Nurses are the first people you’ll meet if you think you have Covid-19. Here, one of our frontline workers describes the rapid changes both healthcare workers and the public are facing. As told to Josie Adams.
I was working at an urgent care clinic in East Auckland when the first reports of Covid-19 came out of Wuhan. A couple of coworkers and I did some basic calculations based on the reports, and we came up with a mortality rate of around 2%. We thought it would all be OK.
We were wrong.
Within a week, we were testing possible cases in the car park. Everyone was on alert, and there were patients who already thought they might have it. One man who worked for border control presented three times. We assessed his symptoms, took his recordings, a history, and provided advice and reassurance each time. He was not sick.
I had one guy ring me up yesterday and say, “I need to come in and get swabbed – now!” I ran him through the checklist and he was negative for everything. He had a headache and had vomited. Once. You get a lot of people who have one symptom and think they’ve got it.
That in no way means we don’t have compassion for the worried. People like to maintain any control they have, real or imagined, over their lives. They think if they stock up on toilet paper they’ve got it sussed, and they’re in control. The reality is: absolutely not. People will do a lot of things to make themselves feel better. That’s why some turn to homeopathy, or similar practices. They want to believe it offers assurance. Some others think that if they eat broccoli every day they’ll never get breast cancer. The likelihood might be reduced, but it’s never eliminated. You don’t have absolute control over what happens to you.
As an essential worker, I control what I can, but at the end of the day I’m at risk. I come home and take my shoes off outside the door, I put all my clothes in the laundry, and I get in the shower. I don’t touch anything else until this is done.
When the government announced we were moving to level three and then four, I was in a break room with four other nurses. Most of them paused, and then wept, quietly. There was a stunned silence and fear, which I imagine was pretty much the universal reaction.
There’s something called the R0 number, and that basically tells you how contagious an infectious disease is. If you’ve seen the movie Contagion you might be familiar with it. We don’t know exactly what Covid-19’s R0 number is, but it’s obviously really high. If this weren’t so contagious, we wouldn’t be so worried.
If you get a small group of people who are infected with the disease, and they’re locked down, you won’t get so much sickness and death. That’s what we’re trying to achieve with alert level four. But if you cast that net wide and get a whole lot of people infected, then you’re going to see what happened in Italy. A lot of infection, and a lot of death.
Italy has an excellent healthcare system. They have 12.5 intensive care beds per 100,000 people. That’s great. In New Zealand, there are about 4.7. That’s what scares me. If things get bad, and lots of people get sick, you’re going to see a bottleneck.
I’m also losing work. I was scheduled to do flu vaccination work at educational institutions and offices over the next couple of weeks, but that’s out. I’ve heard people compare Covid-19 to the flu. In some ways it’s a poor comparison, but they do both kill people. At the GP clinic I worked in last week we were doing drive-by flu shots, which is novel. I’m thinking of offering fries with the jab next time.
I’m an agency nurse, which means I go where I’m needed. Every day my income changes. I’m worried I won’t have one at all. At this point, I don’t even know where I’m working in two days’ time, let alone next week. Clinics all over the country are condensing their services. Many are no longer doing vaccinations, booked, or routine procedures. Hours are reducing for doctors, nurses, and lab techs, many of whom are contractors like myself and not salaried.
There was a woman who called asking if she could still get an ultrasound of her shoulder — no. Not now. It’s not essential. There was a baby due for its six-week vaccinations, and we told the parents not to come in that morning. There was a cluster of sick people outside, and you don’t want that baby caught in that. On that day, in that clinic, with that crowd – that was a bad idea. The Ministry of Health is encouraging people to stick to their vaccination schedules. You’ll get your shot, in the safest way we can manage.
People need to hold off, which scares them, but they need to know that’s not forever. The point is that they need to hold off for now. We’re just getting new processes and protocols in place.
Everyone is doing their best. I have seen so much compassion from doctors and nurses. The prime minister and her government are putting emphasis on the need for kindness and compassion at the moment – shit yeah. When could that be wrong?
People expect us to be on their side, and we are. We do get tiresome questions, but you know what? No-one’s asking them to be a pain in the neck. They’re asking it because they’re scared, and you have to bear that in mind.
These people ringing Healthline and their GP, asking “stupid questions” – they’re not stupid, they just want to feel like they have a handle on things. When patients tell me they rang Healthline and they were “bloody useless”, I tell them exactly what Healthline said with a little extra kindness and give them a bit more time to talk (I can afford to – Healthline can’t). You have to make people feel they’re on the right track if you want them to have any hope.
Doctors are, sometimes, available for a face-to-face. There are illnesses that still require seeing a doctor, things like strep throat; you need to be seen, you need to be swabbed, and you need antibiotics. There’s no way around that.
You will need to call ahead, be met at the door, and given a mask. Every patient needs to be asked the Covid-19 screening questions. This is, as they say, the new normal.
I understand you’re scared. I’m scared too. I can’t control much; but I can control how I make you feel when you visit me.
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