For 30-year-old Dr Philicia Findlay-Hardyal, working on Christmas Day has always been a privilege but this Christmas Day will be extra-special for her as she hopes to ensure that critically ill COVID-19 patients feel special despite not being able to see their families or loved ones.
From day one, Findlay-Hardyal has been on the frontlines of Guyana’s healthcare response to the COVID-19 pandemic. She is one of eight doctors who volunteered to work in the COVID-19 Intensive Care Unit (ICU) prior to the pandemic’s presence in the country. Her husband, a gynecologist, also works with COVID-19 patients.
The first case of COVID-19 was recorded on March 11. The following months would see the confirmation of more than 6,000 COVID-19 cases in Guyana and over 150 deaths due to the virus.
Having witnessed the devastating effect the COVID-19 pandemic has had on families across Guyana, Findlay-Hardyal told Stabroek News during an interview that there is no doubt that this Christmas will be nothing short of memorable.
She recalled that when she first got into the medical field, she knew that sometime in her career she would have to volunteer and possibly work through a pandemic, but she never thought that it would’ve been so early in her career.
The doctor explained that although they are taught a variety of topics on diseases and pandemics in medical school, very little is taught about the socio-economic and psychological impact of a major pandemic. “We are not taught how pandemics completely reshape populations in its entirety and sadly we were never exposed to a pandemic of this magnitude, and never were we ever considering that it would’ve had such an immense impact on our population. It is still very new to us because although we would’ve prepared ourselves mentally during our career to be faced with a pandemic, it’s still a shock.”
Findlay-Hardyal revealed that her expectation of a pandemic partially corresponded to the reality of what it was like but when she and other doctors volunteered to take care of the critically-ill COVID-19 patients, they were aware that they could be exposed to the virus and as result also become infected.
“I was not surprised when it happened,” she said, disclosing that she tested positive for the virus in October.
“There was a period where some of our doctors were exposed, not because of PPE’s (Personal Protection Equipment) or lack of protection within the unit. I do believe that there was a bit of a community acquired infection during the course of this period where a few of doctors became exposed and because we were in contact with the doctors as we all worked together, a group of us were exposed,” she recalled.
She revealed that since March she was tested twice for the virus. The first test result was negative but the second test result was positive. Even before she was tested, Findlay-Hardyal said she knew she was infected with the disease because she had most of the symptoms relating to the virus including runny nose, loss of taste and shortness of breath. She noted that she had fever but she suffers from tachycardia and this made her vulnerable to the virus.
After receiving her results, she was placed in two-week home isolation and slowly recovered with the help of her husband, mother and aunt. Additionally, she said, she received tremendous support from the GPHC, the surveillance team and the Ministry of Health (MoH). Although her experience with the virus was as difficult as she was expecting, Findlay-Hardyal said it certainly had an impact on her mental health. Noting that she had seen some of the worst things that the virus can do to a person and seeing persons infected with the same disease die, she said she was filled with fear and anxiety.
Ventilator
“What if I don’t recover? What if my symptoms worsened and what if I have to go into the ICU and what if I never see my family again or what if I have to go into a ventilator?” were some of the questions constantly on Findlay-Hardyal’s mind during her isolation period. “All these questions overwhelm you for a period of time and even as a doctor you think you can take care of yourself, you know so much about the disease but it works to your disadvantage when you’re sick because you would’ve seen the worst possible outcome of the disease and it is basically your fears coming to life when you’re also in that situation,” she added.
In addition, she said there were many nights that she was not able to sleep. However, she said the support given to her by her family and the prayers and meditation she immersed herself in helped her a lot. In the end, she said, it all depends on the positivity of a person’s thoughts because the scariest part of the recovery process is knowing what can happen if someone becomes critically ill. Following her recovery, she was granted two weeks’ vacation leave after which she returned to work.
For the healthcare workers, the effects of the pandemic also had a devastating impact, mainly because of the feelings of hopelessness that they felt when a patient died. For her, the doctor revealed that she has seen more patients die this year compared to her five years of practicing medicine.
“I’ve seen more patients die in days and months than I’ve seen them die throughout my years of medicine in medical school and throughout being a practitioner, but what was more debilitating was that our patients died from irreversible causes like hypoxia, the lack of oxygen, so regardless of what we tried, nothing seems effective and that made a lot of healthcare workers begin to question our very existence and purpose. If you are not able to provide the care, to treat and to heal, then why were we here? She questioned.
She added that it was very difficult seeing patients die because they got attached to them. She pointed out that they would spend 14 days in the ICU before their condition would worsen. However, she noted they always tried their best to try to keep a patient alive and hope against hope that those on ventilators would recover.
Sacrifice
The sacrifice made by frontline healthcare workers in Guyana has gone unseen even as some of them have taken the option to stay at the doctor quarters at the hospital to ensure that their families are safe.
“It isn’t the most easy decision to make because you’re not only sacrificing your time but you’re also asking your family to make a sacrifice on behalf of you and your career, and that is also one of the precipitating factors that would’ve caused some of our healthcare workers to become mentally affected and unstable at some point during the pandemic,” Findlay-Hardyal said.
Findlay-Hardyal noted that she was not the only one affected mentally by the pandemic. “This pandemic not only affected our health but it has affected us mentally and socially as well. Mentally, I believe most of us were affected because most of the times we don’t recognise the importance of our support system and when that is taken away from us and we are restricted from doing certain things period, I think that is what causes most of our mental disorders during this period. We don’t like to talk about it but not only health care workers were affected but most of our patients that were infected with COVID-19 and recovering were also affected,” she said.
She revealed that she personally witnessed the mental instability of family members who had lost a loved one to the virus and the depression that attacked some of the patients in isolation. “We had lots of patients that have had suicidal thoughts and were depressed in our units and we even had psychotic breakdowns during this time because it was just too much to cope with, not only with the high mortality rate affecting them but the fact that they were isolated from their families,” she added.
Hazmat
Further, she said, it is hard to spend 14 days in the ICU without being able to see someone you love physically and unlike in the normal hospital setting, Doctors have to wear hazmat suits whenever they have to attend to a COVID-19 patient. As a result of this it was difficult for patients to connect with healthcare workers the way they usually would and all this makes the road to recovery longer and slower.
She added after she got infected she was determined to return to work because she understood more clearly what the patients were going through. “I understood the fear that they have and I understand their insecurities and understand what it is like to be isolated and away from the people that you love and so because of that most of us [healthcare workers] that were infected were able to tailor our care to each individual and we were able to immediately recognise behaviour and red flags and immediately offer early intervention to those patients that were exhibiting signs of anxiety or depression or those persons that were isolated and were refusing to communicate. We were able to help them earlier because we lived it and experienced it. We were able to be there for our patients and offer that companionship and offer that channel for reconnection to humanity and I think that is what keeps people going,” Findlay-Hardyal offered. This, she added, is what is motivating her to ensure that COVID-19 patients feel special during Christmas day.
Today, Findlay-Hardyal will be among several doctors tending to critical COVID-19 patients at the Infectious Disease Hospital. “There are no such things as holidays and weekends for healthcare workers,” she said, adding that it is privilege to work on Christmas Day because she gets to spend the day with patients who are not allowed to spend time with their families on such a special day given the nature of the disease that they are infected with.
“It’s actually quite a privilege to work on Christmas because you’re able to share your day with your patients especially as they are not able to share this special days with their families so we need to be there for them.
We can at least be that ray of hope that encourages them to keep going, to offer some comfort, offer a glimmer of hope and joy on [this] day and let them know that they are going to recover and that next year they’re going to be home with their families. It is an honour, it is a privilege, it’s a great opportunity to work on Christmas Day especially during a pandemic because there are always patients who need us more than our families,” she said.
The doctor noted that this is not the first year she has been scheduled to work on Christmas Day and she is very certain that it won’t be the last.
Nothing major has been planned at the Infectious Disease Hospital to celebrate Christmas, however, patients can expect gift cards from doctors and nurses working in the hospital. Findlay-Hardyal revealed that the healthcare workers bought get-well cards for the patients, wishing them a speedy recovery so they can feel appreciated.
In addition, she said, they asked patients to write one wish that they would want granted for Christmas which will be fulfilled later today.
She noted that the COVID-19 ICU team also plans to take the Christmas spirit to the paediatric unit at the Georgetown Public Hospital. Children currently admitted will receive gifts and care packages to brighten their day.
This Christmas will be nothing short of memorable for not only Findlay-Hardyal but for many families across Guyana who have been impacted by the pandemic. She said that she believes that many people are grateful that they made it to December. “This Christmas is special because we are able to appreciate the importance of human connection and we have been humbled by this experience and we realised that life is not only short but life can be taken away from you in an instant and it is just important to live in the moment not just on a special occasion but make every day important. Persons should not see the COVID-19 restrictions as a form of punishment but as a way to guarantee that they will get to spend more Christmases and birthdays in the years to come,” the doctor said.
