A second year intern at Groote Schuur Hospital has shared a post on Heroes of Groote Schuur Facebook page that sheds some light on what health workers are going through right now in South Africa as the country battles its second coronavirus wave.
Dr Zane Stenning explains how, along with others, he was transferred from internal medicine to the Covid respiratory unit with a team consisting of three consultants, three registrars and about five interns. They have basically been managing Covid for the whole second wave.
“Previously everyone was cycling in and out of Covid but then they thought it would just make more sense to have the respiratory guys run the thing. So then our whole team became the Covid team,” says Dr Stenning.
He says the second wave has definitely been “way worse” with “markedly more severe presentations of patients, and younger patients getting tubed”.
The criteria for ICU is based on several factors, he explains – “if you are triaged red, it means that you are a high priority ICU patient. If you triage orange, green or yellow, you have a lesser priority for ICU.
“Currently because there are no beds available, we are only accepting red patients to ICU and even still some red patients aren’t getting accepted.
“Obviously it’s not left to one person to decide who gets into ICU and who doesn’t and I think that’s what’s been good for us as junior staff, because we’ve had a lot of exposure to that now. Our team is stretched very thin so now when we are discussing this kind of thing, we are asked for our input which is a role that interns typically wouldn’t play.”
Looking on the positive side, Dr Stenning says the exposure has been good for the interns in that respect, honing their clinical eye to be better trained to identify the severity of the disease and what a patient needs to look like to require ICU.
He admits though that it’s been “taxing”… “because when you’re standing at the bedside and they say this patient’s not for ICU you know that you’re the one that has to phone the family and tell them and that’s never easy. Especially now with the younger patients, it’s so shocking for the families.
“It’s very taxing – physically, emotionally, definitely. And there’s no getting around it because the next day is work again. We get one weekend off a month so we’re physically coming to work every day, and having long days. And busy days – like we just took a patient to ICU now so that’s a whole intubation, the whole team is there, the patient has crashed, it’s time to tube them, so it’s running round pushing beds up and down to ICU and on a bad day we do like 5 or 6 of those if there’s space in ICU.
“We have patients who are like boarders – they have been here on high flow oxygen for two months. We take our time with patients, if they need the high flow we let them stay on it, but we are still struggling with bed space. ICU is critical. Our ward is full all the time. As soon as there’s a bed available it’s filled.”
Escape from the job is vital to rejuvenate. “I like riding my motorbike or running in the morning before work, but that’s essential. You have to keep those personal escapes otherwise you won’t cope,” he says.
The harrowing experience of being an intern during this pandemic has however made the young intern realise the true value of being a health worker.
He says: “I’ve enjoyed being a doctor more and more during Covid. With the increased responsibility you come to realise that, actually, your patients are better off if you are there. You want to be there for your patients so that you can advocate for them as best you can.”
He’s still shocked though by those who don’t realise the gravity of the situation.
“It’s hectic. And there are still educated people out there saying they won’t take the vaccine. I’d take one in each limb if I could,” says Dr Stenning.