by Nima Ghadiri
"I’m on day 4: high fever, muscle aches, dry cough, no sense of smell. If this is Covid-19, I may not have seen out the worst of it.
The problem is, I don’t know what this is. I do not fit the current government testing criteria for coronavirus, even though I am an ophthalmologist and frontline NHS worker. This uncertainty impacts when I can return to work, as I would have been able to earlier if I knew I didn’t have it. I am in strict isolation now, and thankfully that isn’t a problem; some of my colleagues have at-risk family members they care for.
Reports from Wuhan showed that ophthalmologists and ear, nose and throat doctors were disproportionately affected by coronavirus; both in terms of how likely they were to get it, and how badly. Droplets containing coronavirus enter and exit through the nose, eyes and mouth. Because of how close we get to these body parts, and the length of time we spend near them, we are at high risk of catching the virus. The heroic Wuhan whistleblower Li Wenliang, who died tragically at 33, was an ophthalmologist.
I have always known that my medical profession could put my health at risk, particularly at times of crisis. Yet our political leaders have singularly failed to do what they can to lessen that risk. Routine appointments should have been cancelled earlier, active measures put in place to reduce the risk and degree of exposure. It is true that conflicting clinical advice – such as about the use of personal protective equipment – has made the government’s job of protecting medical professionals more challenging. Yet at times like these, difficult decisions must be made, and quickly. Instead, the government has taken a dangerous laissez-faire approach.
In places such as Hong Kong, meanwhile, proactive measures from early on may well have stemmed the tide of the virus. These measures have included using triage systems to identify patients who were experiencing symptoms of Covid-19; avoiding risky procedures wherever necessary; and asking staff to take their temperatures before working. For ophthalmologists, protective shields were mandated for all slit lamps (the machine we use to examine eyes) and eye protection provided to all staff.
The universal use of masks, hand hygiene and appropriate personal protective equipment were all promoted at departmental level. In the UK, my colleagues and I were dissuaded from wearing face masks and gloves, for fear that we might run out of supplies, or that this protective equipment would create unnecessary anxiety for patients. Yet a sealed face mask and gloves – which many of my colleagues are having to fashion to protect themselves and their families – may have stopped me from getting the virus.
Our government woefully underestimated coronavirus early on, with the prime minister shaking hands with NHS staff just two weeks ago. This approach put us all, but particularly frontline NHS workers, in harm’s way. There have been numerous staff-led initiatives to ensure safeguards for NHS staff in recent days; yet until the government starts listening to us, we are cannon fodder.
By not protecting NHS workers, the government is risking the lives of the very people upon whom it will need to rely during this crisis. It is unclear why it is shooting itself in the foot in this way. The only possible explanation is complacency: Boris Johnson was simply not expecting things to get so bad so quickly, despite all the warnings from public health bodies, and all the evidence from Wuhan and Italy."
Nima Ghadiri is an NHS ophthalmologist based in London.