"Noli Timere"

“Noli Timere” – Be Not Afraid

                         Seamus Heaney

As of May 18th, 7708 (31%) of COVID 19 cases in Ireland are reported in health care workers. This is reflective of what we are seeing around the world during this global pandemic.   This statistic reminds us that what we do is not without risk.  The public acknowledgement in Ireland and around the world of the efforts of health care workers is heartfelt.  The public see the risks, as do we.

This risk is to ourselves and those close to us, both at work and at home.   Susan Murray (RCSI) in Fear and the Front Line (New England Journal of Medicine, May 7) captures this concern succinctly.   There is no doubt that social distancing in the medical workplace is a challenge.  Many personal care tasks, physical examinations, tests, supports and therapy to aid recovery cannot be done 2 meters away from the patient. 

Indeed, the current pandemic brings into sharp focus the changing face of the delivery of health and personal care.  How, in the future, we will manage direct contact and sharing in peoples’ lives, at times of great worry and stress for them?  While the key, and our best defence, is adhering to the public health guidance and infection control guidelines, testing and availability of personal protective equipment will all play a role in reducing the risk of transmission of contagious diseases.  We owe it to each other, our patients, our colleagues, our family and friends to adhere as strictly to the guidance the HSE have put in place.       

I am sure some of you will have read accounts of peoples’ experience of COVID 19 in the public media.  One such experience reported in the Sunday Independent was by Caroline Hickey’s family, who worked in St. Luke’s General Hospital Carlow/Kilkenny.  This was moving, touching and heartbreaking all at the same time. Her family talked, with great pride, of Caroline’s love of her family, her joy of life and her commitment to her work.  We offer our sincere condolences to her family and colleagues in Kilkenny. 

Dr Nasir Khan, worked in the Regional Hospital in Mullingar as a registrar with Dr Clare Fallon and subsequently worked in the Mid Yorkshire Hospitals NHS Foundation Trust.  He died on 29/4/20.  He was a member of the Royal College of Physicians of Ireland.  Dr Clare Fallon remembers him well and how shocked she was at his recent death, she said: “He is fondly remembered, as a caring doctor, he made a great impression on us all, and will be sadly missed by all who knew him”.  On behalf of the IGS, I would like to offer our sincerest sympathies to his family and friends in Ireland, England and Pakistan. 

Dr Mimi Fan, who along with Dr Frances McCarthy and their team in St Mary’s in the Park spearheaded their hospital’s response to COVID, spoke of her recent experiences.  Dr Fan spoke openly and compassionately of her encounter with COVID 19 both on a personal and professional level.  Her article in a recent newspaper, along with her interview on Prime Time is sobering and must-see for us all.  Her advocacy for her patients and the team she works with shines through.  We wish her, and our other frontline workers who have contracted the disease a speedy and full recovery.  But as Dr Fan said, “you are all giving of your expertise selflessly in your work, and I am very proud to be part of our team and the wider teams treating, caring and advocating for older people around the country”.  While direction comes centrally from the Government, the Department Of Health, the Health Services Executive and our National Emergency Public Health Team it is local leadership and implementation on the ground that drives the improvement and change that is needed. 

I would also like to acknowledge those of you reading this, who have waited and worried about a pending swab test result either for yourself, your family, your friend or a colleague - wondering what the implications of the result hold in store for you and for them and their “close or casual contacts”.  Health care workers, in general, have low absenteeism rates from work.  Indeed we sometimes come into work when we should not, for fear of letting colleagues down or adding to their already busy workload.  So among the many things I have learnt during this pandemic is the importance of being professional and understanding the need to be absent from work for the sake of patients and coworkers, in a way I did not truly appreciate before this pandemic.  I do not want to think that I could have been a vector for a transmissible disease at home, at work or with my friends. 

These stories, statistics and more, remind us, if we needed reminding, of the risks we take and the reason we adhere to public health messages.  They all significantly reduce the risk of us contracting what is a very contagious disease, COVID 19. 

If among the actions it needs to take to reduce the risk of harming the patients I look after, family,  friends or colleagues, I am more than happy to wash my hands and get the flu vaccine on offer each year.  However, the responsibility to “first do no harm” is a shared one.   It is shared by each of us on a personal level by our actions and with our fellow citizens following the public health guidance.  But it is shared also with our politicians and our government. 

Our politicians and government must ensure that we have the infrastructure and capacity in place to provide safe and quality health care to the people of Ireland, and the equipment and personal protective equipment to provide that care.  Funding all of this will be one of the many challenges in the years ahead.

For each of us as we head off to work, at the back of our minds is, whatever happens to me, I do not want to visit harm on my patients or those around me.  Leaving and arriving home from work each day I have never been as aware of how important handwashing is - not just for myself and those at work - but for those around me at home.  It adds new meaning and pathos to ‘Go wash your hands’.  But it is more than that, it is your clothes, your keys and your phone.  If vigilance of this nature is all it takes to reduce the risk of harm, then when the flu vaccine is offered towards the end of the year, I will be there first in the queue again! 

Thank you for all you are currently doing in your workplaces.  It is at times draining and exhausting, but together we are stronger.  Rest assured, along with everyone else in Ireland, we here in the IGS are very proud and grateful to you all.  Thank you. 

Finally, on your behalf, I would like to offer our sincere condolences to the families and friends of those who have lost relatives during these times and from this illness. 

Diarmuid O’Shea, IGS President