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POLAND: Frontline doctor Dr B reveals the sheer horror of working on a COVID-19 ward

In this special series ordinary people across the world share stories of their struggle to survive in a pandemic world. Late in 2019, a mysterious illness emerged at a seafood and poultry market in the sprawling capital of Central China’s Hubei province. The growing outbreak was reported to the World Health Organisation on December 31, which confirmed a novel coronavirus was the cause of the respiratory illness in a cluster of people on January 12, 2020. COVID-19 was officially first detected in Poland on March 4, 2020, when a man hospitalised in the western city of Zielona Gora tested positive after being in Germany. Two days later four news cases linked to “patient zero” were announced by authorities. Poland officially declared local transmission to the WHO within the week, and on March 10 all mass events were cancelled. The first death to COVID was recorded on March 12 — a 56-year-old woman from western city of Poznan who had been suffering serious health issues prior to her infection. That day cultural institutions — such as philharmonic orchestras, operas, theatres, museums, and cinemas — were suspended and all schools were closed with students required to continue classes online. On March 20, Prime Minister Mateusz Morawiecki officially declared Poland was battling an epidemic. Poland’s right-wing government ramped up what would become some of the earliest and most stringent lockdown restrictions in Europe, with Poles and the legal community concerned the passing of legislation to prohibit people’s freedoms was in direct conflict with the country’s constitution. The unforgiving restrictions particularly hit a nerve among those who had lived through almost half a century of communist rule that had censored speech and repressed rights from 1945 until its collapse in 1989. News the Ministry of Health had prohibited the medical community from talking about the pandemic emerged in March, sparking an uproar among doctors fighting against the growing infection rates. “As doctors @PChSKALPEL we express our firm opposition to blackmail and attempts to silence the community of National and Provincial Consultants in the fields of medicine!” doctors associated with the SKALPEL Surgeons Alliance wrote on Twitter. “Closing the mouths of doctors by hospital management, the ban on speaking to national consultants without agreeing the content of their speech with the Ministry of Health threatens us all with a disaster." Poland is one of the most religious countries in Europe, and one of the most Catholic countries in the world. Although Catholics largely supported measures to control the outbreak, radical restrictions enforced on church gatherings only added to the return of unwelcome memories of decades under a regime that was steeped in anti-religious sentiment. Under Marxist doctrine, the communist government in Poland had actively advocated for the disenfranchisement of religion and attempted to achieve an atheistic society. As summer holidays approached in Europe, the Polish government loosened restrictions in an effort to mitigate damage to the country’s economy and social fabric. On April 20, 2020, restrictions were relaxed. A second pandemic wave hit and again cases began to rise steeply, this time extending to notable authorities such as Education Minister Przemyslaw Czarnek on October 5, followed swiftly by Polish President Andrzej Duda on October 24. Poland surpassed one million cases by the start of December 2020 with cases growing at an exponential rate. A third wave peaked in March 2021 pushing hospitals to their limits with a significant lack of staff available to treat the sick. In response to poor vaccination rates Poland launched a lottery on July 1 this year to incentivise the jab. Each day, every 500th person to receive a dose would receive a cash prize of PLN200 (AUD70), while every 2000th would win PLN500 (AUD175). The Government also said it would give away five prizes of PLN50,000 (AUD17,000) and hundreds of electric scooters each week until the end of September. But with only half the population fully vaccinated at the time of writing, Poland has fallen well below the European Union average — a particular concern as case rates climb rapidly. At the start of September 2021 the country’s health ministry confirmed a fourth COVID wave had hit Poland, leaving its crippled health system scrambling to cope with the mounting death and disease. Exhausted frontline doctor Dr B — who asked for her full name to be withheld — reveals the sheer enormity of the horror and devastation she has seen at the hands of the deadly pandemic, and the immense frustration she feels towards those who refuse to get vaccinated. DR B, 33, INTERNAL MEDICINE DOCTOR, POLAND ‘Patients show a great fear of death’ From October 2020 to June 2021 my home hospital ward (Internal Medicine Department) was transformed into a COVID Department. Hence, whether they wanted to or not, all the staff became obliged to work with patients suffering from COVID-19. For a few weeks I was also responsible for the qualification for vaccination against COVID-19. At the hospital we were then vaccinating medical staff and teachers. We experienced many difficult moments in the ward as COVID patients were often young people, not burdened with chronic diseases. Increased dyspnoea (shortness of breath) and a great sense of fear of death — which accompanied the patients — were symptoms we had not observed so often at work before. COVID-19 was also characterised by a very rapid course, a rapid deterioration of the condition in the patients, requiring immediate interventions. Unfortunately, our knowledge at that time about the very low survival rate of COVID-19 patients on ventilator therapy did not help us. In addition, despite severe dyspnoea and extremely bad laboratory results, the patient often remained conscious until the very end, unlike in the case of respiratory failure caused by other diseases, such as bronchial asthma or COPD (chronic obstructive pulmonary disease). ‘We ran out of space to store the dead’ Due to the lack of beds in intensive care units, patients during ventilator therapy often remained under our (internal) care. We did not feel able to manage such patients, but we had no choice. Another fact difficult to accept was the number of deaths at that time, problems with the storage of corpses in the hospital. There were a lack of places in the cold room. Another thing we could not come to terms with was the very limited outside help, such as the lack of a psychologist and the lack of a priest at the patient’s sickbed. This may have been caused by the limited access to personal protective equipment, but as far as I know in some neighbouring hospitals such care was provided. ‘My insides are boiling ... I am furious’ I feel powerless when I hear about the Polish people who are sceptical about pandemics and vaccination. My insides are boiling and I am furious, because I am sure that experiencing the same thing I experienced while being in the ward would have dispelled the doubts of most of the non-believers. I understand that for people who have nothing to do with the health service it can be hard to imagine the scale of the problem and the tragedy of so many families around the world. However, I think a complete lack of sense of responsibility for others — and a lack of willingness to learn about the topic from reliable sources but only passing on conspiracy theories — does great harm. ‘My whole family got COVID’ Not long before we became a COVID Unit, despite taking every precaution and personal protection, most of the staff including myself were referred for COVID tests because of contact with a SARS-CoV2 infected person. Shortly after infection, I became ill with typical symptoms such as weakness, muscle aches, sub-febrile (raised temperature) states, massive headaches, loss of smell and taste, and a cough. I did not have time to isolate myself from my family, so my husband developed similar symptoms two days later. My children went through the infection almost asymptomatic. After experiencing COVID, my fear for my family diminished a bit. After three weeks of illness, I returned to work under new and initially frightening conditions. My children during this time went to kindergarten often being the only children in the entire facility. Kindergartens and schools were closed for the national quarantine, but the children of those fighting COVID-19 were cared for during this time. For about six months after the illness I experienced periodic headaches, concentration problems and short episodes of olfactory disturbances. ‘Poles are too afraid to admit they have COVID’ I think all restrictions imposed by the Polish Government were completely right. Closing schools, cultural and entertainment institutions, restaurants, hotels, limits on the number of people in stores and the use of face masks definitely limited the spread of the virus. Certainly there was a time when there was no ventilator for the sick and many times there was no room in intensive care units, but from what we observed in the media I think compared to other countries we were doing well. Some temporary COVID hospitals were not filling up. Unfortunately, many people do not respect the obligation to wear masks. Another problem is the avoidance of quarantine and isolation and ignoring the symptoms of the disease. I have the impression many Poles had COVID without admitting it for fear of financial problems. ‘COVID brought my siblings closer’ Since the cases started appearing in Poland, my siblings and I decided to protect our elderly parents — aged 76 and 81 years old — at all costs. It may seem strange and funny, but I feel that this isolation brought our family even closer together. I am the youngest among my siblings. My oldest sister is a family doctor and paediatrician. In addition to being an active COVID and SARS-CoV2 vaccinator herself, she offered me a lot of support and understanding in the most difficult moments. ‘We can count on neighbours, family and friends’ For many people the problem was the necessity to stay at home, have remote teaching, and have no contact with family or peers. My husband (a police officer) and I worked the same system as before. We could leave the house and the kids could too. Fortunately we did not experience unpleasant situations from the environment. On the contrary, we could count on support from the neighbours, family and friends. ‘We will have to separate again’ I am most concerned about the health of my loved ones, especially my parents. We have been seeing them since they were vaccinated, but if the pandemic wave comes again I feel we will have to separate again. WHO OFFICIAL STATISTICS (AS AT SEPTEMBER 29, 2021) POLAND GLOBAL

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POLAND: Frontline doctor Dr B reveals the sheer horror of working on a COVID-19 ward

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POLAND: Frontline doctor Dr B reveals the sheer horror of working on a COVID-19 ward