Coronavirus (COVID-19): My experience of testing positive

Kathryn S S Dayananda

After finishing the morning hand trauma list, I sat in the doctor’s office with my colleague, who was known to be high-risk. We were discussing the options on how to record and publicise the exemplary and timely changes we felt our unit had made in order to prepare for the coronavirus pandemic...

Kathryn S S Dayananda is a Specialty Trainee in Trauma & Orthopaedic Surgery for the Wales Deanery.

As a patient As a colleague

I started to develop some nasal congestion and This was my longest period of absence for sick headache and decided to head home slightly leave to-date having only had a total of 3-4 days earlier than usual. During the course of my off since qualifying in 2012. Although essential 20-minute commute the headache progressed for my health and the health of others, being off to such an extent that I went straight to bed. work did not come easily or naturally to me. Within an hour I was feverish with flu-like symptoms. It was clear I was ill – was it the Prior to receiving my swab results I blamed coronavirus or something else? myself for being lazy and inefficient with my time. I was frustrated at not being able to I was desperately worried about my colleague. help out about the house or in work. I was I messaged him urgently to let him know. I exasperated by my inability to concentrate felt so awful for sitting with him despite on anything. distancing as much as possible. My symptoms Most of all I worried about progressed rapidly. “Most of all I worried the staff, patients and public I could have infected without I emailed, as per our local department about the staff, patients realising, especially my highrisk teammate and friend. guidelines, to enquire about testing and began the isolation process and public I could have infected without realising, I felt extremely guilty that others would have to step into my immediately. My husband kept away, slept in the spare room especially my high-risk teammate and friend.” on-call slots and other clinical commitments. I would say things like “I’m a team-player and used a separate and I should be in work helping bathroom. I had lost my friends and patients”. my appetite and had no energy to get up. I stayed in bed for three days. As I began improving, I started to feel the Gradually I developed a cough, although this cabin fever effects of isolation, yearning to get wasn’t severe, and completely lost my sense back to ‘normality’ and the dynamic hospital of smell. I felt extremely achy and lethargic, environment. suffered a vasovagal episode, and was short of breath despite minimal exertion. My resting Throughout my illness and return to work heart rate had almost doubled and I was unable I have been fully supported by Consultants, to undertake any activity in my home. colleagues and management. I returned directly onto the nightshift and the realisation Gradually over the following 7-10 days I began that the hospital would be a very different place improving, spending the majority of my time on to how I left it soon dawned on me. I quickly the sofa resting. I received the call from Public caught up with a detailed Consultant lead Health Wales notifying me that my test was handover. I found it reassuring to have at least positive and wishing me a swift recovery. a degree of immunity against the virus. I was

grateful to be back. I was able to interact with and support colleagues, help those in need, and do my part in the National fight against the invisible enemy.

“I hate being at home when everyone else is struggling at work”

“I’d like to try and come for hand clinic Friday. Fingers crossed. And also get back to helping with on calls, because I hate being such a waster.”

– Messages sent by Kat to her rota co-ordinator colleague while off work.

As a specialty trainee care provider

When the news came that all elective operating would be cancelled, the gravity of the situation dawned on me.

Within days our department had made huge logistical changes to the delivery of trauma service provision across Cardiff and Vale University Health Board. With strong leadership, tireless efforts from our Consultants and immense teamwork, the trauma theatre, fracture clinic and trauma ambulatory care unit (TACU) were redistributed to our elective unit on a separate site. Spinal, paediatric and polytrauma remained at our tertiary referral unit. This enabled a degree of containment of COVID-19 in the initial period, releasing beds, and supporting a restructuring of the staff rota. Two separate site rotas were devised to

prevent cross contamination from staff. It also compensated for the redeployment of non-consultant staff at all levels. These changes were encouraging for all trainees. It demonstrated departmental unity and care for each other. The creation of wellbeing boxes confirmed that our departments approach to tackling COVID-19 would be compassionate and charitable. It was reassuring to receive such topdown support.

We all had three key concerns: patient and personal safety and training. Our Training Programme Director, (Mr Khitish Mohanty), gave thorough and clear advice in line with national recommendations regarding ARCPs and job rotations, which reassured us all. Virtual teaching was delivered where possible. Copious access to training sessions such as donning and doffing, medical management of the acutely unwell patient suffering COVID-19, and improving practical and logistical skills in ward management have all been made readily available. A virtual mindfulness session has equipped us with strategies to remain composed in times of distinct uncertainty.

The cohesive nature of the entire department and outstanding links with our orthogeriatric team have been second-to-none. It has made coming to work during these unprecedented times as stress free as possible.

Advice for colleagues

We are here to help others when they can no longer take care of themselves. You must therefore make it your priority to look after yourself. Although for many of us it will go against our nature, you must take full rest when you need, for as long as you need. This can only be dictated by the individual. You have a responsibility to do this for yourself, for your colleagues and for your patients.

Don’t be fearful of accepting you don’t know. As well as providing trauma care, we are here to support specialties we have limited experience in. Many of us will be asked to perform tasks we are out of practice with or are unfamiliar to us. Be humble and ask for guidance and/or help. Like-wise you must go above and beyond to help others in your team, hospital and wider community when they need, ideally before they need to ask.

Keep active. It will protect your mental and physical health.

Try to be in-tune with your emotions. If you identify with increasingly upset feelings do not see this as failure. With increasing numbers of patients, staff, friends and family succumbing to this disease it is natural. Tackle them in the way that suits you, and if you’re not sure how to do this (none of us have lived / worked through a pandemic before) seek advice.

Practice what you preach and do not take part in any unnecessary or risky activities. Avoid any non-essential travel.

And if in doubt, “wear sunscreen”. (Baz Luhrmann)

We wish you all good health and safe practising. From all at the T&O Department in Cardiff and Vale UHB. n