Dr Soosan Jacob
On the last day of the last year, we in the Ophthalmology community looked forward to a good year and decade ahead. Little did anyone notice a small press release from China about fever in Wuhan.
Fast forward to today – about a 100 days of COVID-19 and the entire world and all of ophthalmology will never be the same again. Corona has permeated into every sphere of our life – our homes, jobs, organisations, countries…
In India, we like others, keep looking at daily numbers. Chennai, my city, is the most affected in my state, Tamil Nadu. The Indian government had fortunately announced a countrywide lockdown quite early in the curve. The numbers are slowly going up but we are still hoping that things will not get completely out of hand. All non-essential businesses are closed. We, at Dr Agarwal’s Eye Hospital, had already stopped everything other than emergency surgeries a few days earlier but post-lockdown, non-emergency work in all 97 branches is at a halt. The hospitals still open every day for emergency services and emergency surgeries.
Where I work, a few vitreo-retinal surgeries have already happened. We have a team that mans the hospital every day with a triaging system at the entrance. Since the Indian government is in favour of a universal mask approach, most patients come with either surgical mask, home-made masks or at least a scarf or handkerchief tied around their mouth and nose. History is taken over the telephone. Following examination, the patient is sent out again and treatment explained telephonically. This keeps mutual interaction to a minimum.
Despite the “no talking during examination” rule, the close face-to-face interaction that we have with our patients is painfully obvious. Some slit-lamp procedures such as suture removal etc still need to be done and the slit-lamp shield gives some protection. We change into hospital scrubs on entering and then wear PPE in the form of mask, cap, goggles, gloves and surgical gown. Before leaving, we change into street clothes again.
At this time, I think it is important to be realistic as well as positive. Like most industries, ophthalmology has also taken a hit. However, we need to be ready to meet with the increased number of surgeries that may happen once the situation comes under control. The challenge I feel then will be in trying to formulate out-patient and theatre protocols. Also figuring out who is an asymptomatic carrier – ourselves, the patients we see, our colleagues, staff?? There will be a lot of uncertainty, which will need solutions.
COVID-19 has brought about a new phase in our lives where we have been made to harshly realise that every life is intertwined and that we are only as strong as our weakest link. All systems will have to be strengthened and everything will have to be decided not only for controlling the present COVID-19 wildfire, but also to prevent possible future incidences from having such a catastrophic influence.
Dr Soosan Jacob is Director and Chief of Dr Agarwal’s Refractive and Cornea Foundation at Dr Agarwal’s Eye Hospital, Chennai, India and can be reached at firstname.lastname@example.org
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