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Reflections from the front line: COVID through the eyes of a suburban GP

Each day this month, we publish Tales of 2020, the stories of ordinary Queenslanders enduring an extraordinary year. Today, Brisbane GP Dr Genevieve McGovern steps through the daily changes that kept her colleagues and patients constantly off balance.

Dec 22, 2020, updated Dec 22, 2020
Our GPs have had to change direction, and change focus, in the blink of an eye this year (photo: Unsplash).

Our GPs have had to change direction, and change focus, in the blink of an eye this year (photo: Unsplash).

On March 21, 2020, I was looking forward to catching up with my medical colleague and writer friend at our favourite breakfast café. It was a blue sky, perfect Brisbane morning and I was ready to walk the half hour, already anticipating our regular chat.

Just before stepping out the door, I checked my phone and there was her text, suggesting that perhaps we should bring our own breakfast and meet in the park. It would, after all, set a bad example for two medicos to be meeting at a crowded café.

Like everyone else, I had watched the unfolding drama that this virus was wreaking on the world and was fresh from a meeting at work where we had put strategies in place should the worst happen. It was such a perfect, still day that it was hard to imagine the wheels falling off. This was Brisbane, after all.

My first thought was that my colleague was being over-cautious but then one of the anaesthetists posted charts of the predicted mortality when this insidious infection infiltrated our pristine shores. I pulled out the thermos, boiled an egg and prepared an impromptu picnic. Social media could be a real killjoy.

The following weekend, we were all set to celebrate our daughter’s seventeenth birthday, but the stories on the news were alarming. We cancelled in the last minute.

My workplace was unrecognisable. The chairs were spread far apart in our rooms and the reception staff became a triage desk overnight. Our reception staff took over seven thousand calls in a week, compared to the usual two and a half thousand.

We counted masks and personal protective gear and started to don these when seeing anyone with a cough or fever. The toys and magazines disappeared from the waiting room and we set up an isolation area downstairs where high risk patients were examined separately.

Overnight, elective surgery was cancelled and patients waiting for joint replacements, endoscopies or on the IVF pathway found themselves in a limbo with an unknown period of uncertainty ahead. It was hard to be reassuring to a woman in her late thirties, desperate to conceive or to keep writing scripts for a seventy-year-old now trapped not only by the pain of bone grinding on bone but within the isolation of their home.

To preserve our personal protective equipment, one of our doctors set up an acute respiratory clinic so that all patients who were considered at risk would be swabbed and examined by one doctor from four till six each evening. We set up a roster and those of us not considered vulnerable, volunteered.

The problem was that the goal posts kept changing. Initially, it was returned travellers from certain high-risk destinations – and the countries listed grew longer with each daily missive.
Then it was people working in high-risk professions. Front line medical staff, doctors, nurses, and nursing home staff with symptoms. Each day new protocols were emailed to keep us up to speed but by that evening the morning missives were old news.

Hospitals braced for an onslaught of patients. Intensive care units were cleared out to prepare for the anticipated high numbers of patients felled by this coronavirus. Life at the surgery fell into a strange new routine that became the new ‘abnormal.’

Phone consultations became a new part of the day, slotted between the brave patients who ventured to the surgery in person. Interestingly, we had all done a number of phone consultations daily prior to this crisis. Patients would request scripts and referrals without being seen and there was always the follow up of results.

Now at least, there were item numbers for these non-face to face consults and we were being paid for work that added at least an hour to our day. Mental health work exploded.

On one memorable day, I did four mental health plans when I usually do one or two per week. A couple of women who I knew to be at risk in their relationships started to present more often with minor problems, now that they were forced into lockdown with their partners.

The surgery arranged weekend flu vaccination clinics where for four hours, several of us would jab entire families to protect them from the known influenza viruses. We ran out of vaccinations in the first week, demand was so high.

Patients became edgy and frightened and for the first time we had to put up notices that we would not tolerate aggressive behaviour. We had to discourage stockpiling drugs as regular items like asthma medications were running in low supply.

While the storm threatened on the horizon, we battened down and were prepared for the worst. The storm rumbled and lightening flashed, but here in Australia we were spared the worst of the damage.

There was heightened anxiety amongst colleagues that we would not get things right, fears for our own safety and that of our families.

There was also a lot of laughter and support, jokes about the new look, clad in the full personal protective gear. This is, after all, what we have trained to do, to manage the health and wellbeing of our communities.

We stepped up, navigated a situation without precedent, drew our own road map and chartered our way through the SARS Cov 2 pandemic.

Dr Genevieve McGovern is a Brisbane GP who is married with three children. When she’s not working she is running marathons or writing.

This article was first published in Stories from the Heart, an e-book edited by Dr Johanna Skinner and editor Jane Connolly, and is republished with their permission.  

 

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