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While the rest of us complain about face masks, doctors working on COVID wars don layers upon layers of protective gear, unable to drink water or go to the bathroom as they work. One of them shares his experiences.

Nobody will be surprised to learn that research shows the COVID-19 pandemic has increased levels of stress, anxiety, depression, frustration, and caused a dooming sense of uncertainty for people around the globe. Whoever we are, and wherever we are, we're all living through the very same strange times, after all. We've all, in one way or another, experienced the consequences of the pandemic first-hand. 

During times of crisis, when everything we've built and everything we're used to is up in the air, humans tend to retreat to their own little bubbles, becoming more focused on our own, now more pressing, concerns and needs. 

I'm no different, so when Dr Chris Pavlinec, a SteadyHealth author and a doctor currently treating COVID-19 patients, showed us what he wears when he goes out to work every day, I was temporarily shocked out of my own (also not so normal) "new normal" routine. Chris already shared his experience with working on a COVID-19 ward, but it was his post-apocalyptic work gear that made me want to know — just how does it feel to be a health care worker during these times?

All in a day's work: How does the COVID-19 pandemic impact frontline health workers?

Frontline healthcare workers are, preliminary research suggests, more likely to end up with COVID-19 than the general population. This is especially true when they're not equipped with adequate personal protective equipment, and especially when they also come from minority ethnicity backgrounds. 

The knowledge that you're at a higher risk of being infected with a potentially deadly virus — and one that can leave you with still very much unexplored long-term health damage if you do survive — has got to impact morale. But the difficulties frontline health workers face go beyond the immediate risk of infection, which can be reduced with protective gear. 

Health care workers actively treating COVID patients may face psychological overload and compassion fatigue. In a worldwide context, they'll often be dealing with staff shortages, with long working hours, and with limited resources. Difficult moral decisions, like who gets one of the few available ventilators, may have to be made. Not really knowing which treatment approaches are effective and which are not, since COVID-19 is still new, may mean having to learn through trial and error. The error part of that equation may lead to the loss of life, which has got to weigh on health workers. 

Then, there may be a tremendous personal cost, as health care workers make the choice to separate themselves from their families, including often young children, to reduce the risk that their loved ones will be exposed to the virus. Because of the challenges health workers face, they may even develop PTSD because of COVID-19.

It's in this kind of climate that the World Health Organization also reports personal attacks on health care workers and their families, ranging from physical assault the destruction of belongings, to being called slurs related to fears they might be contagious. 

What's it like to work on a COVID-19 ward?

Doctor and fellow SteadyHealth author Chris Pavlinec describes what's it like to do the work he does with COVID patients in the very analytical way I've come to expect from him. This small glimpse into his day-to-day, and those of many of his colleagues all around the world, certainly puts the dislike many of us have for face masks in a whole different perspective. 

"In our department," Chris explains, "we follow a similar protocol to those around Europe and North America when it comes to PPE."

One side of our department is "Clean' and it is where we do most of our brainstorming for patient care, complete all the documentation, and rest after rounding on the 'Dirty' side. On the 'Clean/ side, it is mandatory that all personnel wear masks and try to isolate themselves from each other as best as possible. 

The "dirty side" brings with it more immediate concerns, because that's where the direct contact with currently infected COVID-19 patients takes place. 

"Depending on the activities that I need to do during that day, my PPE would change slightly," Chris shares. "If no COVID-19 swabs are planned for the day, I will typically wear a pair of one-time use scrubs, surgical stockings, surgical boots, a sterile apron, a surgical handkerchief around my neck, two pairs of gloves, three surgical bandanas, a face shield, and another apron."

When working with COVID patients, in all that protective gear, a shift can only last so long before the doctor needs a break. 

"My shift on the 'Dirty' side would last 3 hours and would include tasks like rounding with all 34 patients we are treating, taking patients for imaging studies like CT scans, giving medications, replacing IV bags and changing clothing or diapers for patients. Due to the limited number of personnel, our nurses and orderlies do not work on the 'Dirty' side while 2 doctors are rounding so it can be tough having to carry out all the responsibilities for three professions while wearing such hot clothing."

The "dress code" doesn't finish there, though, as Chris adds:

"If I need to perform swabs on patients during rounding, my outfit will change slightly. This task represents the most dangerous point of contamination because patients can breathe right on you so I need to be dressed in overalls covering my whole body. After putting on all the other layers of additional protection, like gloves, face shield, hoods and aprons, you feel similar to the Michelin Man. This outfit is even more unforgiving than normal surgical aprons."

During his shift on the 'dirty side" of the department, Chris can't go to the bathroom or have a sip of water, so, he explains, "by the end of the shift, you are quite exhausted, drenched in sweat and anxious for a bottle of water".

The length of these shifts varies depending on the occurrence of unexpected complications ("usually every day", he says), but Chris' planned shifts are three to four hours long. 

Chris' department "has an unofficial rotation where doctors who have gone on the 'Dirty' side will be given at least a day break before having to go back", but that, he says "does not always work out". The end result?

"I will typically spend at least 3 days a week on the 'Dirty' side and have had a similar working pattern for the last two months. Because we are missing a few colleagues away on vacation, I have typically worked 6-day weeks including at least 2 24-hour shifts a week and look forward to the fall when most of my team will return from vacation."

In conclusion, Chris says, "It is without a doubt very demanding work but for now, we just go from day to day and get some renewed energy when a patient improves and can go back home". 

Though all of our lives have been disrupted, sometimes in permanent ways, our frontline health workers quite literally live and (sometimes even) breathe COVID-19 as their day jobs. The same is, in different ways, true for other essential workers, from janitors to retail workers and police officers. 

Chris, and others like him, simply do their jobs, despite and even because of the new challenges they face. Chris certainly wasn't looking for praise or admiration when he shared his experiences with his colleagues at SteadyHealth, but I think he and everyone working on the frontlines deserves it. The rest of us, legitimately psychologically distressed as we may be, also owe them more than that, though. As Chris goes to work in circumstances that would have sounded like fiction not too long ago, we need to, at the very least, put on our masks and wash our hands without whining. 

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