​Senior Resident Dr Sonu Sumit Kumar shares his experience of hope, fear and teamwork when he covered COVID-19 Isolation Ward 66 in April.

“When I was informed that my team would be covering the COVID-19 ward, my wife who is also a frontline healthcare worker motivated me to face it with courage. On my first day in the COVID-19 ward I was a bit nervous initially. But as the day progressed, I felt more and more secure. I was very impressed by how well-organised and resourced my hospital is. There was an adequate supply of PPE in my ward, and the patients were reasonably well-isolated. Which brings me to the topic of PPE…it takes a really long time to don the PPE for ward rounds. In the beginning, it took me an hour to put on all the gear such as gloves, goggles, mask, protective gown, etc. At each step, I had to make sure no part of my body was exposed. Once inside the ward, my colleagues and I helped to inspect each other’s protective equipment every 30 minutes to ensure no part of our body or inner clothing was exposed.

In the ward, I saw mostly migrant workers. Many were from my country of birth - India. So I am able to understand and speak their language well. This helped me foster good rapport and trust with them. Some opened up when I spoke to them in Tamil. They started calling me “Anna” which means brother instead of doctor. This touched my heart.

Every day my team and I would assess their condition to see if any changes had to be made to their management plan, and order any further treatment. For those in serious condition, we will discuss with the senior doctors and specialists during our isolation team huddle, and take measures to help them. To minimise contact time, landline phones were set up so that we could communicate with the patients via their mobile phones for a detailed history, or to answer any questions that they may have. Outside of the ward, I would work on paperwork, update medical notes, order tests and discuss patient management. These were tasks I could not really do in the ward because my glasses kept fogging up making it hard to see clearly. 
 

(from left) Dr Nicole Toh, Dr Kirsten Ong, Dr Chong Jia Ying, Dr Eunice Cheong, Dr Sonu Sumit Kumar. They received a lovely rainbow cake from an appreciative donor.

My team was able to identify many non-COVID issues as well - newly diagnosed Diabetes Mellitus, untreated Diabetes Mellitus, epididymo-orchitis, iliocolitis, dengue and even leptospirosis! Many of the COVID-19 patients were having sinus tachycardia and were thus deemed unfit to be transferred to a community isolation facility. Their preliminary investigations were normal. After speaking to them, we found that many of them were anxious. They were seeing big hospital wards, staff in PPE, medical devices for blood pressure and saturations for the first time. They thought that they were about to fall very ill and may be not able to recover. They were even afraid to ask about their investigations or management plans.

“It’s more important to know what sort of person has a disease than to know what sort of disease a person has.” - Hippocrates

Though many of the COVID-19 patients were very well with symptoms even milder than the usual Upper Respiratory Track Infections, the fear of COVID-19 was running in their veins and could be seen in their eyes. Their fears were not just due to what they had been reading in the news, but also borne out of a fear for their families’ future. Some of them did not inform their family of their admission worrying that they would be afraid. They would stand in the corner of the room to talk to their families and tell them that they were safe and still in the dorms.

Also, some of them were for the very first time not eating their native food. We told them they could also ask for other foods like chapati. That put a smile on their faces. They were also afraid that medical expenses here would be unaffordable; that their wages would stop and push them into financial crisis. Some expressed how they had taken multiple loans back in their country to come here for the good of their families.

Emotional support via video conferencing from our psychologists, as well as news that the Singapore government would cover their treatment expenses helped allay some of their fears and anxieties. We noticed that the tachycardia issues settled, and they were more open and involved in discussions on their management plans.

While the course of the COVID-19 infection can take multiple turns medically, rounding in the COVID-19 ward made me understand that the psychological aspects are very important, too, and should be addressed from the beginning. COVID-19 brings out one’s fear of the unknown. It can be alleviated by taking the time to listen, caring for the individual’s needs, and offering comfort and care beyond medical management.”

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