Volume 11 Issues 2 February, 2021
The New Year bells ushered in with all positive hopes, wishes from family and friends. However, the mumble about novel corona virus was in the mind of health care workers alas without comprehending the enormous avalanche on physical and mental health it would unleash….
Uncertainty existed about the communicability of the virus; the fear started creeping in regarding the morbidity and mortality. Our unique environment catered to malignancy patients which placed additional dilemma about managing the cases due to immunocompromised status.
The initial trauma was immense amongst intensivists and critical care nursing team due to fear of cross infection between patients and health care workers. It took a while for preparedness for the anticipated pandemic, which was negated by WHO protocols, peer collaboration, personal research, and active discussion amongst intensivists. This enabled the health care team to mentally face the positive patient without the fear of getting infected themselves or infecting their families.
After protocols were put in place, creating an isolation intensive care unit, we started treating patients. Healthcare personnel started getting infected in spite of all adequate precautions; fear increased multifold due to a void about the nature of illness. The mounting death toll and media input worldwide made us wonder whether it was even safe to work compromising our own personal health and our family. The end result of the stress was reflected in few of our oncology healthcare workers who quit their jobs for family safety.
The magnitude of stress anticipated was even much higher than expected, which made us realize that we need to strengthen our team by counselling. The critical care team decided to boost the morale of coworkers by augmenting their personal health, i.e., by encouraging nutritious diet, supplements, adequate Covid breaks and addressing their family concerns. This assuaged the apprehension of doctors and nurses to persevere and serve the patients.
As days passed, the infectivity rate was in the upward trend and it made us frightful about the working environment. We realized that the fear was smouldering within our cortex unaware of the consequences it was having on our mental wellbeing. For instance, the Covid RT PCR sensitivity and specificity, effectiveness of changing protocols as the pandemic marched mercilessly.
There was this young patient who had dreams of overseas education and future ideas. She was diagnosed with leukaemia, received bone marrow transplant and was eager to begin her new life. However, she had to face the brut of pandemic, remained positive for several months unlike other cases with no antibodies. Although all aggressive measures were in place, she deteriorated day by day and eventually succumbed.
The trust factor plummeted between co-workers due to asymptomatic carrier state and further isolating ourselves, i.e., eating alone, no informal exchanges, which led to social apathy, sleeplessness, and poor appetite. The above issues were taken into consideration by intensivist team via phone counselling and periodic zoom meetings. This was supported by management at every step. However, it still haunted us, as some of the senior oncology consultants were managed in isolation ICU who required O2 support, positive pressure ventilation and aggressive treatment and gradual decline in working force. This led to rock bottom feeling of life and death and surviving this disaster became the paramount importance.
With the herald of new Covid variant, our mental preparedness may perhaps be in a better state compared to the novel Covid 19 experience. Being an onco-critical care centre, we are aware the cross-infectivity rate and criticality rate will be higher in contrast to any other multispeciality centres; one question remains though whether liberation is in sight!
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