Wating on the sidelines

Illustration by Eoin Coveney If there's one thing I didn't anticipate about the coronavirus outbreak, it's how useless it makes me feel. I love being an ophthalmologist. I wouldn't want to change that. But at a time like this, it’s hard not to feel that if only I had opted for a different specialty, I could have contributed more. The COVID-19 pandemic is pretty much everywhere at this point, but is particularly pervasive in Europe. While Belgium hasn't seen numbers anywhere close of those of Italy, Spain, or France, our numbers are going upward, and the rate of change is accelerating. Nobody has any doubt that we are on the cusp of a coronavirus wave. The only question is what the size of that wave will be. Will it gradually swell into an onslaught that will prove hard — but hopefully not impossible — to deal with? Or will it be a tidal wave, which will wreak havoc on healthcare infrastructure and workers alike? Antwerp University Hospital (UZA) — my home away from home — is one of the COVID-19 reference hospitals in Belgium. For the last few weeks, we've been getting ready for the wave to hit. Shoring up defences, re-purposing infrastructure, equipment and staff alike. The atmosphere is that of a veritable war room, except that the war hasn't really started yet. Many hallways and rooms lie empty, pregnant only with that eerie calm before the storm. There is plenty of great advice and instruction from doctors far smarter than me so I do not mean to tell people what they should be doing. I only want to share my own experiences in this strangest of times about what things look like from the vantage point of the ophthalmology department: All elective procedures are cancelled All non-urgent clinic appointments are cancelled Consultations are handled via telephone or email where possible I have been using WhatsApp to see my keratitis patients where I can. The point is to keep them away from the hospital. I've volunteered for a team to transport known positive patients to ensure we do everything to limit exposure. Ensuring that the protective equipment is sufficient. I am hoping by doing so I can protect the more "useful" doctors and nurses and keep them on the front line. If it is needed, I will be trained to do more practical interventions. Every day we get updates from our medical director, Guy Hans. Meetings are forbidden, so they are in the form of video conference calls. These updates are direct and frank; There are stock shortages, we may run low on crucial equipment, we’re low on manpower, and so on. If this sounds scary, it does not have that effect on me. The tone is calm and reassuring. Yes, I may learn about problems that I was unaware of before. But I also learn about what we're doing to tackle them, and what I can do to help. This in turn, goes a long way to alleviate my sense that I can't do much. My own head of Department, Carina Koppen, is checking in with everyone and leading from the front. We're in this together, and I can do my part. I'm still nervous, but I'm not afraid. I might be a mere foot-soldier marching to the drum beaten by someone else. But I stand shoulder to shoulder with my colleagues, with my friends, saying 'bring it on'. At the moment there are still very few colleagues in the team who have fallen ill; perhaps because our exposure to patients is typically rather low. So as a team we are ready to be placed where we are needed. Some of our residents are being retrained to work in the emergency department, others are learning to intubate. Like reservists, waiting on the sidelines to be deployed where the need is direst. The sense of solidarity extends beyond the walls of the hospital too. When a large government order of face masks fell through at the last minute, several companies donated their stocks of filter masks and one of the product development schools is using their 3D printers to design and make new masks for the infected patients. A call has also been send out for the community to make reusable fabric masks so that the stocks can be reserved for patient contact and procedures. I for one did not expect to see grandmothers with sewing machines as part of a no-holds-barred effort to ramp up local production of protective gear, but here we are. I'm sure all of you can all share similar stories. Better ones too. For me, as this tragedy unfolds, I have found a source of optimism and strength in the way this is bringing people together. My hope is that you too will find such pockets of strength, hope, and resilience, that will allow us to weather this storm together. Sorcha Ní Dhubhghaill MB PhD MRCSI(Ophth) FEBO is an Anterior Segment Ophthalmic Surgeon at the Netherlands Institute for Innovative Ocular Surgery (NIIOS) and Antwerp University Hospital Illustration by Eoin Coveney

Tags: covid-19