This is the latest blog from Jane Chiodini, our Dean of the Faculty of Travel Medicine. Here Jane gives an update on COVID-19 and reflects on the importance of wellbeing.
COVID-19 continues to hold its global grip with confirmed cases now at 2 544 792 and deaths 175,694 according to the World Health Organization report No. 94. Those countries continuing to be most badly affected are illustrated in such a dynamic way on the COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). This remarkable site demonstrates Europe remains very badly affected but that the highest confirmed cases are now in the USA with deaths listed by State – New York being the worst affected with currently over 15,000. The WHO state the latest total number of deaths for the USA stands at 40,073 on 23rd April 2020. The Global Outbreak Alert and Response Network (GOARN) has launched a GOARN COVID-19 Knowledge hub. The hub is designed as a central repository of quality public health information, guidance, tools and webinars which can be accessed freely at any point.
In the UK our daily Government statistics of yesterday announced a total of 138,078 lab-confirmed cases and 18,738 deaths that occurred in hospital. But we now know that the deaths happening in the community are very much on the rise with care homes being particularly badly affected. It’s becoming clear that social distancing and measures to control the number of cases, plus the strain this impact has on the functioning of the NHS is essential for a considerable period of time to come. PPE supplies remain an important issue, but good news that a vaccine has started human phase trials and the number of individuals entered into drug treatment trials is also encouraging. Positive news about effective treatments could be on the horizon if all goes well withing a number of weeks, but vaccine options will take longer and should not be expected within 2020.
Wellbeing has been one of our President’s goals since Professor Jackie Taylor took up her post. How important this is and an even more vital topic in today’s situation. Eleven years ago this Easter I was diagnosed with grade 3 triple-negative breast cancer. It came completely out of the blue, diagnosed on a routine mammogram. The initial shock was immense and I hurled into 15 months of treatment of extensive surgery, an 18 week period of chemotherapy, 4 weeks of radiotherapy and a 12 month drug trial of bevacizumab which I considered myself so fortunate to have been randomised into. I relate these facts not for sympathy, but I’ve found over the past few weeks my mental health has felt in a similar place to that period of time in my life when I wasn’t sure what the outcome was going to be, the ‘journey’ was so difficult and challenging and my emotions were all over the place.
I recall getting intensely upset about all the suffering in the world, not sleeping well (mind you when on all the steroids, one’s brain just went into overdrive), concentration poor with thoughts flitting all over the place, anxiety about my family and their wellbeing and safety. That continued through most of the treatment period and when it was over, many people assumed my life had returned to normal. But that was when reality kicked in, a long battle to come through the fatigue over a number of years and reflecting back, I think I was really quite depressed. Being self-employed in travel medicine education, I’d lost most of my work and I had to rebuild a career back up again. I remember returning to work in the general practice where I did a little clinical work and my confidence was severely dented. But there were many positives, the warmth of family, friends and colleagues and people I didn’t even really know who were so kind and supportive at that time, my husband and sons who were my rocks and I think overall, it enhanced my empathy even more as a healthcare professional.
The one thing I didn’t learn was to look after myself any better really after than I had before the treatment, and my intense pace of work (mostly honorary) has picked up to a level it was before cancer. I find this bizarre, but have just accepted that we all deal with things in our own ways and in my defence, I love the work that I do. The training I received as a nurse in the 1970s never focussed on this aspect of any self care and the nature of the profession has meant I have always given to my patients and colleagues.
The impact of COVID-19 has most certainly heightened my awareness of thoughts and emotions similar to the period during that very successful treatment as a cancer patient. I’ve become very emotional to the ‘pain’ that this unprecedented situation has highlighted, from suffering around the world on so many levels to that of people close to me in situations for example where death of a partner has occurred; shielding of loved ones is essential and all the stress and uncertainty that brings; personal concerns for my immediate family in a variety of situations; anxiety of an elderly and profoundly deaf mother living in a care home where staff now are wearing masks so communication is even more challenging and restriction of movement is impacting her mobility as well; a feeling of real guilt and frustration that as a healthcare professional, I’m not one of those nurses working in the ITU where they are toiling so very hard; and trying to think of other ways I can help towards the cause in a very meaningful way. Those are just a few thoughts that spin around my head in the small hours of most nights!
Over the last few weeks I’ve come to understand my thought processes, similarities with the past and am finding solutions to dealing with the situation. Talking about one’s mental health is still surrounded by stigma, and I relate personal facts with some reticence, but perhaps if being open just helps one person, it was worth the risk! There will be light at the end of the tunnel, but the long-term health impact is going to be great for so many, including healthcare professionals.
But to do our work it’s essential we also care for ourselves, and College has some great resources from the COVID-19 landing page to help achieve this including The LITTLE BOOK of Wellbeing Tips from people working in healthcare on how we can take care of ourselves and each other. So I continue to focus hard for the Faculty of Travel Medicine and the College as a whole – work needs to be ongoing now for a time when we resume other work activities and in many situations, work still needs to be continuing now in healthcare for situations outside COVID-19. And whilst it’s been challenging over the airwaves, I’ve managed to enable my 94 year old mother to FaceTime me independently – she now chats away still not understanding the technology, but as if it’s always been an activity in her repertoire!
Life will never be the same, there’s still a long way to go, but a positive is that we have achieved so many progressive measures in a short period of time. There will be many learnings from this historical time, evaluations, blame, anger to name but a few aspects of the impact, but it’s important we continue to share understanding, tolerance and kindness.