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The Covid-19 death rate is particularly high among hospital staff. The Discovery Life team says two-thirds of the life claims that they’ve had during Covid have been for healthcare workers. In this podcast, BizNews founder Alec Hogg speaks to Dr Adri Kok, a Covid-19 survivor who works at the Netcare Alberton Union and Clinton Hospital, about how staff are coping with their high-risk jobs. As a way to show appreciation for the nurses at her hospital, doctors and members of the community gather to show their gratitude by forming a guard of honour (see the video, below). Having had Covid-19 herself, Dr Kok understands the dangers and the importance of the work that the nurses do. To them, she says: ‘You are our heroes, you are champions, and thank you very much for your service and your sacrifice’. With the pressure on hospital beds easing slightly, Dr Kok insists that you remain vigilant and behave as if everybody around you is positive. – Nadya Swart
Well, there have been some wonderful initiatives during this Covid-19 pandemic, and Dr Adri Kok has been involved in one of the most heartwarming that I’ve seen. Adri, just tell us a bit about yourself. Where exactly are you working?
I’m a specialist physician in the Netcare Alberton Union and Clinton Hospital, and, you know, this Covid pandemic has really hit all the hospitals hard. I think Gauteng, obviously at the moment, is sort of flattening
Is the pressure on the beds at least starting to ease a bit?
A little bit, but we’re still getting people who are desperately ill. Luckily, we are getting some of them home. And it’s really in recognition of our staff that we wanted to have this initiative – that prompted us having this conversation.
I saw the video clip, the doctors lining up outside the hospital.
The guard of honour for Covid-19 heroes, heroines
So the idea was, first of all: it was not just doctors, but the community at large, to invite people to come. And some of these have been patients. Some have had family members that have been in hospital. Our general practitioners supported it. Our physiotherapist and OT’s came. Psychologist, psychiatrist. So, it was really so special to see everybody making the effort.
So what we did was just – at the shift change of the day and night staff in the morning, and then in the night/day staff in the evening – to just stand and give them a guard of honour. And to just clap hands for them and say: ‘You are our heroes, you are champions, and thank you very much for your service and your sacrifice’.
So, that was really the idea behind it, and really, the doctors and community came to the party, as they say, and were fantastic. But the heroes and the champions here are the nursing staff. If you look at the challenges that our nursing staff face – in our hospital group, for example – we’ve lost lives.
Covid-19 claims nurses
They’ve had to see colleagues get ill. They have themselves had Covid. And at the same time, they still adhere to that pledge that they made to look after people and to sacrifice themselves – to the betterment of their fellow human beings.
If you look at some of the situations in the township areas: the nursing staff, because they are wearing a uniform, they obviously stand out and they’ve sometimes been almost rejected, because maybe you can give us Covid – that kind of attitude – just because people don’t always understand. And they’ve gone through all of that.
They’ve had the stress of the job. It’s hard work. To wear personal protective equipment is hard, it’s not easy, you know, you sweat a lot. It’s uncomfortable. You have to wear the mask with a visor. You’ve got gloves on all the time. So, it’s not your usual working environment, and they’ve really coped with all of this tremendously well. We’re very proud of them.
We lost one elderly nurse in our hospital: Sister Virginia – who was the most amazing human being – right at the very start of the Covid pandemic. At the time, she was an older person and she just couldn’t fight the virus. So, that affected everybody because, again, you don’t have that normal ability to attend the funeral, to be with a family – all of that is lost in the Covid pandemic. And even if they’ve lost family members or close friends – they couldn’t attend funerals, for example.
So, all of this has had an impact and they’ve really come through all of that and still given a service in the hospital, which I just applaud and salute them for.
Adri, just to put it in perspective: when Covid struck, we were told the experience from other parts of the world is that healthcare workers were the ones who were by far the most at risk. The figures, some of the figures we got back, were that in ICU workers – 20% in Italy had died.
Covid-19 death toll: far higher among healthcare workers
I was talking with the Discovery Life team last week, and they said two thirds of the life claims that they’ve had during Covid have been healthcare workers. Which, of course, is far, far greater than the proportion of healthcare workers insured. How does it feel going to work in this kind of environment?
I think it’s really a situation where you have to put your fear aside and you have to understand that you have that responsibility. This is your job and this is what you chose to do. But at the same time, you do have that fear, you have that uncertainty. And so, to use the personal protective equipment is absolutely crucial (to get that right).
People forget, you know, they take their mask off to chat to somebody – they just don’t think sometimes that this could be a problem. And I think it’s been a learning curve for everybody to just be as vigilant, as careful as possible. We’ve been very fortunate in our hospital group to have excellent PPE available. This has been really reassuring for the staff.
I know that in some instances this is not always the case, and so – in those hospital groups where it’s not been available – it’s even worse, because if you don’t have that protection, you can imagine how scary this whole pandemic could be for you.
A Covid-19 survivor
And what about yourself? Have you been exposed to Covid-19?
Yes, I had the experience of having the virus myself and I was very lucky that my oxygen percentage did drop. But I was able to stay at home. I had good support from my family and my friends. And at the time, really, you just feel like a heaviness on your chest. And it’s, in a sense, helped me to also, you know, come back to work – for the staff to see I’m back at work, that I’ve come through it, that I’m okay.
The fatigue you sort of had to fight through, and it’s a miserable virus, you know, we just don’t like it – we want it to go away now. We’ve had enough. But luckily, again, you need to set that example: that you could come back to work and you could continue working. We have warned people that it’s not ‘because you’ve had it, that that you’re now immune to it’.
So, you have to just continue to be vigilant and just not take the safety that you have with your PPE, even that, not to take that for granted as well. And, you know, just to enjoy your work and the people that go home – to really celebrate the fact that we could make a difference for those patients.
And the nurses themselves, how they reacted to your guard of honour?
They loved it. Some were a little bit embarrassed: they didn’t quite understand what this was all about.
The ones that I’ve spoken to have really, and many have come to thank us for having taken this action to make them feel special. You know, I think it’s really just to recognise the absolute amazing contribution they’ve made.
It’s a unique profession – nursing. These are often people that may be single parents. They have long hours. They often travel to work in the dark, especially in winter time. They have to wait for taxis to take them home or transport to help them. They often have to travel far to come to work.
And yet, despite that sacrifice, they are also sometimes met by the public here at the hospital with families that can be unreasonable. Patients can sometimes be unreasonable – as many as there are that are appreciative.
There are also some that challenge the situation quite badly, and we want them to understand that these girls and guys are working as hard as they can – under very difficult circumstances – and they’ve been exemplary in how they’ve acquitted themselves of their profession.
South Africa’s low Covid-19 death rate
It’s been quite extraordinary that South Africa’s mortality rate from Covid-19 is so much lower than elsewhere in the world. What do you put that down to?
I think we had the benefit that we did have an opportunity to learn from the international experience. You know, we could sort of see what worked, what didn’t work, should you use this, should you use that, you know, this works, that doesn’t.
We’ve had education from the international community on how to ventilate patients: who to ventilate, what ventilatory support to use, what medications do work, what don’t. We’ve learnt about diabetes being a challenge, obesity, male patients have been at risk specifically. So, I think we had that advantage.
Secondly, we actually have an excellent academic community in South Africa and we also communicated with one another. What is your experience? What worked for you? Okay, this worked for me… And we shared that clinical experience, to be able to say this is the way that we can really fight this virus.
I think also – importantly – is that the lockdown did help. I do think though – looking at the economic situation and the job losses – that even though the lockdown helped, it is now starting to be the negative side where it’s really affecting people very badly. So it may be a situation where you’re going to have to accept that some people are not going to make it. But you can’t, again, sacrifice the rest of your fellow South Africans in the sense from an economic point of view.
But also, the stress of it: of being isolated, not back at work normally, the school situation – many people, especially the nurses, have families, and who do they leave the children with? So, there’s been those challenges that are not so easy to overcome. Some people have a good socioeconomic situation where they can get help, but many people can’t. And that responsibility, again, they carry with them as they come to work.
Vigilance is key – everybody around you is positive
So, I think the lockdown helped, but I think it’s time that needs to be lifted. We just have to absolutely enforce the mask wearing, the social distancing, the awareness that this can make a difference. Your hand sanitiser: you know, whether it’s in a restaurant, whether you’re going to have your hair cut, whether you’re going to put petrol in your vehicle, whether you’re in a taxi – it doesn’t matter where you are. This really does make a difference, and the mask wearing, as painful and as irritating as it is, can save your life.
I think that is important and most important, what I say to people: everybody around you is positive.
I don’t care what they look like. I don’t know who they are. You’ve got to take that everybody around you, including your family, may be positive. And that’s how you really have to have that attitude: that you have to protect, not yourself, but everybody around you as well.
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