Coronavirus: Health workers are pushing beyond their limits; alarm bells are ringing

Sep 05, 2021 Dr Zulfikar Bux, Features / Columnists

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By Dr. Zulfikar Bux
Assistant Professor of Emergency Medicine

Kaieteur News – Last night I was speaking with a colleague who was expressing concerns for fellow medical colleagues in the frontlines who are exhausted. Yesterday was one of the worst days we’ve had at the frontlines since this pandemic started. Patients were coming so sick that there were too many resuscitations (CPR); unfortunately, some didn’t make it. My concern is that there will be more days like this and even worse, given the COVID-19 wave that we are currently experiencing. Health workers are obviously absorbing the brunt of this wave and like everyone else, we have limits. I am concerned that some of my colleagues are beginning to show signs of emotional trauma and burnout from the constant influx of sick patients and deaths they have had to deal with, especially in the recent weeks.

What is currently happening in Guyana
Given the trend worldwide, it seems that we are in the “Delta wave” of the pandemic, which has been the most aggressive one so far. Our current seven-day case numbers and death rates are at its highest since the pandemic started. Majority of the deaths and hospitalisations are avoidable since it is patients that chose to take a chance without vaccines. Unfortunately, they are the main victims of the “Delta wave” and given our low vaccine uptake, I worry that there are sufficient numbers of unvaccinated for the Delta variant to infect and overwhelm us with deaths.

The patients that suffer
While we do see a few infected vaccinated patients, the numbers of hospitalisations or deaths from this category are not cause for worry. However, the recent massive influx of deaths and severe infections from the unvaccinated is worrying as the Delta variant (assuming it is) is showing to be more efficient in taking these patients down than any other previous variants. While the numbers of these patients surge, the numbers of non-COVID-19 cases have not dropped and it is becoming a challenge to cope with the “storm that is brewing.”

Health workers are suffering
Imagine the scenario of three patients presented to the emergency dying. One is confirmed COVID-19, the other is a patient with a “breathing problem” and the last one’s heart has stopped beating because of complications from diabetes. It takes a minimum of four health workers to resuscitate (perform CPR) on each patient and each resuscitation can last between 20 minutes to an hour. The confirmed COVID-19 patient dies, the diabetic patient is saved and placed on a ventilator (life support) and the “breathing problem” patient is alive for now but you find out the relatives were hiding information, and the patient is COVID-19 positive. You rush to make sure that all of your colleagues had sufficient protection when each of them would have spent extensive time trying to save this patient. While all of this is happening, the load of sick patients with other conditions waiting to be seen keeps increasing. Everyone is bombarding you for miracles, wants to be seen right away, or needs more information about their sick relative. You have not had a chance to eat or drink for more than nine hours and you are broken inside because of the suffering that you had to witness your patients go through. You suck it up and continue on till your shift is over and stay on a bit after to ensure your patients are dispositioned. You leave tired and hungry, worrying that you are returning the next day to a similar situation or even worse. This is not a scenario, it is the reality of what ER staff are faced with daily. What I’ve described is not even half of what we endure daily to make sure our overwhelming load of patients get the care they so desperately need.

What may happen in the coming weeks if we do not act responsibly
While the scenario above, and it is currently what we are faced with, the situation will get far worse if we do not curb the spread of infections immediately. If that happens, it will not be fair to “bash” or blame the health workers when they can’t deliver the “miracle” that we all keep expecting as the situation worsens daily. Like the US and India and so many other countries, the situation may reach a point where we do not have oxygen for everyone that needs it. We may not be able to save every life that can be saved and suffering will be like never before. It is what happens when a pandemic overwhelms a system where callous behaviour continues to be the norm.
We can avoid this by being responsible and practicing the preventative measures that mitigate our risks of becoming infected. However, we have a powerful weapon in the form of vaccines. They are doing what they were designed to do; drastically reduce deaths and hospitalisations from COVID-19. This is the best armour you can put on at this stage of the pandemic. It will protect you and others and it will give the health workers the boost they need to save more lives.

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