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Frontline doctor believes care for COVID-19 patients must be person-centred

By Lara Pickford-Gordon

Dr Reatha Leigh Padmore has been on the frontline conducting screening tests on persons suspected of having COVID-19. She has found one of the most supportive things in her interactions with persons at this vulnerable time was to “treat them humanely”.
Padmore, a eucharistic minister at St Theresa’s RC Malick, was one of the featured presenters at the Trinidad and Tobago Society of St Vincent de Paul’s online training session for members on October 24. Her talk was on Medical considerations in the adaptation process
As a District Medical Officer, she shared her first experience dealing with a suspected COVID case, a family of five who had returned to Trinidad from vacation in Europe in February. One of the elder members had started displaying fever and respiratory symptoms on the flight back. Prior to a formal plan for managing residents in the country, Dr Padmore said she researched how to put on personal protective equipment (PPE) and do a PCR swab test watching YouTube videos. She said the “technical side” was fairly straightforward and when formal training was provided some two weeks after, she was able to share her experience doing a demonstration for colleagues. From February to May when nationals were still self-quarantining at home, Padmore along with a nurse and driver visited “door to door” doing testing on persons with symptoms.
Padmore said just as the service with the SVP is working with persons who are at a vulnerable time in their lives, her job too involves working with persons at an uncertain time with heightened anxiety, worry and doubt. She approached them “as one human to another not as a professional with a particular title and job to do”. Padmore was mindful she was providing a service but also as a way of demonstrating care, love, patience through faith and through our acts of servicethat we do, sharing the love of God with them. “I see their humanity; I see their vulnerability in what I do. It is a real privilege to serve in Trinidad and a Trinidadian in my capacity as a frontline worker, as a health care worker”, she said.
In the early days of doing swabs on suspected cases, the names, addresses of new patients come to her electronically. Padmore said she took time to telephone persons before visiting to explain the procedure so persons can be familiar with her voice and receive reassurance.
She was grateful for technology during the pandemic; WhatsApp video chat allowed persons to see her face beforehand since the PPE obscured her appearance. This helped with “continuity of care” and lessening their anxiety about the experience.

She said the persons at work or home who fall ill with symptoms—high fever, body ache, difficulty breathing, cough, runny nose, sore throat and diarrhoea—can access testing for COVID-19 at all health centres. She explained a “parallel” treatment system was operating at health centres just like the public hospitals and interviews and assessments can be conducted. Padmore added, “if it is deemed necessary, they be investigated for coronavirus, they can be tested on site and if appropriate referred to hospital”. Offering advice on ‘Medical considerations’ Dr Padmore said everything she would be telling them would reiterate the mitigation measures that have been publicised during the year. Dr Padmore said masks should be worn properly and “mould to the face”.

She explained it should cover the nose, nose bridge and be tucked under the chin. If the mask moves and shifts below the nose while speaking, it is not fitting correctly. Dr Padmore clarified further, “If there is a gap between the mask and your nose or gap on your chin, that is not a well-fitting mask; you are putting yourself and persons you interact [with] at risk”. She urged people to wash hands repeatedly and if not possible use hand sanitiser and maintain a safe social distancing. Dr Padmore said if a food collection drive or charity event is being held, the set up should allow a “one way” flow for attendees including volunteers. She recommended one entry and separate exit to avoid back and forth movements and people “crossing each other”.

A sink, soap and water should be set up at the entrance but if resources are limited then a sink and water alone was still good. There should be someone at the entrance to ensure persons adhere to hand washing. Dr Padmore said hands should be dried because wet hands are better at attracting germs. Screening with a few questions should be done before persons enter to make sure they have no symptoms. She said instead of using “flu-like symptoms” the language should be specific. Dr Padmore said outdoor venues serve as a better space for events because they are well ventilated. She stressed that if any SVP member was not feeling “100 per cent” they should not go out. “The early days before someone becomes symptomatic are still vulnerable days during which they can shed the virus.”