.
The hospitals I work at stopped operating on elective patients early to ward off possible infection and to keep the resources free for new Covid-19 admissions. Hospitals then started recruiting and regrouping their staff and healthcare workers into preparatory teams for the possibility of having to admit large numbers of ill Covid-19 patients.
We’ve started training everyone on how to put on, and safely remove, the critically necessary PPE that they require in order to prevent them from getting infected at work. We’ve also started creating training teams for staff that may not otherwise be trained in treating critically ill patients but may be required to do so when the hospitals become very full.
This has largely been supported under the excellent guidance of the South African Society of Anaesthesiologists who has been providing us with daily guidelines, training videos, global clinical updates and resources so that we can be as prepared as possible for the pandemic.
Protecting ourselves as healthcare workers is critical because there are already too few of us, and if any of us fall ill or have to go into quarantine, that’s one less professional to treat all the patients still to come.” Dr C
“Most hospitals in my region have had to scale down on outpatient services, non-emergency services and elective surgical cases. Wards have been reconfigured to house patients who might require admission with Covid-19, so that they’re not mixed up with other non-infected patients. Our staff are being continuously trained on screening and testing (where indicated) of patients who come in, and everyone has been pulled from all departments to assist in this regard.
PPE is now controlled as there is a critical global shortage of masks, gloves etc.
Some departments are giving staff time off on a rotational basis to minimise the risk of exposure to staff all at once, and to ensure that the workforce remains healthy and ready. But even though people are given this time off, they are on standby and ready to be back on duty.”
“I’ve been doing weekly visits to one of the community clinics in one of the townships around Cape Town. Last week, the clinic was still packed in the waiting area, and staff had no PPE on. But this week, access was more controlled, and staff were wearing PPE. However, social distancing is still not happening as it should, as patients were still clustered together in the waiting area. This has to improve.” Dr J
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Adjusting to a new normal
“We no longer have working hours, and days of the week have become very blurred. The planning phase has required extensive meetings, training and preparation with many of us facing 18-20-hour work days. We need to be as ready as we can be, so that our patients are able to get the best care we can give them.
As the Covid-19 pandemic peaks in SA, and we slowly move to shift work, we will try as best as possible to keep to fixed 12-hour shifts. But I believe that as healthcare workers, and as seen internationally, it’s likely that we will do the best we can regardless of shifts or hours or days.
Our greatest emergency currently is still getting enough appropriate PPE to our healthcare workers so that they can safely treat patients. Without this, they will just become statistics.
In Italy, one in every six cases of Covid-19 is a healthcare worker. In South Africa, we absolutely can’t afford that – we just have too few healthcare workers to lose any. So, our greatest emergency outside of the virus currently is ensuring that you, the public get to have staff to treat you and that those staff are not infected in the process. Without them we can’t fight this!” Dr C
“In my case, our workload has decreased significantly since this period as our unit has had less referrals. Fortunately, we haven’t had much exposure to high risk patients as they’re screened before coming to us.” Dr J
The hospital environment
“The mood in the hospitals is very sombre, a very palpable and hushed calm before the storm. We’re still busy with some of the preparations, getting used to the restructuring and re-organisation of hospitals with isolated entrances, hand sanitisers and masks wherever we go. But there’s a readiness, and an undertone of comradery that we all feel together.
Specialists are all working closely together, training and preparing side by side so we can do the best we can to treat our patients.
Public support has been incredible, and we hope that people continue to stay home, wear the appropriate masks when they go out, follow the guidelines when they are ill, and above all – have hope – because we do. It’s our best weapon!” Dr C
“Initially there was a lot of panic in my area, because everyone was caught off guard. But as we got more clarity and direction from management, the staff began to calm down.
There’s still an element of anxiety brought on by the fear of the ongoing risk of exposure, but we soldier on and we support each other as colleagues.” Dr J
Possible solutions and outcomes
“It’s difficult to predict the course of the virus at all. We do know that we have certainly not reached the peak of infection rates yet, nationally or internationally. We know that the national lockdown was an absolute blessing from our president, and it will certainly help to flatten the curve. But it will only have true impact with continued social distancing, more testing and good hygiene practices for months to come.
We need to work together to combat Covid-19 and to live with it amongst us until it passes. Every single South African needs to take responsibility for themselves and their families with respect to following all the guidelines and regulations given to us to keep us all safe and healthy.
A global vaccine is not predicted for some time. Many international entities are working on numerous options, but these aren’t something we can rely on likely this year.
South Africans are however already vaccinated against TB in the form of the BCG vaccine and according to new research, this is believed, to possibly offer some degree of improved resistance to the virus. Data is not yet conclusive and the WHO is still investigating the link, but we’re hopeful that it may mean that South Africans, and all those countries in which the BCG was given as a mandatory vaccine in infancy, may possibly see a less severe impact from Covid-19. We are watching the research optimistically!
Until then, we need to take care of ourselves and each other, as we should every day. Have hope, wish for health and find happiness in the new normal.” Dr C
Written by Tammy Jacks