Last September, in what turned out to be peak-pandemic week for Sydney hospitals, I ran a COVID ward for seven days. Which is odd, given that I am a cancer specialist, but we had run out of virus specialists. However, even though they didn’t have time to run the wards themselves, they provided fantastic supervision. So not that many people died.
These Deltas were really sick, and by my estimation (unverifiable educated guess), fully half of them would not have survived if they hadn’t had a NSW public hospital to go to, and staff who volunteered to be there.
Constant vigilance for hospital staff. Credit:Dominic Lorrimer
I’m not young and most of the staff had a lot more to lose than I did. Nevertheless, it didn’t escape my notice that there was a chance (admittedly small) that I could die from this. I absolutely do not need any thanks for this, but others do, so let’s recognise a system that looks after everyone who turns up at the front door, whatever language they speak and whatever life stuff-ups they have managed to accumulate (and boy, did I see a lot).
Thus endeth the lesson and I am now in a different but even more interesting position – watching Omicron evolve in front of my eyes but from the sidelines. I’m not in a COVID ward (yet). I’m back in character as a cancer specialist. There being no other contenders, all the skaters having fallen over, I am head of department. Lots of decisions about testing, PPE, can we give chemotherapy to the unvaccinated, what about the patients having radiotherapy, who gets to come in and see their dying relatives – frankly heartbreaking decisions my colleagues across the radiation, haematology and palliative care services and I need to make.
But Omicron is definitely different from Delta. Partly out of interest, but mainly because I can’t work out how to unconnect from the Teams thingy I am connected to, my phone still pings every time there is a COVID admission to my hospital. It’s a fascinating experience. Here’s what I have learnt:
First, they aren’t as sick. When I was doing peak Delta, every person admitted to hospital had low oxygen levels. Give them oxygen now. The infectious diseases experts would send me a text. Give drugs A, B and C, roll them over on their fronts, get ICU to review. Now it’s more like “don’t need any drugs yet, let’s wait and see …”
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Second, a lot of the admissions are about something else. She’s breathless, her heart failure meds need reviewing, but we just found she has COVID … Or, he’s having chemotherapy, now he has a fever, we just found out he has COVID. They all end up in a COVID ward … but probably not because of COVID.
Third, this just happened to me yesterday. I went down to the emergency department because there were two patients I needed to see. They both needed to come in and the registrar and I spent some time assessing them. The hospital being full, it was a day before they got to my ward. At which time we got a message: there was a COVID-positive patient next to them, so they are both “close contacts”. I know the definition is changing hourly, but at the moment, they need to stay isolated in hospital for several days. Although we have fixed them … ready to go home … I have to keep them in. Meanwhile, I don’t have enough beds to cope with the cancer patients who really need to be with us.
The heartbreaking choices we must make to juggle hospital resources for COVID
Source: Philippines Alive
