Coronavirus: Life in the ER is getting tougher; help us to help you

Jul 19, 2020 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

As our efforts continue to contain COVID-19, I believe it is important that I remind the public that it is important for us to work together if we are to see the needful outcome. This was aptly emphasized in an article I wrote at the beginning of this month.
I again share this article with you and appeal to you to not only read it, but endeavour to apply the recommendations.
“Doc it’s becoming very difficult for us”. Those were the words of a member of my team earlier this week while taking care of patients in the Emergency Room (ER) at GPHC. While I had noticed the surge in patient numbers over the past few weeks, it’s never easy hearing the toll it is taking on the ER staff. The ER at GPHC is the place that never sleeps. No matter what’s the obstacle (believe me there are many), my ER team is always ready to practice ‘MacGyver’ tactics to ensure we can continue to deliver for our patients. It is a thankless job that has become even more challenging during the COVID-19 pandemic. We are now seeing an unprecedented rise in COVID-19 cases in Guyana and if it continues to surge, it will take a toll on us in the ER and the healthcare system in Guyana.
THE UNPRECEDENTED RISE IN COVID-19 CASES
Over the past weeks, we have seen an increased number of COVID-19 cases. This is a sharp rise when compared to the slow rise in the initial numbers. My biggest worry is that we haven’t reached our peak and if we do not improve on our preventative measures, it will overwhelm Guyana. We need to learn from other countries and not make the same mistakes that have cost so many lives and have left so many incapacitated. We have also seen the increase in COVID-19 cases at the ER. While we are managing to keep the ship afloat, I am beginning to see the possibility of kinks that can overwhelm us if our COVID-19 cases continue to climb at unprecedented rates.
THERE IS EVEN A RISE IN NON COVID19 CASES
In the initial stages of the COVID-19 outbreak in Guyana when persons were more adherent to restriction guidelines, the number of patients coming to the ER had dropped significantly. This gave us the time to adapt and also manage with the smaller number of COVID-19 cases that was coming. It does take more time and effort to manage COVID-19 patients than non COVID-19 patients because of factors too numerous to mention. Unfortunately, as persons have become more tolerant to the situation and less adherent to guidelines, we are seeing a rise in non COVID-19 patients presenting for care. What is distasteful, is the fact that many of these non COVID-19 emergencies are avoidable. There are many trauma cases presenting during the curfew hours; quite a few of them are intoxicated with alcohol. Injuries from interpersonal violence are also prevalent. These are all avoidable conditions that add to our already stretched lists of patients.
HOW IS THE ER STAFF COPING?
No one can ever say they are fully prepared and are doing well during a pandemic. This is a first time experience for us all. Working in the ER or the “fast lane” as it’s sometimes called, you have to be resilient and cope with abnormal amounts of stress on a daily basis. In a pandemic, stress levels can go through the roof and overwhelm any system including hospitals and their ERs. For now, we are coping; but there are signs of things getting out of hand. There is only so much that our system was designed to handle. If this surge continues, we may become overwhelmed and it will not be good for us and our patients. Every day we continue to strive and find the balance between concurrently caring for COVID-19 and non COVID-19 patients while pushing our safety levels to the brink. I am fearful of the day that we will not be able to find that BALANCE.
HOW CAN YOU HELP US TO HELP YOU?
Every week I write and ask for us all to practice preventative measures. It’s the only way for us to safely maneuver and be successful against this pandemic. Today, I’m pleading for the sake of my ER team and all the health workers in Guyana to:
• Stay at home and social distance if you have to go out
• Always wear a mask when you are out
• Practice good hand and general hygiene
• Adhere to restriction guidelines
• Spread the word about preventative measures to everyone you know
If all of us do these five things well, I’m confident that we will flatten this surge and win the fight against this pandemic. With COVID-19, the health workers need you more than you need them. I wish to thank my ER team at GPHC for their unfaltering will to strive for their patients during this time; what we do matters, let’s keep doing it. To my fellow health workers in Guyana, keep up the will to battle and soldier on. To my fellow Guyanese, be responsible; please help us so that we can help you.