By Dr Michelle Natividad Bautista, MBBS, Honours, FANZCA
Dr. Natividad works at multiple hospitals both in public and private in Melbourne. She is an anaesthetist called to help and manage deteriorating COVID-19 patients, or those with cardio-respiratory arrests requiring resuscitation, intubations and ventilations in the wards, emergency departments, on top of anaesthetising patients undergoing emergency surgery.
Here is her story:
I’ve been asked about our worsening situation here in Victoria and here are my thoughts. We did so well at the start of the pandemic, a model really, until all was destroyed by immoral, corrupt individuals who allowed infected returned overseas passengers out of quarantine hotels, into the community, compounded by rule breakers with complete disregard for social distancing and crowd limitations. This has led to huge community transmissions that we are now seeing.
As of today, 19 July 2020, we knew the situation was bad but it is starting to feel like we are losing control. We’ve had over 1 week of Stage 3 lockdown (for the second time), 2 weeks in hotspot areas, with no plateauing case numbers.
The positive rate is also increasing, despite lower threshold for testing. We have almost 3000 active cases now.
15% (450) of these 3000 cases will need hospitalisation. 4-5% (150) will end up in ICU. 1% (30) dead.
As an anaesthetist, we are called to help and manage deteriorating patients, cardio-respiratory arrests, intubations and ventilations of critically ill patients in the wards, emergency departments and ICU, on top of anaesthetising patients undergoing surgery.
Except now, critically ill patients presenting to emergency departments, whether from medical conditions, surgical conditions or trauma are presumed COVID positive. A few colleagues have inadvertently been infected with COVID.
Going to work is scary, but I’m okay. All patients are now being tested for COVID before going to hospital (and emergencies as they are admitted). I go to my asymptomatic screening (which is yuck!!!!), but I’ve always been negative thus far.
Elective surgical activities have been reduced because of 3 reasons;
1. In preparation for more COVID patients requiring hospital admissions
2. Reduced staff numbers, as quite a lot of healthcare workers are in home isolation after testing positive or being in contact with a positive case in the community. Most of these healthcare workers got the infection from the community and NOT from the hospitals. There are minimal hospital transmissions as yet.
3. Conservation of PPE. Hospitals have now implemented a no visitor policy (except for paediatric patients of course and those with special needs), so it’s so sad for the inpatients but it’s for their protection and those of other patients and staff.
What can we, Victorians do? Stay home!
Then, as a government, we need to know what we’d like to aim for. Elimination (zero active cases) vs suppression (flatten the curve). Elimination will likely require stage 4 restrictions and for longer. It would mean not easing restrictions until there are zero active cases for 2 weeks. This of course will have significant economic (business closures, job loses etc) and social costs (including mental health and the eye opening reality of significant domestic abuse in Australia).
VS Suppression, when we can ease restrictions when case numbers are very low. But we’ve done this before and it resulted in another surge/second wave/whatever you want to call it. And this opening and closing of businesses may in fact have more detrimental effects.
I don’t know the right answer. By chance, other states in Australia have eliminated the disease and its great. But they didn’t have the returning passengers from repatriation flights (infected with COVID) guarded in quarantine by corrupt security guards. There are definitely Victorians who broke the rules and had large illegal parties, facilitating the spread of the virus, but I think, Victorians are no worse than other states in terms of following rules (or breaking them).
We just happened to have the undetected active cases.
We can’t live in a bubble where Victoria (with the second largest economy) is separated from the rest of the country. I just wish people follow rules. Because staying home works!
“I don’t go out, not even for groceries. I only leave home for work and to get fresh air and exercise, away from people!”
More than 400 Victorian healthcare workers are infected with COVID-19 and hundreds more are in isolation after coming into contact with confirmed coronavirus cases.
Nurses and doctors are dropping off like flies. And if the situation remains uncontrolled, the hospitals will be overwhelmed, and more patients will die.
I’m on all weekend. And yes, I’m scared this time around. I’m on duty during the day and on call overnight all weekend. I started at 7am, so here’s me, before I face my first patient. I just got here but I’m looking forward to going home, virus free.
Dr. Natividad completed a Bachelor of Medicine, Bachelor of surgery 1999, with Honours at Monash University. She finished her anaesthesia training 2007, completing her examinations with merit.
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