ER Doctor : 4 patients caught lying about their Mainland visits in one shift and other observations
[From Facebook: Ask Dr Friend - Dr. Giraffe, 2020/01/26 ]
Just off from work, this is the first day that I got back to work in the battlefield since the epidemic situation deteriorated significantly. Here, I will share some observations and updates as a frontline staff.
Frontline medical staff are already overwhelmed
The situation kept changing so quickly, and information was so chaotic. During the work day, I kept getting ''real-time'' updates on guidelines changes. I would barely have finished checking on two patients before getting updates on WhatsApp about where new cases should be assigned.
I believe this isn’t only happening at my hospital but many others, too. It also confirmed what LegCo Councillor Pierre Chan reflected from frontline medical staff, who are having a hard time keeping up with the frequent and rapidly changing guidelines (such as Centre for Health Protection’s reporting criteria).
However, I don't think it’s a bad thing to closely monitor the situation and make instant adjustments accordingly. This means that we can respond to these changes in a timely manner, which is better than reacting slowly. Though, medical staff have to make greater efforts to keep up with the frequent changes.
Self-declaration of health status not reliable, not even with local residents
Do not expect too much from the health declaration measures. As I had expected, the current situation is looking pretty grim, it is actually much worse than I thought.
I have 20 to 30 patients under my care in one shift. Surprisingly, I've already caught 4 patients who have lied their way past triage when being asked whether they have been to mainland China recently. When I specifically raised that question again during their rounds, these four all answered "yes" nervously - not to Wuhan, but other cities in mainland China.
Some came for minor illnesses, not colds, coughs, or fevers (that is, it wouldn't matter if they had visited mainland China). And not all of them who lied were mainlanders, some were Hongkongers. They were worried about being forced to take the diagnostics test.
From my own observation:
- There is no hope that the self-declaration mechanism will work. The only merit for it is contact tracing. You can imagine how effective the self-declaration procedure will be, when even local people would not be honest about it.
- Border restrictions or closure, at least against mainland regions ravaged by the epidemic, seems much more assuring to me. Other preventive measures have been minimally effective, that's why I think more needs to be done.
The infection control methods announced today are standard medical practice, but I still think they should be more stringent.
Having worked at the frontline for a day now, I think more stringent measures need to be in place. The two major concerns most people have in mind are:
- Everyone should be wearing a mask. Based on my onservation of people out on the streets today, the number of people wearing a mask is pretty low - maybe only about 70%?
- Restrictions on border entry
As for the press conference today, I feel rather puzzled about what Professor Gabriel Leung said - that there is no need for any border entry restrictions because epidemic control should be based on science rather than politics .
Just contrary to what I've said, not placing restrictions on border entry to people from other countries or regions is usually due to political or international relations reasons. From a scientific perspective, restricting entry will definitely help the situation, even though it may not stop every single case of infection from entering. I never expected you to do it but at least give me a better explanation than this.
My thoughts on medical workers' taking job action to pressure the government for full border closure. After working today, I found greater incentive for that.
But because of my specialty, I can't go on strike. There are still many patients who needed to be seen urgently today - local people, non-locals, seniors, and the young. The Emergency Department cannot shut down.
I definitely support colleagues' from other departments to go on strike though. I will be there with you guys in spirit while I hold the fort at the frontline.
That's the end of my report. I’m totally exhausted…from catching buses and checking messages at the same time.
Source: Stand News, January 2020
https://www.thestandnews.com/society/%E5%B0%8D%E7%96%AB%E6%83%85%E7%9A%84%E4%B8%80%E9%BB%9E%E8%A7%80%E5%AF%9F%E5%92%8C%E5%BB%BA%E8%A8%80/ (https://www.thestandnews.com/society/%E5%B0%8D%E7%96%AB%E6%83%85%E7%9A%84%E4%B8%80%E9%BB%9E%E8%A7%80%E5%AF%9F%E5%92%8C%E5%BB%BA%E8%A8%80/)