The importance of being COVID ‘positive’

Despite the well documented devastation wrought by the COVID-19 pandemic, it has also impacted my life and our clinic in a very positive way.
 
I work three days a week as a GP in an urban practice with my husband who is a dentist. We run the group clinic with two other part-time GPs and two part-time dentists. 
 
Early in the pandemic we embraced the huge changes that were necessary to adapt to the pandemic. Recommendations by government were at first difficult, and rapidly changing.
 
Our primary focus was to continue to serve our patients and community while also ensuring the protection of our staff from COVID-19 infection. We had to maintain a positive attitude to adopt the changes.
 
Improved infection control capabilities
We installed clear patient screens at the front reception desk to reduce transmission of aerosol spread of SARS-CoV-2, and with support from our local Primary Health Network, we had access to personal protective equipment (PPE) and were able to familiarise all staff on how to use it appropriately.
 
The transition from not wearing masks to wearing P2/n95 masks all the time with patients in a consulting room was extremely difficult.
 
It felt suffocating when we were not able to have a breather without them. Now we continue to wear level 3 surgical face masks in low-risk situations as they are more comfortable, despite not being as effective as the P2 masks in reducing transmission of the virus.
 
We believe that masks continue to play an important role in protecting our staff and our patients.
Most of our patients are continuing to wear their masks, except for a handful who find them difficult. All patients are welcomed to the practice whether they are wearing a mask or not.
 
Ventilation is important, so each consulting room has a window we leave open for clean air. We also installed a new front security door to keep the front and back doors open for circulation of air, and the reception area and the main medical consulting room have air purifiers with inbuilt ionisers.
 
Most staff now wear scrubs which make us look a lot more professional, and we have continued other protocols such as surface cleaning. We also purchased a large batch of COVID rapid antigen tests and offered these for free to staff to test before work, when and if required.
 
Healthier staff
The most noticeable difference we have experienced since the start of the pandemic, is that not a single staff member has taken time off for any respiratory infections – not one.
 
Prior to COVID, staff consistently needed to take time off for flus or colds, despite immunisation with the flu vaccine.
 
This experience correlates with influenza infection rate reductions in Australia and has been a positive outcome of the protective measures we have implemented at work. The challenge will be maintaining this record now that influenza is making a comeback in Australia.
 
We have valued these positive changes, which together with telehealth have had a positive effect on our practice. While several staff have been infected with COVID-19, this occurred over their holiday breaks – not from work exposure.
 
Occasionally staff needed to take time off following exposure to a household contact, but since the recent changes to guidelines, this is no longer required if they are negative on testing and asymptomatic.
 
Enhanced technology
The introduction of electronic prescribing, ordering of pathology and radiology testing by emailing patients, and the use of either telephone or telehealth for consultations was enormously welcomed by our patients and staff.
 
Some patients preferred to continue seeing the doctors face-to-face and that was all ok – we had an equal mix of face-to-face and telehealth consultations.
 
Positive outcomes included less paperwork and the ability to consult with patients if they had respiratory symptoms or COVID-19 infection when safe to be cared for at home. The support of COVID-related government services is incredibly useful and we are grateful to the Department of Health for their mostly swift advice, support and action in these areas.  
 
Cleaner air
Lockdowns caused enormous challenges for many of our patients.
 
GPs and healthcare professionals were lucky – we were able to continue working. But the repeated and extended lockdowns escalated COVID anxiety and stress due to isolation, loss of employment for many, business disruption and/or collapse, uncertainty, and staying home more than usual.
 
These devastating impacts were felt across the community and should not be discounted; however, a wonderful biproduct was the significant drop in traffic when restrictions came in and more people were working from home. The fewer vehicles on the road made our streets quieter and safer, and resulted in less air pollution and cleaner air.

COVID lockdowns provided an opportunity to focus on improving health and wellbeing, writes Dr Vicki Kotsirilos.
 
Stress management and coping mechanisms
Doctors and healthcare workers have been greatly impacted by COVID stress and mental health-related issues.
 
In our efforts to continue serving our patients and the community, we became very busy at work, and acutely aware that we were now working harder. So, preventing burnout was a big challenge with the extra demands and workload.
 
It was important staff talked about their feelings and emotions, supported each other, and discussed strategies to minimise stress at home and in the work environment.
 
What helped us cope?
 
All staff now aim to have a one-hour lunch break, and use the time to rest, exercise and stretch. It was important we continued to practise self-care to stay mentally and physically healthy. This helped us to develop resilience.
 
Personally, practising mindfulness-based stress reduction in my garden every morning helps me cope. I also directed patients to useful internet sites to learn mindfulness when required, eg Headspace and Beyond Blue.
 
These techniques have also proved invaluable when helping patients with their own mental health challenges.
 
Working from home and self-care
For some people, working from home during the pandemic was satisfying and continues to be so due to less travel time to work and creating more time for self-care, such as exercise.
 
I found it to be a good opportunity to speak to patients about the importance of positive behavioural and lifestyle approaches, daily exercise, adequate sun exposure, healthy eating habits, and nutrition to support a healthy immune system.
 
Smoking avoidance; breathing clean air; addressing obesity and chronic diseases, such as diabetes also play an important role in supporting the immune system.
 
Apart from general health benefits such as CVD and diabetes control, daily moderate outdoor exercise helps to manage stress, moods, and restore good sleeping patterns.
 
With more exercise, people were appreciating and spending more time in nature. This was the way I coped during the pandemic.
 
Connecting with nature
Every morning I spent 30 minutes to one hour a day before work, and longer on my days off, using mindfulness walking on the beach, at a local park or a forest.
 
A study found nature contact ‘buffers’ the negative effect of lockdown on mental health, helped people cope better with lockdown measures, and was associated with more positive emotions.
 
So, our connection with nature helps us cope and gives us even more reasons why we need to take better care of our planet.
 
The COVID lockdowns were a great opportunity for myself, our practice staff and the wider community to focus on improving our health and wellbeing through lifestyle, connection with nature and positive behavioural changes.
 
Crisis breeds opportunity, and destruction often provides the platform for regeneration.
 
So it has been with COVID-19, and while the past two or so years have been among the most challenging in recent memory, they have also given us the chance to create a better and more positive world for ourselves and future generations.
 
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COVID-19 mental health pandemic self-care