Doctors tell of their experiences and offer hope in a time of Covid-19

Hospitals scrambling, a disease without a vaccine (yet) or a cure, hospital beds dwindling, patients increasing and testing the patience of medics who are trying to keep up. Covid-19 is creating a peace-time battle line at which doctors and nurses go to war against a coronavirus. From Italy to China, Iran to the US; doctors are scrambling to contain the virus in their communities and hospitals. Emergency Rooms are working hard to host everyone who is concerned, has been diagnosed and even quarantined. TRT World caught up with doctors to find out how they're handling the crisis. 

In Modena, in northern Italy, infectious disease doctor Giovanni Guaraldi is working 16-hour shifts, treating patients and trying to understand the viral mutation. "The major damage that is produced by this virus appears to be [not only] a disproportionate inflammatory reaction affecting both of the lungs, but also the whole body," he said.

He explained that patients who are more at risk of death aren't just isolated to the elderly, but anyone, even the middle aged who may have ‘comorbidity conditions’ or multiple medical conditions which they are already treating, makes contracting this coronavirus a ‘unique issue’. So far, doctors have used a drug called Kaletra, an antiviral treatment which has been used for HIV patients. And in recent months, for severe cases, Guaraldi said they were using Remdesivir, which is still only in clinical trials. He said that because "the number of people eligible were so many" the company that produces it, Gilead “reduced the possibility of access and now they are rejecting” it for those who are not in intensive care. 

The fact remains there is no officially approved antiviral, and so it seems, the treatment for Covid-19 is its own experiment.

But beyond symptoms and medicine; doctors and nurses worry about protecting themselves. "We need to work now. This means I [tell] my children, better not see you tonight, I ask parents, my friends, I am a bit isolated." Guaraldi said. "When we go home, we stay alone and we try to rest. Of course this implies the psychological reaction...we say two patients of mine died, three patients of mine died, ….every day this is quite stressing. But we also appreciate a lot of messaging, [to] encourage us. Of course, we need psychological support but I’m proud to be in my position." 

Meanwhile, in Rome, the Red Cross of Italy welcomed a team of Chinese doctors to assist in organising efforts to contain the virus. General Practitioner, Dr Andi Nganso, who heads up the office in Rome and is deployed from Northern Europe said they have faced serious challenges in responding to the virus. He told TRT World: “There are a lot of [Red Cross] workers that are now affected, so now we have to manage, like a puzzle, all of the ambulances, to be sure we can continue to assist patients.” 

The Red Cross supports up to 70 percent of the ambulance assistance for the country’s national health system. They are first responders in communities across the country, regularly receiving calls about protocol and psychological support. 

In just the last few days, Nganso has been scrambling to organise everyone’s post. Ngansoo is thankful for the Chinese support: “Their knowledge, they are serious,...it will be good to understand the next step for Italy.” 

He misses his family, spread across Germany, France and Belgium. “I’m alone. it’s really stressful, I have difficulties sleeping. I hear too many stories and I have to manage them,” he said. 

Nevertheless, he presses on and encourages the public to seek information, only from official sources, such as the Red Cross, or National Health Agencies or their doctors. “We understand the fear,” he said. 

Across the oceans, in Hong Kong, Chinese doctors are still managing. Resident and respiratory specialist Dr Joyce Ng just finished her shift. Every week, she serves an overnight call to take in new patients in the isolation ward. 

She said her team has been greatly supported by their superiors. “We can test whoever we like, there is no restriction. We have four batches of testing everyday, the results can come back quite quickly, around four hours. It’s around the clock,” she said. 

She also noted many people are nervous and may come in with minor symptoms which can strain their bed capacity. Even so, some patients with no symptoms at all still show haziness over their lungs. 

Ng did say she is taking precautions to protect herself as well, wear proper gear and has moved out of her family home, but, she says, the morale of her team remains high. “Every one of us, on the team is a volunteer, so we have a very good team spirit. That helps a lot. We help each other,” she said. 

Many Asian nations are capping the spread quickly. Singapore has been praised for its reduction of infected patients. Kuala Lumpur has yet to report any deaths and China’s numbers are halted. Asian countries, however, have dealt with outbreaks before, namely SARS in 2002 and 2003. Even before viral outbreaks, due to pollution, sick people knew to wear masks in public. And it’s worth noting; ancient Eastern medicines and preventive care are often found to boost quality of life in their cultures. Still, there’s much work to be done. 

Singapore’s Prime Minister Lee Hsieng Loong stated in a public video: “Everyone feels the impact.” But by taking preventive measures and being transparent, he believes planning for “a possible spike” will keep everyone safe, calm and “bring the numbers back down”. He is not shutting down the country and with reassurances, citizens are far more mindful of reducing public consumption and refraining from larger crowds. 

The World Health Organization also issued a statement last week from its Director General Tedros Adhanom Ghebreyesus, who said: "All countries must strike a fine balance between protecting health, minimising economic and social disruption, and respecting human rights….every individual must be involved in the fight.” 

But the US is largely behind as President Donald Trump dismissed its gravitas earlier in the year. He’s come under intense fire from health officials and opposing party politicians for his lack of an effective response. His failure to act early and issue proper testing throughout the country has created confusion for much of the public. Most hospitals don’t have enough tests to offer the growing number of suspected cases coming through. 

Doctors in the US are largely overwhelmed and it was difficult to reach them. But many have taken to YouTube and social media websites to dispense their own messages of assurance, reduce public panic and offer preventative advice, which largely follows social distancing, hand-washing and mindfulness of symptom severity. Mental health professionals are also issuing statements to help people cope with the chaos. 

Back in Italy, Guaraldi said he believes it’s important to “build up infrastructure” for the most vulnerable and will take a “big welfare” system to make it happen. 

But it was his closing message that echoed the loudest: “‘Frightened’ doesn't protect people,” he said. “Frightening [people] in infectious diseases produces disaster. We knew it from previous epidemics ...from history. We know that we can cope with this epidemic. Give people hope, at the same time make people understand, now, their lifestyle must change.” 

Perhaps, then, it’s time we follow the doctor's orders before it’s too late.