Taking on the challenge head-on

The year 2020 has been a historical year, where the word pandemic has become a source of despair, anxiety, and fear. Words like PPE, oxygen saturation, and N95 masks have become part of an everyday conversation and pulse-oximeters and infrared thermometers have probably been the most bought medical apparatus by the general public this year!! As we slowly move into 2021, the approval of the Covid vaccine is the most anticipated event of the decade if not the century.

Anaesthesia as a medical fraternity has probably got the most recognition in this pandemic, and deservedly so. Anaesthetists have been at the forefront along side the intensive care physicians in taking care of sick Covid affected patients, exposing themselves to the highest degree of risk of getting the disease.

The picture of an anesthetist on the cover of TIME magazine is testimony to the contribution of the speciality. During the COVID-19 pandemic, anesthetists are facing long hours, additional training, the fear of bringing sickness home to their families, and a resulting additional emotional toll. Anesthesiology is listed among professions that feature prominently in a book by David Zweig, Invisibles: The Power of Anonymous Work in an Age of Relentless Self-Promotion. Zweig explains that there are three traits common to individuals who excel in these invisible roles: ambivalence toward recognition; meticulous attention to detail; and willingness to assume responsibility. After an interview with one anesthesiologist, Zweig comments, “He could have gone into any number of specialties within medicine, but he chose to do something where when he did his job perfectly, the patients aren’t really going to think of him that much.”

Anaesthetists and other perioperative care providers are particularly at risk when providing respiratory care and tracheal intubation of patients with COVID-19.

Any procedure involving the airway of a covid positive patient has been identified as an aerosol generating process that carries the maximum risk of transmitting the disease to the attending team. And it is of paramount importance to make sure that adequate precautions are taken while performing such procedures. This requires a strong infection control department to chalk out policies and an equally eager and supportive administration to ensure that these infection control policies are implemented and followed.

This obviously entails costs and the hospital administration has to be supportive in the cause to make sure the covid team is protected. I am privileged to be in a hospital that has all the support we can possibly ask for, whether it is in terms of adequate supply of PPE, protective gear for the eyes, designated area for doffing and donning the PPE, designated area for care of Covid affected patients so that the rest of the non covid patients and the staff are not exposed.

In fact, we were the one of the earliest hospitals to buy and use the PAPR (Powered Air Purifying Respirator) for intubations in the ICU and also for emergency procedures in the OT. We as an institute always continued to cater to noncovid patients even during the lockdown so that the regular care of the patients was not affected.

The institute also had made sure that any staff that was affected by covid was taken care of by the hospital, which was an extremely important and supportive step as far getting the confidence of the staff was concerned.

Investing in getting the confidence of the staff is probably the best investment a hospital can make, especially in trying circumstances.

As I write this article many of my colleagues in the UK are already getting their COVID vaccine shots. Only time will tell how effective any of these vaccines will prove to be.

We can only hope that the worst has passed and the best is yet to come. Albert Einstein is quoted as saying, “In the midst of every crisis, lies great opportunity.”And I am sure that each one of us knowingly or unknowingly has created an opportunity in the midst of this pandemic to emerge stronger.