Dr Curtis St John is a Medical Officer on Alford Ward which is a surgical ward for male patients. He is responsible for the day-to-day hospital care needs for the patients on this Ward. Currently, due to the suspension of most Outpatient Clinics, he is also responsible for dealing with follow up appointments after a patient has been discharged from the Ward.
Dr St John’s role, as with many of his colleagues at the hospital, is to keep taking care of persons who are unwell and need hospitalisation. There are many people whose illnesses are not related at all to COVID and they still need care.
Dr St John is one of those healthcare warriors who contribute, every day, to keep the wheels of the healthcare system turning outside of the COVID battle zone.
Dr St John sat down with DNO to answer some questions and below is the transcript of his interview with DNO.
Q: How can you be certain that the patients you are looking after on Alford Ward are not carrying the COVID19 Virus?
A: There are robust protocols in place to prevent anyone with the virus or suspected of having the virus from entering the main hospital, for example, we have a protocol for anyone entering the hospital.
Q: What is the protocol to enter the hospital?
A: Upon arrival, you will be screened at the entrance of the hospital by trained medical staff. Every person entering the hospital including doctors, nurses and other hospital staff are screened – not just members of the public. We screen for respiratory illnesses, fever and other symptoms that are attributed to the COVID virus and only if we are satisfied that you are clear will you be allowed to enter the relevant department that you are going to. Whatever the reason for your visit to the hospital you will have to be screened first outside of the entrance before you are allowed to enter.
Q: What is the protocol if you present with symptoms such as a fever, a cough or difficulty breathing?
A: If you present with symptoms of a fever, you will be redirected to separate screening unit, still outside of the hospital, which is manned by doctors and nurses equipped to fully assist you and test you for COVID19.
We have a COVID Medical Team consisting of members of the Cuban Brigade and local doctors and nurses. Their role is to assess and where necessary test persons who present with symptoms that may suggest they are carrying the virus. There is a separate unit specifically for this purpose and so any person suspected of having the virus will be stopped at the entrance and redirected to the COVID team.
Q: Do you consider that the protocols in place are adequate and do you feel that you are working in a safe environment having regard to the fact that you and your colleagues are on the front line?
A: I am very satisfied with the protocols in place and I believe that the hospital is probably one of the safest places to be during this COVID virus. I am confident that my colleagues at the front gate are taking all precautions with the screening process and to date we have not had a single COVID case enter the hospital as far as I am aware. We are doing well.
Q: In many countries, our frontline doctors and nurses are falling victims to the virus. Many have lost their lives. Are you concerned at all this? Do you feel that you have sufficient protective equipment?
A: I am not all concerned. I believe that we have adequate personal protective equipment, especially for staff working in the Casualty Department and those working with COVID patients. For those of us working on the wards despite the fact that every member of the team is screened before coming onto the ward we ensure that we wear our facial masks at all times. Even the patients are given masks! We practice social distancing and I must say that we have really taken hand hygiene to another level. Our team are looking out for each other and constantly remind each other about hand hygiene/sanitising. We are being equipped daily with personal protective equipment. There is no shortage of supplies and this is very reassuring for the team.
Q: What is Staff morale like on your ward?
A: Staff morale is good. There is a sense of togetherness. Staff are concerned and a lot more cautious since the outbreak. Everyone is working as a team to ensure that all hygiene protocols are being adhered to. I have noticed that colleagues will point out if your mask isn’t fitted properly and you can see that all staff are really following the handwashing protocols rigidly. Social distancing is very much in place at the hospital.
Q: What is the most challenging part of your job at this time?
A: The most challenging part of my job at the moment is dealing with work that would normally be dealt with in the outpatients’ clinics. All the discharged patients have to return to the wards for their follow up appointments and that has increased our [the doctors’] workload somewhat. Also for patients that have emergencies and needs to see a doctor, we still have ward reviews. They can contact the ward and we can set up a date for them to come in to see a doctor.
Q: We know that the majority of the outpatient clinics have been suspended. What is the position with, for example, dialysis patients?
A: Dialysis patients continue to attend for their dialysis as normal. Nothing has changed except of course they are screened on arrival and before being allowed to enter the hospital grounds.
Q: What is your view on the manner in which the COVID19 virus has been managed in Dominica?
A: Based on the number of COVID cases we have I think that we have been successful. We have been very effective. We no longer have any new cases. A lot of contact tracing has been done. The number of active cases has dropped significantly. We have had no deaths directly related to COVID-19 infection. We are doing well. I think that the government’s approach in managing COVID 19 in Dominica has been a success. They have done an excellent job.
Q: If you were able to pass a message to the Dominican public, what would it be?
A: The public have been really good – cooperative and I want to say to them please continue to stay home if you do not need to go out. Continue to follow safe hygiene practices. Continue to observe social distancing. Wash your hands, don’t touch your face, wear a face mask in public. If you are leaving your home to go out then wear a face mask. Practice your social distancing and try staying at home as much as possible. Based on our numbers we can see that these practices are working and we should continue until COVID 19 is no longer a risk – may be because a cure has been found – a vaccine. For Dominica, I think we think we could be fully cleared soon as long as everyone continues to observe the safe practices. We have no one reporting symptoms. However, we have to be mindful that once our ports are reopened there is a risk of more cases. Also, we are hearing of overseas of cases where persons becoming reinfected.
We have to be cautious. We cannot let down our guard.
Interviewer: DNO, on behalf of the people of Dominica want to extend our thanks and gratitude to you and your Team. Although you are not involved in the with the medical management of COVID patients (and currently we are proud to say we have no confirmed case on island) you are an integral part of front line staff and it is reassuring to know that our day-to-day medical services are continuing even in with the management of the COVID-19 crisis.