A hospital in Austria has set up shipping containers in the car park to triage patients before being allowed into the hospital building. (Supplied)
I’m writing to you at midnight from a night shift on the A&E department at my little 500-bed regional hospital just east of Innsbruck.
It’s about a 40-minute drive from here to the now closed Italian border, but I drive 20 minutes towards Italy on the highway to get home.
Tyrol is currently the hotspot of Austria’s COVID-19 pandemic, which makes sense when you consider the huge thoroughfare of traffic to and from Italy via the Brenner Pass.
For scale, Austria itself is the size of South East Queensland, squashed into a tadpole shape with a third of Australia’s population — about 9 million people.
Society here has now been in lockdown for one week.
As of Sunday March 15, all hotels and ski resorts were closed. The ski season prematurely ended, leaving Austrians who rely on the tourism dollar, financially devastated.
The Government initially suggested closing schools on Wednesday March 18, but as the situation worsened we were asked to keep the kids at home from Monday, March 16.
I have three children aged under 10. They are now at home with their father.
The Government had issued a general “house arrest” for a few high-risk villages that were in quarantine, but then last Sunday, during a 24-hour shift at the hospital, we were notified it was now “enforced quarantine effective immediately”, with all of Tyrol classified as a high-risk area.
Suddenly it became irrelevant for me to ask my patients where they’d been in the last couple of weeks; everywhere was now a hotspot.
The feeling here is very surreal.
Driving down empty three-lane highways to work feels like a ghost town — all that is missing is the tumbleweed.
With my hospital ID I am permitted to leave home. I get to work and secretly whip out my industrial grade Dettol cleaning wipe to push open doors.
It looks like a snotty tissue but this little secret routine of mine gives me such a sense of security, that this alone will sort the wheat from the chaff, and I will remain standing when everyone else has fallen victim to the virus.
Police officers walk at the metro station in Vienna, Austria after the government restricted freedom of movement. (AP: Ronald Zak)
Shipping containers moved to hospital car park
In front of the hospital doors I’m approached by a burly security guard in a hazmat suit wielding a very modern-looking scanning thermometer — 36.9 degrees Celsius and an ID flash grants me access into the hospital.
No visitors whatsoever are allowed at the moment.
All potential patients have to enter the pop-up triage tents — which have since been upgraded to triage shipping containers — in the front carpark.
There they are seen by a doctor and nurse in full hazmat gear, who assess how legitimate and urgent their clinical picture is.
Some are sent home or told to visit their GP.
The non-feverish non-respiratory cases (heart problems and the like) are allowed to come in and see me, and anyone with a fever or with the classic COVID-19 symptoms are either swabbed and sent home (if they’re stable) or swabbed and admitted into quarantine (if they’re struggling to breathe).
This week I worked on a ward assisting two consultants. On Tuesday we discovered that a female patient, who had been on our ward with unrelated non-COVID-19 symptoms and who we’d discharged a few days before, had tested positive.
The ward fell into chaos.
The poor woman who had been in the bed beside her was due to have elective surgery last week before unexpectedly discovering she had leukaemia in a preoperative blood test.
And now she is told the next horrific news on top of that bombshell — she’s been sleeping beside a positive COVID-19 case for the last few days.
The rules change daily
In the midst of the mayhem we doctors are told to just keep working until we feel symptoms because if we self-isolated for two weeks after having contact with a positive COVID-19 person, like we tell our patients to do, there would quickly be no doctors left here.
But the rules and the protocols are changing daily.
At 10:00am we were told all persons who’d been in direct contact with the COVID-19 patient should wear a mask at all times.
An hour later we got a message that all workers on the ward should be wearing masks at all times, regardless if they’d had direct contact with that particular patient — we oblige.
In the afternoon a consultant came by and asked why we were all wearing face masks.
“It’s the new rule,” I explained.
“Huh,” he grunted. “Should we make the rounds?”
We went on the ward round together. He was the only one not wearing a mask. At the end he announced he was going to head home early because he was “feeling flu-ish”.
I thought he was joking. He wasn’t.
I then came to work today for my night shift and was told upon arrival that two consultants had tested positive.
Minutes after hearing this I got a phone call from the Health Ministry informing me that I was now officially a high-risk contact person and must get swabbed at the end of my shift.
So, I’m working, feeling nervous but otherwise fine, seeing patients and hoping for the best.
More and more tests are positive
Of course I’m doing my best to disinfect my hands frequently, to the point my knuckles are red, and wearing a face mask at all times, and keeping back from people and only touching my patients when absolutely necessary … but it all feels useless, to be honest.
If I’ve got it, I’m sure I’m spreading it everywhere.
The key — and I can’t stress this enough — is isolation.
A luxury my job unfortunately doesn’t allow.
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At the moment the tests take two days to come through.
Two of our four wards have been turned into isolation stations and are clogged up with suspected COVID-19 patients awaiting test results.
Most come back negative, but more and more are positive.
The ward I was working on last week is now officially under lockdown and not taking any new patients.
That leaves me only one ward that I could admit a cardiologic patient to. That ward has 20 beds total.
That’s all we’re left with for the non-COVID-19 patients right now.
Despite the dwindling beds the good news is this hospital doesn’t have any patients on ventilation so our capacity in terms of ICU beds is still hopeful.
I hold on to the fact that most patients will make a recovery thanks to symptomatic therapy and, when required, intubation and ventilation — we have the equipment to help patients fight this virus and hopefully soon antiviral drugs too.
Face masks in short supply
When I’m outside the hospital I’m more aware of how at-risk and under stress we are in there, but when I’m inside, it’s impossible to keep that level of anxiety up.
The disinfecting and masks have become routine.
It’s nothing like being in a war of course, but I can imagine it was the same for soldiers in the trenches — it’s impossible for a functioning mind to constantly contemplate your human vulnerability.
So despite the eerie feeling of these empty hospital hallways, morale amongst the staff has skyrocketed.
What the experts are saying about coronavirus:
If or when I’m needed on the COVID-19 ward in the night, I’ll drowsily don the double gloves, gown, head cap, face mask, shoe protectors and protective eyewear before entering their room.
Oh and on the topic of face masks — the head of my department told me he was trying to source face masks from the USA on the black market, because as of Tuesday last week the entire hospital only had 400 FFP masks in stock and could not order more.
I’m sure they’re all gone by now.
Now we’re using normal surgical masks, which are better than nothing (they’re a mechanical barrier) but the material they’re made from only stops bacteria, it lets the viruses through.
It feels inevitable that this thing will spread.
It really feels like we’re not in a hospital, but in a shack on an empty beach… the other beachgoers have deserted us, leaving eskies and umbrellas in their wake… and we are just watching as the tsunami approaches.
That’s how this hospital feels.
So, I lie here writing to you, awaiting my swab in the morning.
I’m not that worried about getting the virus itself — there are single cases like the sporty 43-year-old with no medical conditions in the ICU, but that’s extremely unlikely.
I’m not even that worried about my 2-year-old son, who I was sending into fits of giggles by blowing raspberries into his neck just this morning. He will barely feel it, if he’s positive.
But if I am right now passing it on to dozens of sick people here in the hospital … that would be so irresponsible and unnecessary.
I don’t even want to think about that.
Your questions on coronavirus answered:
But my hands are tied. I can’t just stop working — if we all did that there’d be no-one here.
The WhatsApp doctor’s group is already nuts with people swapping shifts and dropping shifts completely due to symptoms or quarantine. The system is in meltdown.
Austria’s response to the crisis has been rapid and effective, despite taking a few days to get everyone on board with social distancing, but by now everyone knows someone who has tested positive.
We all — inside and outside of hospitals — need to assume we are asymptomatic positive carriers of COVID-19 and act accordingly, rather than assuming it’s, “out there” and, “I feel fine, so I don’t have it”.
Everyone — the general public and health workers — should be assuming they have it.
That means strict quarantine for the public, and inside hospitals mandatory face masks for everyone, strict hygiene measures and reduced unnecessary human traffic.
Please Aussies, stay away from each other and just wait this tsunami out. It’s the only real way to treat this.
*The identity of the doctor has been withheld for privacy reasons.
Editor’s note: Just prior to publication the doctor notified the ABC that her swab returned a negative result for COVID-19. She continues to work.