Tales from the COVID-19 frontline: ‘There is nothing easy about this’

Doctors train for the worst

“It’s become very real,” said one doctor from Mater Dei Hospital who asked to remain anonymous. “It’s rather overwhelming hearing only a few weeks ago it was in China and suddenly we hear it's in Italy. The main issue is that it’s the calm before the storm we are very aware that there are going to be very long days ahead. We don’t even know how long it is going to last.

“Do we even know how to deal with this? Do we have the know-how? Suddenly other specialties are being recruited to help with COVID cases. Can you imagine an orthopedic surgeon dusting off his books to study and help with respiratory cases?

“Do we also have the resources to protect ourselves and treat the patients? PPE (Personal Protective Equipment) will run out eventually.”

The hospital is gearing up for a massive influx of patients: “The staff canteen will be closed and converted into a ward or store. The library is full of beds. Lecture rooms are full of beds. In the corridors, all the doors are open so people don’t touch them. We’ve heard the number of ventilators we have ready to go and the technology for monitoring patients outside ITU. These make us feel a lot better,” she said, describing the preparations at Mater Dei Hospital as “a massive overhaul, with no expense spared”.

The hospital is running three batches of tests per day, while other countries can only muster one. “I feel that we are preparing a lot. Ultimately we are in for a rough time – this is an uncomfortable calm before the storm hits.”

Meanwhile other non-COVID cases continue. “We are rationalising essential tests and are lining up patients we can’t ignore, looking up ways to communicate with patients at home. We’ve become inventive,” said the doctor.

“What is also very real is the fear for yourself and your family. Most people have resorted to not meeting with family,  but what if you live with your parents? I have one young colleague who took the step of renting a place out for herself to avoid infecting her parents.”

Healthcare workers who have children are also facing problems. Doctors have 24-hour shifts and it gets complicated with childcare, especially if they are afraid to send their children to hospital’s in-house childcare.

Doctors and medical staff are undergoing extensive training in not getting infected. Donning doffing, wiping all surfaces, communications. Individual departments are conducting constant drills for various scenarios.

One constant worry is the fear that the doctors are going to infect their patients. “Is it infective before symptoms show? We don’t know enough about this virus.”

A system is now in place whereby if a doctor is treating a COVID positive patient, they are not allowed to treat non-infected patients.

There are a lot of behind-the-scenes preparations being done. Doctors in private practice are being enlisted to help hospital doctors should an outbreak occur. “We are amassing an army,” jokes the doctor.

“When things get too heavy we try to take care of each other. There’s a lot of solidarity but it’s a great upheaval. It’s going to affect us mentally, but ultimately this is what we’re here for.

“It’s amazing how people have come together and thought about these things. We are in it for the long haul and we are all in it together. We’re very, very well prepared I think.”

Supermarkets make safety arrangements

With the exception of doctors, nobody is facing more danger than supermarket employees because of the sheer number of people who they come into contact with on a daily basis.

One supermarket manager spoken to said his supermarket’s entire modus operandi has had to change due to the virus.

“We have had to focus our efforts on setting up preventative and precautionary measures such as the set-up of Perspex screens on all cash desks and counters, setting up zones that cannot be crossed to go in line with the one-metre distance policy, we have introduced mandatory daily temperature checks by the Red Cross to all staff and employees and people rendering a service entering the supermarket, mandatory hand sanitisation of hands and trolleys upon entrance which is supervised by the Red Cross standing at each entrance. We have set up multiple points with signage advising the customers and staff about these new policies as well as ongoing audiovisual notices being played throughout the shop floor on a regular basis.”

Online orders have exploded for supermarkets, he said, replacing crowds on the shop-floor. “The shop floor is relatively quiet as many people are choosing to stay away from crowded places. We have had to increase the online team and delivery capacity in order to keep up with the influx of online orders... our business has shifted to a digital mode which is a phenomenon that is occurring in many other businesses.

“As employees we all do our mandatory part to ensure we keep our distance from people and each other. I personally use a mask when I go down on the shop floor and sanitise my hands regularly at the hand sanitisation stations now in place around the shop floor.

“There are stricter measures that will be taken if the situation gets worse but so far we have not had to implement them.”

Police face long court delays

Police sources told MaltaToday that the closure of the law courts was obviously going to cause delays, even to straightforward cases. Arrests are going on as normal, said one, but third-party service providers like Appogg and interpreters are all working remotely. “Imagine trying to interrogate someone through an interpreter, who is on the other side of a phone call.”

Pharmacist fears having to close if infected

One community pharmacist told us that she is “surviving day by day” and that despite everything work is “somehow still extremely busy.” She spoke of exhaustion, taking four times as many phone calls as normal, as well as dealing with walk-in customers and handling requests for doctors. “Sometimes people come to the pharmacy with no prescription I'd have to call the doctor to confirm details.” The fact that people are only being allowed in one at a time is an additional stress burden for the pharmacist who can see queues building up outside.

“And in the background there is the worry that we have to be extra careful not to get sick... we’d need to quarantine the whole pharmacy. I worry that I’d need to close the pharmacy and how would POYC (Pharmacy of Your Choice) customers get their medicines? What are we going to do when pharmacists start ending up in quarantine because of contact with infected persons?

“There is nothing easy about this.”

But the pharmacist had nothing but praise for the health authorities, who she said “are doing a great job, looking out for us”.

“I personally feel that we have support out there. The earlier closing hours are a good idea as this equates to an extra hour of safety and an extra hour of rest.”

The pharmacist observed with concern that she was still seeing elderly patients coming to collect things from the pharmacy, despite not living alone at home or who have children. “The more elderly people who come here, the more cases in hospital and the less beds available. This is not the time to be shy, if you need to ask someone to help you, you ask. If you are young and not at risk, go and help them.”