CoVid Chronicles: An Essential Worker’s Perspective

Here’s part 2 of my Covid-19 chronicles. Catch part 1 here.

I completed medical school last June so I’ve been a doctor in a Jamaican public hospital for 9 months now and counting. During that time I’ve seen a lot and gained a world of experience. When this current strain of coronavirus emerged, it sounded surreal BUT we all knew it was a matter of time before our country and region would be affected too given how highly virulent this pathogen is and how closely connected our world has become through the 21st century’s ease of travel. Subsequently, Jamaica recorded its first case on March 10. Every day since, or rather every hour, there’s something new. One minute it’s a public attraction closing its doors, the next it’s a restaurant, a factory, the schools, offices, then finally the country’s airports on March 21. At the time of publishing this post, the number of confirmed cases is at 26 and our nation has recorded 1 death.

My hospital has cancelled most outpatient clinics but a few like the antenatal and postnatal clinics have to continue for obvious reasons. Jamaicans have a habit of coming to hospital for trivial reasons such as an insignificant rash (we’re alarmingly preoccupied with rashes, while choosing to present late for serious, life-threatening and potentially fatal conditions, go figure). The Ministry of Health & Wellness through the media has strongly encouraged people with those complaints to stay home, but this plea has fallen on deaf ears. Elective surgeries have been postponed indefinitely and visiting hours have been curtailed to one visitor per patient and to only an hour each day but again, visitors haven’t been compliant. Jamaicans are truly an unruly bunch. We have a dedicated isolation ward for suspected and confirmed cases at my hospital, and there has been the creation of several protocols and guides, even if they’re still in the developmental stages and not yet released to the front-line staff which needs it. Some training sessions have been conducted even if the times have been inconvenient for many who weren’t able to leave their posts to access the training, and generally there has been a tangible change in the atmosphere and culture of the hospital.

Personal protective equipment (PPEs) have to be hidden with only select staff being told where to find it on a need-to-know basis because our stocks have been ravaged repeatedly by the vermin among us who sell PPEs on the black market to people who don’t even need it, but everyone wants gloves and masks for a false sense of security in these streets. Plus, even hospital staff with zero patient interaction demand masks, further depleting our stash. We still have water lock-offs at my hospital despite the ministry’s plea for us to wash our hands more frequently but at least we have alcohol and hand sanitizer. Taxi drivers refuse to pick up nurses in their uniform and several restaurants have closed or refuse to deliver food to the hospital out of fear. We have fewer patients (except on the maternity ward and I’ll save my theories as to why) but still, no one really wants to be there– neither staff nor patient.

You never know if and when you’re going to get in contact with an infected patient. Some of us have comorbidities which make us vulnerable or we have relatives at home who are, and we can’t bear the thought of knowing we could lose a loved one from an illness we inadvertently bring home. A lot of us choose to self-isolate after work as a result which isn’t really the best thing to do for our mental health. There’s just this palpable air of anxiety and panic through the wards and corridors at work from both staff and patients and relatives alike, and I hate it. What a time to be a doctor.

Here are some other things I’ve come to realize in my weeks of pondering this crisis which is growing larger than life each day:

1) Given that the disease is transmitted airborne via infectious droplets, it’s actually too easy to contract this disease. Also, it lives on the common every day surfaces we touch as we go about our daily lives for up to 72 hours– doorknobs, handles, railings, ATM buttons, light switches etc. We simply can’t sanitize every single surface we come in contact with often enough. Surfaces which can transmit diseases are known as fomites and even the most innocent-looking commonly used devices like our cellphones can become fomites. Germ-o-phobes may feel happy knowing that they had been on to something from long before corona, but it’s literally impossible to keep up with sanitizing every single thing we touch. That means once you interact with even a single human being or go out into the outside world, which is unavoidable for us as we continue our essential duties, we’re at risk.

2) Not everyone who is feeling ill will stay at home, putting so many of us at risk of contracting the virus. Also, the 2 week incubation period means people can be infected from common every day errands like getting groceries at the supermarket and don’t even know it, thus going around and infecting other people before showing signs and symptoms.

3) The tests available, not just in Jamaica but in most countries worldwide, are in limited supply which means there has to be a criteria for determining who to test. We only test people who are symptomatic and who we deem to have had significant exposure risk which means there may be lots more infected people than the statistics say. Many may still be asymptomatic or show very mild symptoms, therefore not presenting or qualifying for testing meanwhile infecting other more susceptible individuals.

4) The stark reality is the majority of personal protective equipment (PPEs) being made available to a lot of people on the front-lines is either unsuitable or inadequate. Surgical masks and gowns don’t adequately prevent one from contracting an airborne disease, and N-95 masks and haz-mat suits are limited, must be well-fitted, are actually very hot and uncomfortable for the user and proper donning and duffing of appropriate gear must be taught. That means a lot of people are either walking around with a false sense of security thinking that any PPE they get their hands on can actually give them protection, and hence tend to get lax with handwashing, making them more likely to either contract or transfer to virus particles to other people.

5) Patients don’t walk into hospitals with a diagnosis on their foreheads. The only way we can determine if you require coronavirus testing is by actually interviewing the patient, which if conducted while not properly attired, puts that worker plus his or her relatives at risk, even if immediately placed into quarantine. Not every patient will do the astute thing of staying home and calling the Ministry’s hotline or hospital for care.

6) There may come a time where enough health care workers are exposed that too many of us will be in quarantine, depriving the already understaffed sector of a labour force to fight this thing.

Last but not least,

7) Essential workers are so much more than just doctors and nurses.

Here’s a list of the other essential workers and people providing an essential service during this trying time while many of you have the option of social distancing and isolation. Keep them in your prayers. It’s not easy to continue going about business as usual while everyone else gets to work from home, spend more time with their families at home and rest.

• Patient care assistants
• Medical technologists and laboratory staff
• Orderlies
• Radiographers
• Pharmacists
• Physiotherapists
• Other hospital staff such as those who work at maintenance, laundry, dietary, medical records and administration.
• Policemen
• Firemen
• Soldiers
• Ambulance drivers
• Taxi and bus drivers
• Garbage collectors
• Janitors at places providing essential service
• Some government staff such as at the Ministry of Health.
• People who work in wholesales, supermarkets, the retail and shipping industry, some fast food chains and restaurants, and of course truckers and delivery men from these companies.
• People who work at the electricity, telecommunications and water companies.
• Reporters and journalists.

For everyone playing their part in this crisis, I salute you. My prayers also go out to everyone whose livelihood has been or will be affected by this global shutdown.

Lastly, keep those memes coming. Staying cheerful is how we shall beat this thing. Worry makes us immunocompromised, and we can’t afford to have that right now.

This post is a day late (I usually publish on Thursdays) but life happens.

Stay safe and walk good! ‘Til next time✌🏽.

Read next: Protecting your mental health during quarantine.

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