Calm heads and professional solidarity vital - EuroTimes

Calm heads and professional solidarity vital

Michael Amon MD

Michael Amon MD, PhD, Head of the Department of Ophthalmology Academic Teaching Hospital of St. John Chair for Ophthalmology at Sigmund Freud Private-University in Vienna spoke to EuroTimes contributing editor Dermot McGrath about the current situation in Austria

How is Austria dealing with the COVID-19 pandemic so far?
I think it is a case of “so far so good” in terms of our management of COVID-19. We have sufficient hospital capacity for the moment to deal with the most severe cases, although we are all aware of how quickly that can change as the virus spreads throughout the population.

How has ophthalmic care been impacted by the virus?
I think the biggest impact has been on the organisation of our clinics and private practices. Everything has had to be changed to try to deal with the patient load. All elective surgery has been postponed and we have so many patients who are waiting for surgery now that it represents quite an organisational challenge to deal with all the administrative aspects of that. We are still handling emergency cases such as retinal detachments and trauma but everything else has stopped for the moment.

The problem is the high number of cases that I call “urgent elective surgeries”. They do not fall neatly into the category of ocular emergencies but they are urgent nonetheless. This applies, for instance, to cases such as paediatric patients with cataract who are at risk of amblyopia, intumescent cataract with secondary glaucoma or some advanced glaucoma cases. We have pooled all the patient data gathered from doctors in our network with a view to examining cases one by one and deciding whether or not it is necessary to proceed with surgery or whether it can be safely postponed.

What measures can be taken given that the situation is likely to endure for some weeks if not months?
Well it’s definitely a major problem as the patient load is increasing. We already had some waiting lists for cataracts and other procedures and these are only going to increase as we have stopped all these routine procedures. I think we are going to run into problems after the pandemic is over as I don’t think we will have the surgical capacity to deal with the demand. It will take some considerable time to get through the backlog after the immediate COVID-19 crisis has passed. We will also see patients who are not considered as emergency cases who will become urgent cases as the time passes and their condition worsens. We are not seeing our routine patients, so there is the increased likelihood that some of them will fall between the cracks and develop problems while everything is put on hold. It all adds up to a major organisational and logistical challenge.

Is Austria ready to deal with this epidemic?
I think so. We have split our doctors and nursing assistants and support staff into three teams, two of which work from home offices at any given time while the other team is in the hospital. We adjust the teams according to the evolving situation – for instance, if one of the doctors falls sick. We have also put in place a protocol to ensure all the recommended sanitary measures are put in place to protect both the staff and the patients who come to the hospital.

It is a bit deceptive at the moment because everything is fairly quiet in terms of eye care at the moment given that all non-emergency procedures have been postponed. We are dealing with an average of one or two emergency cases a day. Some of my fellow ophthalmologists are helping out as general doctors where the demand is greatest.

Overall, the social distancing and confinement measures taken by the authorities seem to be helping to flatten the curve, although of course we remain vigilant for any sudden upsurge in cases. I think it is very important that we all keep calm and rational and not give in to panic. If we stay on track and keep calm, I think we will manage to get through this and meet the challenge with appropriate measures.

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