At a hospital in south-east Queensland recently I was speaking with a doctor who works in a field other than dealing directly with the coronavirus infection. He told me that his department has been affected very little by the pandemic saying, “Just mainly a change in hospital policy of how to see patients — with all the PPE etc. — but in terms of day-to-day, it’s only affected us in indirect ways like slowing bed flow and downstream effects.”
I asked this doctor — who wishes to remain anonymous — what the downstream effects were and I was surprised by his reply. I’d not realised how much hospitals have been affected by this insidious virus.
“What I mean by this is when someone has a Covid-19 test, our hospital policy often means we need to treat them as if they are positive until they are proven to be negative,” he says.
He explained this also meant more time is spent covering up with gloves, gowns, mask, glasses etc., which of course slows the ward round down and the job of doctors and nursing staff takes longer, on average, as a whole.
“Additionally, as we aren’t allowed to stand in the room to document the notes while someone is seeing the patient, things will need to be repeated by the doctor once they exit the patient’s room,” he says.
Sometimes the patient is otherwise well — and may have a disposition (for example they may be from a nursing home, or they may have private insurance) and be awaiting transfer to a private hospital, however, often the policy of these places simply doesn’t allow a ‘Covid-positive’ or ‘Covid-pending’ patient.
“Resultantly, hospitals [have to] hold on to otherwise-well patients that [remain] in-patients due to policies external to the hospital itself”, the doctor says.
The downstream effects of this include people who are awaiting transfer from another hospital having to wait longer times than usual. The efficiency of the entire health system declines, because hospitals that do highly specialised procedures such as cardiothoracic or neurosurgery, may not be able to receive patients to operate on (or send patients away after the procedure) due to the delays.
“While our day-to-day won’t be as directly affected as the frontline emergency department staff, the downstream effects of both Covid-19 and the policies that Covid-19 necessitates, impacts the health service as a whole.”
I had never considered this aspect. I had only thought about those working in a Covid-19 ward or in the Intensive Care Unit. It’s clear to me now the entire health system and those who rely on it have been impacted. It doesn’t matter whether one lives in the northern hemisphere or the southern hemisphere.
This discussion also shed more light on why some ‘minor’ surgical operations have to wait at the bottom of the queue for hospital admissions. It is not just that the doctors and nurses have been transferred to serve in critical care wards, it’s because work in other areas are hampered in the ways the good doctor explained. The coronavirus pandemic has affected all hospital medical staff, not just those working on the frontline!
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