Striking the right balance in Portugal

Filomena Ribeiro MD, PhD, FEBO, Head of the Ophthalmology Department at Hospital da Luz; Prof. at University of Lisbon, Portugal, describes the situation in her hospital to EuroTimes Contributing Editor Dermot McGrath. What protective measures are you taking for you and your patients? We have implemented strict measures at our hospital to try to limit exposure to COVID-19. We carry out an epidemiological questionnaire with patients before they are allowed to enter the hospital and also perform a temperature check. We have provided all staff with surgical masks, glasses, gloves and waterproof gowns. We use acrylic protectors for the slit lamp. We have stopped performing air puff tonometry and applanation tonometry except where absolutely necessary and use disposable tips. All of the rooms, materials and surfaces are thoroughly disinfected after every patient. These measures imply a major change in the structure and service compared to what we are used to. How are you organising things to deal with the crisis? By now, we have stratified the risk by pathologies in order to call only the most urgent cases. We have also developed guidelines for video consultations which we have started implementing. All departments at the hospital, including the OR, have separate circuits for positive and negative COVID-19 patients. In this way we try to minimise the risks for patients of worsening their ophthalmological diseases, which is a great risk during quarantine. On the other hand, our patients are usually elderly and have to be protected, so we try to strike the right balance. Thinking about the long term, we are hopeful that serological immunity tests will perhaps allow us to return to caring for our routine patients in the near future. The restart will have to be phased while maintaining the safety conditions for patients and professionals. A return to usual practice will be gradual and a long period of strict controls await us. We need to maintain this balance without jeopardising the visual health of our population. At this point in time, only a small percentage of the population will be immune and obtaining group immunity requires at least half of the population to have been infected with COVID-19, so the process is long. What are the more long-term implications for surgeons and their practices once the immediate crisis is over? I believe that even as citizens will be facing a new world after this catastrophe and its consequences will transform our way of practising. On the one hand, we will be more attentive to threats and the balance of resources that we have, as well as hopefully introducing more humanism into the equation. However, we will have to be very attentive to issues of poverty and economic difficulties that will emerge as a result of the pandemic. As doctors, we have to regain our value as a scientific community for society at large in terms of our primary role in treatment and research. That role has been mitigated in recent times by the influence of managers, regulators and politicians. If the COVID-19 crisis has taught us anything, it is that healthcare is a fundamental cornerstone of any healthy society and should not be measured only in terms of balance sheets and economics.

Tags: covid-19 Portugal