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A day in the life of a frontline worker in the trenches

Dr Eric Khumalo, a registered medical practioner, shared with us his first-hand experiences from the trenches where he deals with Covid-19 patients.

Dr Khumalo writes:

I am currently based at Kiaat Private Hospital where I do emergency medical intervention shifts, which include attending to acutely ill and very sick patients at times.

I visit the ICU regularly, where I intubate (insertion of a breathing tube) confirmed Covid-19 patients who struggle to breathe and have to be assisted with ventilation via a ventilator. I also admit confirmed patients of the virus at Mediclinic Nelspruit, where I attend to them until they are discharged. I do emergency work and ward admissions for the private hospital in Barberton (RH Phodi Clinic), over and above running my own practice in KaMagugu.

I am the chairperson of the Kiaat Private Hospital’s Covid-19 steering committee that meets every week to look at our response and preparedness in dealing with these patients. I have a weekly slot on Ligwalagwala FM, every Thursday at 11:30, where we discuss Covid-19-related matters.

My working day includes ward rounds at two private hospital in Mbombela: Mediclinic Nelspruit and Kiaat Private Hospital. Sometimes I end up at Barberton’s RH Phodi Clinic if I have ward patients there as well. Thereafter, a brief rest and then I start consultation at my practice in KaMagugu, and start a shift at either Kiaat Private Hospital or the RH Phodi Clinic, if I am scheduled to do an emergency night shift in the hospitals’ emergency section. If not, I go home and rest for the day, which is seldom with this pandemic.

Many of my patients got Covid-19. Fortunately the majority had mild symptoms and I could treat them as outpatients while others had to be admitted. I cared for them while they were in hospital (either Mediclinic Nelspruit or Kiaat Private Hospital) and referred those without medical aid cover to Rob Ferreira Hospital. The good news is that more than 90 per cent of patients with the virus pulled through, although some still suffer from the symptoms of chronic Covid-19.

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The challenges was the availability of hospital beds to treat very sick patients during the first wave and even more so during the second one. It is very frustrating when someone cannot be helped and eventually passes away due to lack of resources.

Fortunately for me, I dealt with HIV a lot in the beginning when people still became very sick as a result of the virus, and Covid-19 reminded me of those days when HIV was still a serious health problem. So I was prepared and ready when this pandemic broke out. It took much of my time to attend to the patients, but I am a clinician who always have, and still do, dedicated much of my time to patients.

Yes, unfortunately some of them who were close to me lost their lives as a result of Covid-19, especially during the second wave, despite them being provided with the utmost care, including being oxygenated and ventilated.

Adhering to protocols and regulations ensured that the risk of me getting infected was reduced and mitigated. Regular handwashing and using personal protective equipment appropriately all the time ensured that the risk of becoming infected was reduced, but I must be quick to point out that some colleagues still got infected despite all these measures. I thank God that I was and still am spared from contracting Covid-19.

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People are humans and they remain humans even if they have the virus. Some healthcare workers would even be scared to enter a room or touch a confirmed Covid-19 patient in the fear of being infected, and this unfortunately created a stigma for these patients. It is important that in the quest to protect ourselves from contracting the virus, we also treat these patients with respect and appreciate the circumstances they go through.

We must be resilient in our quest to help and assist those confirmed with Covid-19. Indeed, we will lose some along the way, but we have to soldier on; we are faced with a pandemic that is threatening our lives and those of society. Protect yourselves and your family at all times by ensuring that your work clothes/scrubs and shoes are changed before you come in contact with anyone in your household. Let us do everything within our power to help our patients and avoid making them feel like lepers by displaying a non-caring attitude towards them.

With the relaxation of the lockdown levels (moving to lockdown level 1), a third wave becomes a possibility, because some people do not adhere to regulations and protocols. Covid-19 has demonstrated an ability to mutate (change) and this is the most likely threat to a third wave. A new strain can infect people (including those who have already recovered from the virus) at a faster rate and is non-selective (as we have seen with the second wave where young, healthy people succumbed to it because it was no longer an issue of comorbidities).

With the vaccination, the more people to get vaccinated the less likely the risk of a third wave, but it remains a possibility. We are ready for the third, if and when it comes, but the challenge remains of the inadequacy of hospital beds or ICU beds, especially when a large number of patients are in need of such. Nevertheless, with the vaccine the incidents of Covid-19 patients requiring hospitalisation and ICU beds will be most likely reduced.

Ordinary people need to discipline themselves and ensure that they adhere and follow regulations without being enforced to do so. For instance, people wear face masks wrongly, with the nose and sometimes the mouth out of the mask. In the townships people do not wear them. Let us follow food hygiene protocols i.e. washing of hands and sanitising them with an alcohol-based sanitiser, avoid parties and large gatherings until it is safe to do so. Seek medical help early if you are not feeling well.

Currently there is no medication that you can use to avoid getting Covid-19 and there is no cure for it. Currently the vaccine is our only hope in overcoming the virus, so please, when the vaccine has been made available to ordinary people, do take the opportunity and get vaccinated against Covid-19 and continue adhering to regulations even after being vaccinated.

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