In the Jungle of Infections

Moara work at the Clinical Hospital of Federal University of Goiás (Brazil) since 2015. She is an infectious diseases physician. She studied medicine in Brazil, now she is a Professor at the Institute of Tropical Pathology and Public Health. She is currently Chief Physician for Infectious Diseases at the COVID-19 ward and for the Hospital Infection Control Service. At the hospital, they have a separate infirmary for COVID-19 patients. Most doctors were reallocated to work there: pulmonologists, cardiologists, endocrinologists, neurologists, different types of surgeons, among other specialists. In this place, there is a person responsible for discussions of viral infection, antibiotics, time of treatment, and discharge. It is advised by the IDSA and WHO that an infectious disease (Infectologist) specialist be present to discuss the cases and help how to conduct these patients. This is now Moara.

“Since March 2020 we have changed the way how we evaluate and conduct patients with respiratory cases. We standardized the use of Personal Protective Equipment which are necessary for professionals caring for these patients. We launched uncountable training events for teaching how to don and doff PPE. We now wear masks all the time at work and at other public places. In addition, we try to maintain at least a 6 feet distance from one another at all times. No touching, no hugs. This is very difficult for most people. The fact that the patients are previously evaluated at other healthcare facilities and then transferred to us as suspected cases of COVID-19 probably give us gives us the possibility of being prepared. But sometimes the suspicion happens after hours or days after the admission. And this is when all the concerns blow. Even when we do everything right, the fear of being exposed and contaminated persists. Better testing availability would probably help in these situations.
We have nerves through the bones. We are afraid and concerned about our well-being, our patients, and our families. Even the support amongst ourselves is limited by distance and masks. Most of us choose to avoid visiting parents, grandparents, friends, and even partners. I think every day about how would be if a relative or a friend became sick. I try not to be afraid and think everything will be ok. But I fear this loneliness because when you are hospitalized with COVID-19, you’ll probably be alone and never see your family again before you are discharged from hospital. Many times, I suffer about patients dying alone and about a burial without family and friends. Loneliness, and stress are both frequent and devastating. Psychological support should be mandatory for everyone. Without this I would probably be depressed. I have psychological and family support; I try to talk to friends that are living in the same situation; I still see my boyfriend. But even with this support, I experience feelings of sadness.
In my opinion, there are created professional improvements in this situation. The healthcare workers start to pay attention to standard precautions that Infectious Diseases Services tried hard to teach for so long. The public health system showed an important role. And perhaps it will be valued and receive more investments. The attitude of the public has changed towards the healthcare system. People are afraid of going to healthcare facilities and get COVID-19. It’s possible that they are being more cautious about looking for emergency units. But unfortunately, the life of most Brazilian people didn’t change the way it should. In Brazil, we are facing many problems with the fulfillment of social distancing, wearing masks, and science belief. Part of people doesn’t realize that COVID-19 is is a truly challenging disease and we are at risk of living a very worrying situation.
I think everything will change once the pandemic is over. We will use maximum personal protection for almost every assistance we do. The costs probably will be higher than used to be. The other diseases will be neglected and the risk of dying from them will be significant. The healthcare system must adapt to accommodate all the best. I think the benefit of this situation is, that people will see life differently. Relationships, time, and especially how little moments with family and friend worth it. In hospitals, healthcare workers will value the personal protective equipment and use them as routine. The science will be respected and appreciated as something important.”

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