Frontline medical staff pour their hearts out
Dealing with risk a challenge as hours and workloads increase
Frontline health workers are vital to the global response to Covid-19. They are taking on personal risk and working hard with limited resources.
In Thailand, it has been almost two years since the pandemic struck. Frontline medical staff have played a key role in fighting the novel coronavirus war especially the third wave reported in early April in which seven medical staff have lost their lives and many more infected.
The Bangkok Post talked to three physicians at various hospitals about their experiences.
Away from home
A third-year internal medicine resident at a hospital in Nakhon Nayok, 30, said his hospital has devoted two floors to Covid-19 patients, enough for 120-150 patients, while there were only 8–10 doctors, including him, to look after them.
When coma cases arrived, they would lose more staff for only one patient, which made the rest overloaded with work.
"A coma case requires the special care. There was a big man weighing around 120 kilogrammes and the virus spread all over his body and caused kidney failure. His brain was 'eaten' by the virus.
"This patient required 6–10 nurses and 3–4 doctors from many departments to take care of him," said the doctor, who asked not to be named.
Devoting staff to Covid–19 cases caused a scarcity of personnel elsewhere, as those who work in the ward needed to stay in the same area to prevent the potential spread among staff and patients.
"Not all of these doctors focus on pulmonology and the respiratory system. Some are from the surgical department or even the general internal medicine department.
"They need to be trained about Covid–19 to help reduce cases at the hospital. They have to stay in that ward only. As a result, staff in their department of origin have to triple their effort to keep up with rising number of non-Covid–19 patients," he added.
His working hours have increased from 9 hours to 10–12 hours a day.
"However, although I have worked hard during this pandemic, I do not get extra pay.
"I even have to register for Covid–19 insurance myself as we get no support on this," he said.
He understood that medical health workers are important in the fight against Covid-19, so he decided to put on hold his specialist study in pulmonology.
"I have not gone home to see my family in four months and I miss them so much,'' he said.
Putting self into quarantine
A first year internal medicine resident at a Bangkok hospital, 28, said he was quarantined while working at the hospital.
"The hospital announced there were doctors infected with the virus and they did active case finding among medical staff. Unfortunately, my co-worker was diagnosed and I was in the room with him the day result released. So I had to put myself into quarantine for 14 days," he said.
Ten doctors including himself ended up being quarantined. He had to call on a friend at 11pm to work his shift instead.
"I felt bad that I had to interrupt his downtime and he had only just arrived home when I called. I feel like I added to his burden during this time of crisis where staff are scarce," he added.
"Although our hospital has Covid–19 insurance to medical staff, it does not cover compensation during quarantine,'' he added. However, he said he was willing to do this duty to help take care of Covid-19 patients.
Facing a heavy workload
An emergency doctor in a hospital in Rayong, 31, said the Covid-19 pandemic has forced him to work overtime. He was also assigned to take care of people who had just received a Covid-19 jab at the hospital.
"Sometimes I just want to go to a department store nearby to relax but I can't leave the patients,'' he said.
He worked hard every day especially when people experienced side effects from the vaccine, such as muscle spasms. The doctor also talked about the lack of medical resources during the crisis.
"Most of the equipment, such as PPE [Personal Protective Equipment] suits, gloves, masks, are single-use. But PAPR [Powered Air Purifying Respirator] suits have to be rewashed, sterilised and reused because they are expensive; the filtration system alone costs around 20,000-40,000 baht per piece. In other countries they would throw it away after a single use," he said.
"There is nothing we can do as the hospital has a limited budget. My hospital used its own money to help support the cost of equipment. All we can do is try to take good care of ourselves," he added.
Call for sympathy
Somsak Akksilp, the Department of Medical Sciences director–general, said some medical staff had not been able to return to their families for two months.
Medical staff whom he visited asked for five things: a clear policy, cooperation, disease control, a strong medical system and inclusive vaccinations.
"The frontline workers are having a hard time. I have visited them at Prasat Neurological Institute, Ratchawithi Hospital, Lerdsin Hospital, Nopparat Ratchathani Hospital.
"If these five mechanisms can be provided, I think we can solve this situation," Dr Somsak said.
Thanarak Plipat, Regional Health 5 Office CEO, said he acknowledged the hardship of medical staff during this time.
"Medical personnel have been working tirelessly during this pandemic. My team and I have been stationed here since the first outbreak and this wave has eaten up a lot of our energy," he said.
Workloads are particularly heavy in provinces with a high incidence of the disease, such as Bangkok and its vicinity. However, he said, better days will come when everyone has been vaccinated.
"When we talk about work overload, it does not mean that every province is being swamped by Covid-19 cases. Some provinces, in fact, do not have many new cases," Dr Thanarak said.