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| LETTER TO EDITOR |
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| Year : 2020 | Volume
: 3
| Issue : 1 | Page : 30-31 |
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Response to Quo Vadis COVID responder – Beat the Chinese virus, carpe diem
Rinelle Mascarenhas
Department of General and Laparoscopic Surgery, Ganga Ram Institute of Postgraduate Medical Education and Research, New Delhi, India
| Date of Submission | 02-Jul-2020 |
| Date of Decision | 21-Jul-2020 |
| Date of Acceptance | 11-Jul-2020 |
| Date of Web Publication | 02-Oct-2020 |
Correspondence Address:
Dr. Rinelle Mascarenhas
Room 1645, Department of General and Laparoscopic Surgery, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi - 110 060
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJCS.IJCS_16_20
How to cite this article:
Mascarenhas R. Response to Quo Vadis COVID responder – Beat the Chinese virus, carpe diem. Indian J Colo-Rectal Surg 2020;3:30-1 |
Dear Editor,
I read your editorial titled Quo Vadis COVID Responder – Beat the Chinese Virus, Carpe diem.[1] In response to the aforementioned article, the views expressed below are from a senior surgical resident's perspective, practicing in a high-volume tertiary care multispecialty hospital in a developing country.
We are now a few months into our lockdown lifestyle. In the BC era (Before Corona), if someone asked me whether surgeons would be corona warriors, I'd have chuckled. COVID-19 is a severe respiratory illness and so far, physicians have been on the frontline. At the time of writing this article, India has crossed 5.75 lakh COVID-19 cases with around 15,000 deaths.[2] Due to the growing demand of skilled doctors and lack of resources, I found myself, posted in the COVID team.
As surgeons, we have to constantly reinvent ourselves and adapt to the changing situations, and that helped me in the role I was expected to play in this pandemic. We're used to the usual approach to protective gear and sterility in the operation theater (OT). COVID-19 has high transmission rate between people through close contact and droplets. Personal protective equipment (PPE) and N95 masks/respirators are added layers to the already-existing sterility measures in the OT. They have propensity to considerably reduce the chances of transmission.[3] To normalize the sight of PPE being worn in the patient wards rather than in the OT, is something we might have to get used to in future.
This experience has taught me that we depend too much on referrals to our physician colleagues. Although patient care requires multidisciplinary effort, understanding the physiological effects of medical illnesses isn't given much thought. In our surgical training, I can confidently say that if a patient presented with fever, it had to be one out of ten possible causes. I was forced to scramble my brain and put my final MBBS knowledge to some use.
Operating on preoperatively undiagnosed and asymptomatic COVID-19 patients can lead to hazardous postoperative outcomes.[4] This poses a challenge in patient selection. With most elective and nonemergent surgeries being canceled, surgeons have had a difficult couple of months. While most patients understood and were grateful that we worked long hours to keep them safe, there were those few who didn't, and I found myself unable to respond with compassion and patience that I usually manage to muster. In retrospect, working on an average day in 24 h shifts felt like a breeze, compared to every minute in the PPE which felt like I fighting an internal battle. The constant fear of being a source of infection to those at home, adds to the mental and emotional turmoil.
These are unprecedented circumstances. With 3 months of routine surgical training lost and academic activities taking a hit, we have found the use and advantage of technology in the most unconventional way. Our seminars and conferences are now being held through online platforms, making sure we make the best out of our given situation. This is a new “normal,” and we can use it to our advantage. Given our high patient load, we can conduct detailed research on effects and outcomes of surgery on COVID patients.
While I pen these words, I would like to take a moment to appreciate the nursing staff, administration, and nonmedical hospital personnel, without whom doctors and the health-care system would not be able to function. COVID and PPEs are here to stay, and while we slowly adapt our existing health-care infrastructure to the needs of this pandemic, let's not forget to continue to support each other in the surgical fraternity.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Agarwal BB, Agarwal N. Quo vadis COVID responder – Beat the Chinese virus, carpe diem. Indian J Colo-Rectal Surg 2019;2:1-2.  |
| 2. | Coronavirus in India: Latest Map and Case Count. Covid19india.org; 2020. Available from: https://www.covid19india.org/. [Last accessed 2020 June 30]. |
| 3. | World Health Organization. Rational Use of Personal Protective Equipment (PPE) for Coronavirus Disease (COVID-19): Interim Guidance; 19 March 2020. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/331498. [Last accessed on 2020 Jun 30]. |
| 4. | Nahshon C, Bitterman A, Haddad R, Hazzan D, Lavie O. Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling all Asymptomatic Patients Before Surgical Treatment. World J Surg 2020;44:2477-81. |
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