COVID-19 reflections from a frontline physician

Over the last several days I saw my hospital suddenly transform into a ghost town. Quads and walkways once crowded with patients now lay bare and buildings stood in silence. I made my way across deserted courtyards and walked through quiet hallways that echoed with my footsteps. As a gust of wind blew, I involuntarily held my breath hoping to stall the biological onslaught in the air.

It all began a few months ago with seemingly obscure reports of a newly discovered virus in China. As news filtered in, some paid attention, but for most it seemed a distant worry. My hope of the bug not surviving rising temperatures soon burst into flames when the virus not only survived but thrived, rapidly spreading from host to host, country to country, traversing latitudes and longitudes.

Within days it turned from a possibility to an absolute certainty. All too soon it appeared to be threatening the wellness of the masses and embroiled the physically vulnerable in a battle for survival. Just as we were beginning to prepare ourselves, the epidemic evolved into a pandemic at a speed and proportion never witnessed before in our lifetime. The world then sat up and began to pay heed.

Some governments sprang into action to mobilise resources and inform the masses. Pakistan fortunately activated its systems sooner than many others and COVID-19 centres were identified, with ours being one of the first. Overnight protocols were created and staffing was arranged. Little did we know that the unprecedented magnitude of the situation would bring with it mayhem of even greater proportion.

Walking up the ramp to my clinic, I finally came across patients who were scattered across the waiting area, some trying to keep their distance, others huddled on benches wearing masks, and the rest queued up, anxiously waiting for their turn to speak to the masked and gloved staff. With possible contagion all around me, I too donned a mask and walked over to join my colleagues.

At the clinic counter I found the staff nurse being pulled in different directions, so I stepped in to answer the queries of the people lined up. Every story I heard was peppered with emotions and reactions to match. There were passengers that came directly from airports while some wanted clearance to travel. I saw patients who were sick and others who were anticipating the illness. There were dozens who were anxious family members, others who had fleeting encounters with a possible patient. All of them desperately sought answers and reassurances.

Over the coming days our primary care doctors and nurses teamed up to screen and swab countless patients following rapidly changing guidelines. The rising volumes made separating the anxious from those truly at risk an enormous task for all of us. We were fortunate to have protective gear that we donned with meticulous care. We practiced obsessive levels of hand hygiene to minimise the risk of getting the virus and taking it back home to our families.

As I moved through these days in a daze, I witnessed emotions and behaviors on my side of the queue counter as well. I saw anxiety and apprehension, I saw courage and camaraderie. I witnessed the self-assured succumb to fear and I saw the meek become the mighty in this surreal time.

Soon the cavalry started shrinking. Some of the staff succumbed to exhaustion, others with prior illnesses could not work in high risk areas anymore, and some who had been exposed to infected patients went into quarantine.  The remaining few had to quickly re-calibrate and, fortunately, God graced them with the shutting down of towns and thinning out of crowds, for a bit. What sustained us during that time and continues to do so every day are the prayers and well-wishes from our family and friends who lend us their support during an extraordinary time.

As I reflect upon these days a few constants have emerged from this chaos created by the pandemic. Confusion was the first constant, caused by the novelty of the disease and the rapidly evolving information. Anxiety and fear were the second constant, found not only in patients but also healthcare providers worried about their own safety and that of their loved ones. When I now look back, it has been weeks since I hugged my children or sat in the same room with my mother because of this fear.

Through all this confusion and fear some ‘other’ constants have emerged too. The first being an unwavering sense of duty seen in the medical staff that continues to triumph over their fatigue and battled burnout. The second constant has been the creation of new bonds and respect for colleagues old and new, senior or junior. The most admirable constant in my mind, however, is the tenacious grit and courage that has allowed some to subjugate their fears and inspire others.

We continue to be in the midst of a catastrophe never seen before. We are unsure of its middle and uncertain about its end, however, it is these ‘other’ constants and characteristics of the human spirit displayed by several ordinary yet remarkable individuals that will help us emerge triumphantly from this crisis.