Indian-origin NHS doctor reveals what it is like to fight COVID-19 from the frontline

dr-sneha Dr Sneha Singh | via Facebook

As of on Monday, 449 patients died in the last 24 hours UK after contracting coronavirus. The total death toll due to COVID-19 in the UK as of now is 16,509.

UK doctors have been protesting a shortage in PPE equipment in the past week. Equipment shortage or not, being on the frontline, fighting a pandemic—something like the fast-spreading coronavirus—cannot be an easy task. Not for a doctor, a nurse, cleaning staff, someone working in the pharmacy or an ambulance driver.

Dr Sneha Singh, Emergency Medicine Registrar, NHS Oxford Deanery tells us what is has been like fighting the pandemic.

Q. How has the experience of working in PPE been? What are issues you face in using PPE?

In the UK, we follow the Public Health England guidance for PPE. We have had to be fit-tested for the FFP3 masks we wear, to test that there are no leaks. Apart from the mask, we have to wear multiple other pieces of protective layers as well which can be quite claustrophobic and hot. It is crucial to wear this in a particular order and manner as, it is during this that many healthcare professionals are at risk of getting infected.

PPE is certainly not pleasant for the healthcare professional or our patients, but it is the only way to protect ourselves from getting infected. The most challenging part is, it limits our ability to communicate with our patients and colleagues. Most of our patients are scared when they come to the emergency department and not being able to see our faces adds to their anxiety. The non-verbal cues that we give to reassure our patients are lost underneath the mask.

We keep the PPE on for 4 to 5 hours at a stretch during which we cannot eat, drink or even use the toilets. So we try not to drink too much water before putting on the PPE.

Q. The COVID-19 outbreak was spotted almost 5 months ago-how better equipped are medical professionals in reaching a diagnosis now than compared with say, January?

A few months ago, COVID-19 was unheard of. We have come a long way in terms of testing. The swab tests that most places are using only have a sensitivity of about 70 per cent-- which means 3 out of 10 patients with the disease will test negative. We are hopeful that the antibody test will give us additional information, especially regarding reinfection rates. Having said that, for most individuals requiring hospital admission for COVID-19, the changes on their chest X-ray or CT scan are very typical.

Q. How has your personal-professional life changed as a result of COVID-19? Are you facing any mental fatigue?

As emergency physicians, we are always on our feet, so the physical retributions of Covid-19 are manageable. For me, the consequences of COVID -19 have been more emotional. There is no right way to tell someone that their loved one is dying and that they can’t come and see them in the hospital because they need to self isolate themselves. Our masked faces are the last faces that many patients will see. At times, all you can do is just hold their hand and tell them they are not alone, as they breathe their last. There are times I just wait to enter my home to let out a cry, but praying for them gives me some solace.

Q. There are stories of medical professionals getting infected? How do you deal with the emotional strain of such risk of exposure?

From the beginning, most emergency physicians had accepted the fact that a majority of us will get the virus—given the number of undifferentiated patients that we see. We just pray that our body will be able to fight it and try and take all the necessary precautions.

Q. Are you worried that you might contract the virus at some point? How are you dealing with the feeling that you might contract the virus at some point?

It is highly likely that I will contract it (if I have not already), but what I worry more about is passing it on to my loved ones and vulnerable people.

Q. How much do you think medical professionals and health systems changed due to COVID-19 and what changes would u personally want to see?

It has been an incredible experience to see how the medical fraternity has gotten together to fight this. All elective surgeries and non-urgent clinics have been closed and their staff have been redeployed to help on the frontline. We are now working on an emergency response rota where all of our annual leaves have been cancelled. We are all battling this together, and it has been very humbling to see how everyone is supporting each other.

I strongly believe a public health system, such as the NHS, is a fundamental human right, with no distinction between the rich and the poor. The most important lesson we have learnt from this is that countries across the world need to collaborate and build an early emergency response system to face the next epidemic and prevent it from becoming a pandemic.

Q. One thing you would like to tell people staying at home, rather doing their best to stay at home, not being able to see their mother/child/sibling

Healthcare professionals are putting their lives at risk to care for your loved ones, please do your part by staying at home and follow the guidance provided by your government.

Q. UK still is a society that tends to compartmentalise people according to their race and class. Do you see racism or discrimination of any sorts taking place, especially in this circumstance?

The NHS is extremely diverse and there is zero-tolerance for racism. It is an overwhelming experience to see how different communities have come together to support the frontline staff, right from making visors to delivering hot meals to the hospitals across the UK. The silver lining that I see in these difficult times is that of communities coming closer to support each other regardless of their background.

Q. What is the longest you have worked after the COVID-19 outbreak without a break?

Our shifts are 9 or 10 hours long, and, we get a 30-minute break midway during our shift. These breaks are being adhered to much more religiously now because we know that tired physicians make mistakes, and our patients are most vulnerable now.

Personal disclaimer: The above views and opinions represented are personal and belong solely to the interviewee, and do not represent those of people, institutions, or organizations she is affiliated with in professional or personal capacity, unless explicitly stated.