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‘We Are Under Intense Psychological Stress’: One Egyptian Doctor’s Story

‘We Are Under Intense Psychological Stress’: One Egyptian Doctor’s Story

Dr. Maha Mahmoud and Dr. Sama from the surveillance team at the hospital. (Credit: Dr. Maha Mahmoud).

In a series of documenting the stories of health workers in Egypt, one doctor tells Egyptian Streets what it feels like to work amid the Covid-19 crisis.

I am an internal medicine specialist who works in a hospital, which is part of the Ministry of Health, in Al Sherouk, usually dealing with chronically ill patients. I would like to share my own very small experience as a health worker in Egypt during the coronavirus pandemic.

Before we had any cases in Egypt, we were obviously aware of the novel virus spreading in other parts of the world. But everything carried on as usual, the emergency department and all the other departments, and we did not feel the urgency of the crisis. After one week, the cases began slowly appearing, and the Ministry of Health started sending us certain protocols through email to follow.

Work Flow

We were first told to set up a triage committee consisting of doctors and nurses, who are responsible for reviewing all incoming patients before they enter the hospital and refer them to other relevant clinics or hospital to treat their case. If they suspect anyone with COVID-19, particularly those who came from abroad, were in contact with others that were infected with COVID-19 or have severe symptoms.

We then set up an isolation room for those suspected of carrying COVID-19, which includes a doctor who also analyses the case and looks at its history, and whether it was in contact with another person who was infected. The doctor then summons another GI doctor from outpatient clinics to come and check on the patient, and if it is clear that the patient has a suspected coronavirus disease, then we report it and refer it to El Hommeyat hospital.

If people come to us suspecting that they have it but seem to have mild symptoms, they are sent home to self-isolate and take an antipyretic to reduce fever. After 14 days, if their symptoms start to intensify, then we tell them to call the ministry’s hotline or go directly to El Hommeyat hospital.

Usually, they would provide an ambulance vehicle to transfer the case to the hospital, and over there they carry out sample analysis and testing, and if tested positive he is referred to the isolation hospital.

We were also told to control the number of patients entering the hospital, so it was determined that not more than 30 patients can enter, and they must all enter one after the other so we limit the gatherings and comply with social distancing measures.

A surveillance team was also set up to monitor the staff and patients at the hospital, and who is in contact with who to write a daily report and send it to the ministry. If a case of coronavirus is found, then the entire hospital gets closed down with the staff, and then all become tested after two weeks.

After cases in Egypt began to increase, the ministry ordered that all outpatient clinics be closed to limit gatherings and that the hospital focuses on emergency cases, and doctors working in those clinics were referred instead to primary health centers. We carry out the same protocol in these centres and follow the same routine.

Challenges

Supplies and personal protective equipment are not always enough, and some of the staff have been taking it back to their homes, which worries me because this is wrong and might even transmit it to other individuals in the households.

We have around five or more ventilators in the hospital, but we are told that if there will be any case, then enough equipment will be sent to us. Currently, however, we are definitely not prepared for any case of COVID-19, and it can be quite frustrating – no one should be asked to treat a COVID-19 patient without having enough equipment.

The atmosphere is cooperative but there is always an undercurrent of fear and panic. We faced many patients who had mild flues but came to us panicking that they have the coronavirus. One engineer came to me saying that he has been shivering since yesterday from fear that he has the virus.

Our main role is to support them psychologically and try to raise their awareness on the main symptoms of the coronavirus and when should they contact the ministry’s hotline.

The problem is that, though we are keen on providing psychological support for the patients, we as doctors and healthcare workers are under intense psychological pressure every day. I go to work extremely stressed that I will transmit the virus to my home and my kids, and I try as much as I can to lower my panic level. I am quite concerned that we might end up getting health problems due to the stress that is placed upon us.

The saddest moment for me was when a 60 year-old woman came to us; she had multiple myeloma (a cancer of plasma cells). When we realized that she had high fever, we were very concerned, so she was placed in the isolation room. After collecting a throat swab and carrying out a PCR test, she passed away a few hours later. Many were afraid that it might have been due to COVID-19, but her results came out negative. Either way, to see someone die during this time is still heartbreaking.

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