Even infectious disease experts are constantly learning about Covid-19 -- no one has the full picture
All over the world, doctors, nurses, paramedics, and hospital cleaners have been putting themselves in the front lines to deal with what some people have called the “invisible enemy.”
All of them have been trained to assist those who are sick, committed to the relief of suffering. In many countries, particularly at the beginning of the pandemic in February and March when there was a worldwide shortage of protective personal equipment (PPE), all these personnel were putting themselves in harm’s way and many became infected and, sadly, there were significant numbers of deaths.
In Bangladesh, as in all countries, the medical personnel faced a dilemma. They wanted to treat their patients even though they knew that they risked infection, which could endanger themselves and their families. An experienced infectious disease specialist explained to me that his years of experience meant very little because everyone was and is learning about Covid-19 all the time, day by day.
He wanted to help and support junior doctors and other medical staff as much as possible, but found it difficult, as he was also learning new things every day.
He said that, as much as it was important to learn more about the disease, it was also very important to develop good habits like disinfecting your phone, pen, stethoscope, leaving unnecessary things at home, changing clothes, and washing them at the end of the day.
By talking to doctors and nurses, I have come to understand some of the difficulties they face when they sometimes need to take split second decisions which could mean the life or death of a patient.
Often, when a seriously ill patient comes to the hospital in a serious condition, with breathing and possible heart related problems, the first reaction of the doctors and nurses is to attend immediately with CPR (cardiopulmonary resuscitation), but, as all patients are suspected to have Covid-19, staff need to wear the full PPE. And putting it on properly can take a few minutes.
The staff need to familiarize -- practice -- how to put the PPE on properly and how to take it off carefully and dispose of it safely.
While appreciating the dedication of medical staff and the need for adequate PPE, one needs to understand that, sometimes, for a seriously ill patient with suspected Covid-19, four or five members of medical staff might need to be in attendance and new PPE for all staff is required for each patient they tend to.
My son, who is a doctor in the UK, says that, on some days on duty with Covid-19 patients, he needed to change his PPE five times in a day and have a thorough shower each time. Therefore, it is easy to see why huge quantities of PPE are required all the time and the quantities required are difficult to estimate.
In addition, while appreciating the remarkable dedication of the front line staff, one needs to understand the emotional and psychological toll on them. Covid-19 patients are not allowed to have visitors for fear of further spreading infection, and so, if and when a patient is dying, the only person who can be with them to hold their hand and pray with them is a member of the medical staff.
In normal times, a doctor can inform family members face to face about what has happened but, with Covid-19, it can only be done by phone.
In over 50 years connected with and living in Bangladesh, I have always admired the quality of the doctors and their advice and have overcome many medical problems, including cancer. It is also true to say that, without doctors from the sub-continent, Britain’s National Health Service (NHS) would have collapsed long ago.
Now that the UK is leaving the European Union and the first waves of South Asian doctors to come to the UK have retired, it is possible that the UK will again be looking to recruit doctors and nurses from Bangladesh, India, Pakistan, and Sri Lanka to keep the NHS afloat.
Having said that, it will not be at all helpful for the development of health care in Bangladesh if there is a medical “brain drain” to the UK. There may be difficult days and difficult decisions ahead.
Julian Francis has been associated with relief and development activities of Bangladesh since the War of Liberation. In 2012, the Government of Bangladesh awarded him the ‘Friends of Liberation War Honour’ in recognition of his work among the refugees in India in 1971 and in 2018 honoured him with full Bangladesh citizenship.