The Effect of Covid on Doctors

A bit about myself...

My name is Dr Coert Gous. I have been working in the field of Emergency Medicine for the better part of 17 years. After 11 years of studying, one year working under the guidance of Prof. Gert Saayman and my good friend Dr Servaas Rossouw in the Dept of Forensic Medicine, and another 2 years in the Department of Emergency Medicine at Steve Biko Academic Hospital under Prof. Dries Engelbrecht, I eventually ended up here at the beautiful Zuid Afrikaans Hospital as the Director of the Emergency Unit since 2008 where I have been practicing the Art of Emergency Medicine ever since.

Did I always wanted to become a doctor?

Indeed. My mother told me that the first time I entered our family doctor’s surgery (Dr Louis Kruger) in the West Rand, when I was about 3 years old, she knew that I was going to become a doctor.

The impact of the Covid-19 pandemic on the Medical Practitioner.

I can’t think of a single colleague of mine that has not felt the impact of this disease - not only physically, but also emotionally, mentally and financially.... and sometimes devastatingly so.
I think most people have seen visuals of tired and drained Health Care Workers somewhere in the media. This was real.... not fake news.
You can only imagine the emotional and mental impact on doctors for having to cope daily with death and dying, with concerned family members not able to see their loved ones - and this sometimes for the last time - and with being confronted with making the difficult ethical decisions of who gets a ventilator and who not.... a decision not easily made when you are dealing with the precious gift of human life.

All of this is of course greatly exacerbated by the near complete financial ruin of many private medical practices all over our beautiful. I can understand that people think that doctors (and hospitals alike) were some of the only entities that “made money out of Covid” but I can assure you that it was not the case at all. Our industry suffered massive financial losses as a direct result of the Covid-19 pandemic: hospitals and in my case, Emergency units alike, had to to procure much more PPE to offer safe environments for staff and patients. The cost of this massively outweighs the income generated from each patient. Almost every single practice has seen a massive decrease in “other than Covid patients” - sometimes with as much as 70%. Keeping in mind that staff salaries still need to be paid, with all the other overhead costs escalating as well to deliver good quality healthcare to our patients, the financial impact was huge.

My biggest challenges in the war against Covid-19?

I think the unpredictability of the disease and the disease process for me, wins the prize. How it can strike anyone, of any age at any time with different severities still baffles our minds in the medical fraternity. It made our efforts to respond appropriately much more difficult and almost left us to work on a case by case basis, managing everyone in hospital as if they are going to complicate anyway, in an attempt not to underestimate a patients milder symptoms, most of the time unnecessarily so.

First wave vs. Second wave

We saw many more patients with Covid infection during the second wave and their might have been a larger portion of younger patients. I do however feel that the reason for this was not that the virus mutated to a more dangerous one but that the lowering of the “Lockdown level” from 5 to 3 with the resultant increase in exposure, as well as the apparent increase in contagiousness of the virus had some role to play. It basically boils down to more people being infected, with more people suffering from complicated disease, thus increasing the burden on the healthcare system even though percentage wise, it was very similar (i.e.. 5 sick and 1 complicate vs 20 sick and 4 complicate).
I am also of the opinion that we were better prepared.

Our loved ones.... the unsung heroes.

These are the people that deserve all the gratitude. You can just imagine their fear and stress everyday. Not to mention the impact on their social lives. For us it was difficult to visit family and friend as a result of my high level of daily exposure to critically ill patients in the Emergency Room and our hospital’s Intensive Care Units. This even at a time when it was allowed. People close to us were worried about their exposure to my family. If I remember one thing about this time in our lives it will be the support of my family.... I love them.

Coping with the idea of getting infected?

I would compare this with a policeman or soldier who are about to confront a dangerous situation. We believe in and expect of them to confront those situations on our behalf to keep us and our world safe. With a pandemic we, the healthcare workers are the “policemen or soldiers” - this our war and we will win.... we always have.

Key lessons

  1. The more we learn and the more we know about this disease, the more we understand that our knowledge about Covid-19 and about the wonderful world of genetics and immunology is still very much in its infancy.... opportunity!!!!... nudge nudge... wink wink....
  2. I also learned and experienced the value of real nursing, not paper work..... real old fashioned nursing.

 

Will this pandemic change how we think about health and healthcare in SA?

I hope so and I think with a bit of creative thinking we could easily solve many problems in our country with regards to healthcare. The private and public sectors have now proven that they can work together if they are forced to do so and that the one can help the other when it comes to the health of our people in the country.

I also hope that this pandemic has changed our medical fraternity’s and more specifically, our academic colleagues involved in research, to be even more open minded about different possibilities and opinions. Keep an open mind and more knowledge will enter.

My advice to the public

Only 4 things are enough:

  1. Wear your mask.
  2. Wash your hands.
  3. Sanitize.
  4. Visit your doctor earlier rather than later.... DON’T WAIT!! This is most probably the most important message I would like to convey with this article. A huge chunk of the so called “excessive deaths” calculated by government is a direct consequence of people not seeking medical attention early enough for all or any of their ailments due to fear of contracting COVID-19 in the hospitals. Please know that we at Zuid-Afrikaans Hospital have done and still does everything within our means to keep patients safe when they visit our hospital or any of the doctors or other services available in our hospital. PLEASE don’t wait until your ailment has deteriorated and your pain has progressed to such an extent that lengthy hospitalisation is unavoidable. SEEK HELP EARLY!!!