“Since I started as an epidemiologist, I’ve been preaching hand hygiene as one of the most effective ways to fight infection. Now I don’t have to say it twice,” muses Dr Sergiu Sîngeorzan, senior epidemiologist at Miercurea Ciuc hospital, Romania.
Dr Sîngeorzan points out that COVID-19 has taught people to wash their hands. If the message sticks, it would go a long way towards improving the safety of health-care workers and patients, he says, adding that “now, everybody washes their hands, not only in hospitals, but also in the community”.
Risk of burnout
Hand hygiene is one of the physical measures that health-care workers can take to protect themselves from the virus, but they must also take recovery breaks, resting hours, and planned holidays where no one from work disturbs them.
Dr Andreea Moldovan, senior physician on infectious diseases and epidemiology specialist at Brașov hospital in Romania says the wear and tear of day-to-day duties is mental rather than physical. Burnout is a risk for patient safety, and health-care workers do everything they can to avoid it and to stop themselves getting “campaign fatigue”.
Staff, supplies and facilities – all essential elements for a successful response
“I had a formative experience at the very beginning,” recalls Dr Sîngeorzan on being deployed from Miercurea Ciuc hospital to Suceava, where there were hundreds of cases. “I learned that the human factor is what makes or breaks a hospital. Suceava hospital had everything to mount a great response in terms of hospital infrastructure, supplies and facilities. Once it was properly staffed and the staff were looked after, the COVID-19 response improved, and the outbreak was controlled.”
Human resources are key to a successful response. Brașov Infectious Diseases Hospital was designated as a COVID-19 hospital from the outset of the pandemic. As patients began to be transferred, staff took precautions to protect themselves from the virus. Dr Moldovan says she felt completely safe in the hospital, where there was sufficient personal protective equipment (PPE), effective disinfectant, proper ventilation and a willingness to adhere closely to infection prevention and control rules.
“At all times, health-care workers are aware that following rules and properly using PPE is critical,” she observes. “Our health, and the health of patients, depends on these simple but lifesaving gestures.”
Even when there were disinfectant shortages, settings like Miercurea Ciuc hospital made their own alcohol-based solutions in their laboratories, using the WHO production guide. The hospital also implemented a WHO COVID-19 risk assessment survey for health-care workers, which allowed them to adapt their response to the virus based on accurate, reliable and real-time hospital data.
Gratitude, concern and satisfaction
In Brașov, most COVID-19 cases were found to have originated in the community. “As doctors and nurses, we often felt small and helpless in the face of this virus, but we received generous support and donations from the community in Brașov and nationwide,” explains Dr Moldovan, who describes a mass movement in support of medical staff across the country.
Although COVID-19 wrought a radical change in people’s professional and personal lives, health-care workers still felt great satisfaction as COVID-19 patients began to return home. Precautions to protect both their physical and mental health paid off. However, staff in those hospitals also worry for non-COVID-19 patients who had to be transferred to other health facilities. “It is important not to abandon the other patients as we focus on this virus,” warns Dr Moldovan.