In December 2019, whilst enjoying my traditional Christmas activities, I saw reports on the news and social media of a new respiratory illness that was affecting persons in Wuhan, China. This illness appeared to be quickly spreading among the population causing significant morbidity and mortality. I periodically followed up on this health alert, while continuing the usual clinics and normal routines. At that time, I worked in health centres in rural communities, where the relationship between staff and patients are more intimate due to the relatively smaller size. In one particular community, the health centre was a focal point and a place to ‘meet and greet ‘neighbours. I was able to sit, talk and exchange best “Christmas wishes” with my patients during routine consultations. The staff Christmas party was arranged and I was able to enjoy socialising and had a ‘light’ moment with my colleagues at the clinic as we celebrated our hard work during the year.
It is almost a year since the new mysterious respiratory illness emerged in Wuhan. It is the now the notorious COVID-19 pandemic that many countries are battling to contain. The COVID-19 pandemic has changed way of life for almost everyone globally. The routine of a year ago, is greatly different to that of today. As a physician working in primary care, the COVID-19 has changed the operations in the clinical setting as well as in my personal life.
The COVID-19 pandemic has tested my commitment to adhere to the ideals of the medical profession. When I graduated from university and took my Oath to practice medicine, I knew that I would be called upon to serve others before myself on many occasions. This pandemic has truly put this part of the oath to the test. As a physician in primary care, I envision myself as a guardian of patients and communities promoting health and protecting against preventable causes of disease. As a new disease, there were many things that were unknown about the transmission, treatment and prevention of COVID-19 that was gradually being discovered. As such there were times I felt like a soldier going to battle not fully understanding the opponent, but facing the challenge head on with all valour that I could conjure. I know that I was not alone in this feeling, as most of the discussions with my colleagues were focused on the latest evidence in the prevention and treatment of COVID-19.
Providing quality patient care is always a priority for physicians. Physicians are however ultimately human, and personal safety and the safety of our own family members are always at the forefront of our minds. In the COVID-19 pandemic, many healthcare professionals have been infected around the globe. Many having long term morbidity and sadly some have lost their lives. The availability of adequate Personal Protective Equipment (PPE) was crucial in performing as a frontline healthcare worker. During the times of increasing numbers of COVID-19 cases from June- August in Trinidad and Tobago, it became more apparent that every interaction with a patient was a potential exposure to the corona virus. There was adequate PPE provided at the clinics I worked in, which was a relief as there were many stories of the disastrous shortages of PPE in several countries. It became a routine for each member of staff to ensure that every member of the team wore their PPE at the start of each day. In essence, we looked out for each other. We wanted to ensure that we all remained safe and also protected our families at home. This was a reflection of the team spirit of the community healthcare staff.
The nature of the patient consultation was also changed. To reduce the number of patients in clinics that are usually crowded, phone consultations were used. ‘Telemedicine’ has become an efficient and effective way to ensure the continuity of patient care. Although, there are some challenges associated with Telemedicine, I have grown to enjoy it and would continue with it in the future. Patient education continues to be a main method in combating the virus. As the behaviour changes that are needed to be practiced by the public need consistent reinforcement. Telemedicine and other virtual medial have truly been useful tools in keeping the population informed and engaging them in protecting their health.
The pandemic has also caused a significant increase in the work load for health care workers. My fellow colleagues and I have worked longer hours, more intense shifts and rescheduled vacation leave. I have become a close news follower. The national COVID-19 updates is an indicator of the success of the current efforts to prevent the spread of COVID-19 at the community level, as well as giving an idea of the expected workload. ‘Burn out’ is a condition that can quickly develop and must be avoided as much as possible. This time has reminded me of the importance of self -care. Removing my ‘physician hat’ at times to relax and rejuvenate has become even more important to me and I have started making time in my schedule for this. I do feel the challenges of the reduction of group activities and the changes to normal ‘social life’ that has accompanied the COVID-19 pandemic. Mental health, particularly methods for coping with stress, anxiety and depression are important for patients as well as myself.
Although, the number of COVID-19 cases in many countries are rapidly increasing there is hope as there is promising news of effective treatment and prevention measures including vaccines. I can foresee primary care continuing to play a significant role in any managing this pandemic. I am confident that we can continue to adapt to meet any challenges that may arise. I look forward to the future when we can say that “We have conquered COVID-19” and I can enjoy another Christmas party with my colleagues and patients again.