Dr George Somers is a general practitioner based across Prahran and Emerald in Victoria. He specialises in mental health, and has vast experience in trauma.
The following is an edited transcript of his interview with Crikey‘s Charlie Lewis.
For a long time, I’ve been a bit paranoid about the possibility of a pandemic. I was actually one of those people doing a bit of hoarding during the bird flu. The pantry was always well stocked during that period.
When we heard initially about the coronavirus, we didn’t know how serious it would get, both in terms of its spread, and the severity of health impacts; and we’re still finding that out. Some people get a sniffle, and some people die.
We’ve maintained face-to-face consults at the practice as much as possible. But we’ve had to make a lot of change. Two of our regular patients have ended up being positive with COVID-19, but we sent them to hospital before they ever came in.
Our door is locked now. People can’t just walk in. We have an outside room, and anyone who has any flu symptoms is treated there.
The protective gear we use is whatever we have — in my case it’s been the same protective mask for a week, a plastic apron and gloves. The government hasn’t sent us anything more, because at the moment there isn’t anything more. I’m 70 myself, so it’s concerning.
And of course even with all our vetting, occasionally someone sneaks through and has a bit of a cough in your office and you think “oh God, that was the one”.
I’ve been in medicine for more than 40 years, and I’ve done a huge amount of work with disaster medicine and community resilience.
The takeaway at the moment, for health workers, is that we feel like we’ve started a new job. While we have all the same duties, the environment is suddenly completely different: we’ve got a new boss, we’re learning a new set of rules. I said to a patient the other day, who asked what it was like, “it’s like walking backwards. We can’t see what’s coming”.
A group that’s been forgotten about are general patients who still have legitimate problems. Does someone calling up with a sore throat have strep tonsillitis, a standard cold, or is COVID? That can be hard to tell if they’re in front of you, let alone over the phone.
In terms of my experiences with disaster medicine, it’s probably closer to Aceh than Ash Wednesday. The experience of the bushfires was more in pockets, there were portions of the community who weren’t effected.
In Aceh, after the tsunami, every person I dealt with — every single person — had lost up to a dozen family members. Everyone was affected. This crisis right now is affecting the whole world.
That said, most of my patients who see me about their mental health are actually taking the crisis on the chin so far … I suspect the mental health problems will come at the other end of this.
I don’t have any patients coming to me regarding family violence at the moment, and I’m very worried that that’s going to get worse and worse with people locked in together.
The real place I’ve seen a jump in anxiety and stress has been among other health workers. I work across two practices and we’ve had a doctor at each become just completely emotionally overwhelmed. Other staff members are beginning to show signs of PTSD. And health workers getting inadequate information from the government and, having that information change so frequently, is contributing to that.
I’m encouraged by the current numbers of new cases, which appear to be slowing. And I think this new blood test, which can tell you if you’ve had it — where the swab test just tells you if you currently have it — will be very important.
If people who’ve had it develop an immunity, that’s really important for us to know, as soon as possible.
Once their immunity is established, recovering patients, both symptomatic and asymptomatic, form a growing army of potential volunteers. Even if this test for immunity could be applied today, their numbers are currently only growing at one thousand or so per day, which isn’t enough to get the economy restarted yet. However those with relevant skills could be co-opted to relieve some of the load from the front-line workers and the rest could be invited to join the essential workers. At that rate they could reduce the number of infectable workers facing an infectious public.
Plasma from blood donations by recovered patients contains antibodies, which can be used to suppress the viral load in critical patients. If this treatment can be made practical and widespread, it would relieve the demand on (ICU) ventilators.
Well said George, we were in Aceh/Nias for 5 months post tsunami (the big one) and this pandemic reminds me of that strange world we found ourselves in. The huge difference was that as aid workers, we were not exposed to a deadly disease that is as contagious as COVID -19. We did live with the constant fear of quakes and new tsunamis but that was something where we could always make sure we had adequate escape routes. COVID -19 is more frightening because you can’t see or hear it coming …. and that is going to do a lot of harm to a lot of people. (ps: where were you working in Aceh? … we had the aid ship Batavia so did not interact much with other agencies on the ground). Rick
There was an old conundrum, during WWII, when penicillin was in short supply – “If Churchill & Truman desperately needed to only dose available, who should get it?”
We’ve seen in the case of Boris that the better class of person gets instant access to ICUs and all the toys modern medicine can offer.
Hoi polloi?. Not so much – “…in my case it’s been the same protective mask for a week, a plastic apron and gloves.”
Why am I reminded of puerperal fever pre Lister & carbolic acid?