A day in the wards with Covid-19
You’d think that as a healthcare worker, I’d be used to seeing patients with Covid-19 by now, right? After all, it’s been nearly 2 years at this point with multiple waves of disease rippling through the community.
But I was wrong.
Australia turned into a fortress during the pandemic with very severe restrictions on who could come in or out of the country. This meant that we’ve lived in an isolated bubble for the better part of 2 years. This has also meant that for Australians trapped outside this bubble, they haven’t been able to return home.
On the inside, it’s been bubbles inside bubbles: each state and territory at different stages has enacted some kind of travel restriction to prevent movement. As I write this in early November 2021, I can leave Melbourne and head to New Zealand or Singapore from next week without requiring to quarantine (as long as I have a negative test result and am fully vaccinated), but I can’t travel to another state in the SAME COUNTRY without 14 days in isolation.
It’s a strange set of rules, but the this patchwork of regulation dreamt up in a hurry has resulted in 1 thing: one of the lowest death rates in the world from the disease.
During the first wave, I was involved in the teams that were responsible for inducing a coma and placing breathing tubes into a patient’s trachea and starting them on a breathing machine before intensive care came to take over. Back then, the majority we’re elderly but a few young patients did also need such intensive therapies. We watched Italy, the rest of Europe and America try and cope with ever increasing numbers and thought we’d run out of hospital beds.
Thankfully, that didn’t happen. There was a wave of death as the disease spread throughout nursing homes and aged care facilities causing untold misery for families, but by and large, the population was relatively safe compared with elsewhere in the world.
At the time, there was nothing else that could be done except to hunker down, maintain social distance and reduce the spread and pray that we had a treatment for this horrible disease…
Fast forward to today.
After nearly a year of doing clinical anaesthesia, I’m part of the “outreach” intensive care team. My job is to partner up with a senior intensive care nurse and head to the “Covid ward” where patients who are sick with the disease, but not severe enough to require intensive care and ventillators are located. Our job is to flag any worsening patients for transfer and support the ward nurses in caring for patients far sicker than they’re used to.
Having done this job a year ago, I thought I was ready for it. But reality had different plans.
Don’t get me wrong: from a medical point of view, it’s a bit easier to deal with covid now than before. We’ve had a huge amount of experience, data from studies and advances in therapies which mean that we now know what works and what doesn’t. The staff doing this everyday (unlike me, who was “visiting”) had developed a knack for knowing how far a patient was along in their journey with the disease, who was likely to worsen and who had gotten over the hump of their worst days. This is markedly different to the feeling of flying blind previously.
What I wasn’t ready for were the stories of such preventable despair.
Most of the patients on the ward were unvaccinated or elderly with complicating conditions. In one of the rooms was an 80 year old lady. We had been told that she didn’t speak English well and kept taking her oxygen tubing off her nose. In full mask/goggles/space suit, I went to see her this morning. She had some serious underlying lung conditions but given all that, she wasn’t looking to bad, sitting out of bed in a chair in a giant room by herself. Reading her file, I knew she was a grandmother and resided in a lively family with her grandkids. Now, she was here in a strange room all by herself. She had a limited grasp of English, so communication was hard. All she said was “yes” to everything I asked, but between the layers of my mask, the buzz of the air purifiers and the general noise of hospitals, maybe she just couldn’t hear anything.
She sat there for hours, just fidgeting with her oxygen tubing. What else was there to do?
She was early in her disease, but she looked pretty well. She had delayed getting the vaccine but at least she had had a dose. The next patient wasn’t quite like that.
He was in his late 40s. Unvaccinated and staunchly against it when he came in. Within 24 hours of being here, he knew he was in trouble. We normally breath on 21% oxygen in the air. He was needing over 50% and still struggling. At one point in the morning, we had him at 95% oxygen and then on a tight face mask that assists with delivering oxygen. It was the last step before needing a breathing tube.
He was going downhill fast. We organised a transfer into intensive care so that if he needed intubation, we could do that quickly. As we took him down to the ward, you could see that even with the mask and machine assisting his breathing, he was exhausted. Just from sitting in bed and breathing. During the handover, some tidbits of his social life came to the fore. He had recently moved back with his elderly parents. They too were coughing at home now. Many guessed that we would be seeing them in a few days. And he also had a 6 year old child.
I couldn’t help but be sad and angry at all this. Sad, because here was a father who couldn’t be there right now to look after his child because he could barely breathe, who may or may not be alive in a few weeks. His parents also are likely infected and may do worse because of their age. A young child who is watching their family crumble around them…
And this time, there WAS something that could’ve been done. Yet, due to media scare mongering, poor government policies and the general rise in people promoting misinformation to gain popularity, we have situation where an entire family could be decimated. The patient understood this and was willing to accept any therapy we thought necessary and I hope we can get him through.
Unlike last time, it might’ve all been preventable. And it’s that feeling of sadness and anger that I didn’t expect this time.
(some details changed to protect patient privacy)
