In late January, as the extent of the COVID-19 outbreak became more evident, Prince of Wales Hospital (PWH) set up a team to take care of confirmed and suspected cases of the novel coronavirus disease. Although the team is colloquially dubbed the “Dirty Team”, Dr. Kai Ming CHOW (MBChB 1995), Consultant and Chief-of-Service in the Department of Medicine and Therapeutics, points out that this is a misnomer. “Far from being dirty, we are cleaner than other teams because we wear more protective gear and are extremely vigilant about hygiene.” Intern Dr. Alcina KONG (MBChB 2019) agrees, adding, “This period is probably the cleanest I’ve ever been in my life!”
The relaxed demeanour of these courageous medical practitioners belies the fact that they face new unknowns every day with this new disease. They put themselves at greater risks of infection and are more stressed than usual on the job.
Sixteen alumni of the Faculty of Medicine, including doctors and intern doctors at PWH, have so far volunteered to work with COVID-19 patients. Dr. CHOW, who leads the team, reveals that members were not selected through a “life and death” draw. Instead, all of them volunteered for the job, a fact he is deeply moved by and extremely proud of. “These doctors, as well as our colleagues at PWH, are dedicated, united and determined to fight this tough battle together.”
Dr. Carmen CHEUNG (MBChB 2011), a resident specialist of haematology, decided to volunteer because she felt her family burden is relatively small. “When Hong Kong recorded its first confirmed case, the hospital had not yet set up a designated team. The colleague, who happened to be on duty and attended to the patient with COVID-19, has a baby. I thought the situation was not ideal for her,” she explains.
As a secondary school student during the SARS outbreak 17 years ago, Dr. CHEUNG had been awed by the medical staff who fought hard to contain the epidemic. “They inspired me to become a doctor. Hong Kong, being confronted with a new threat of viral pneumonia, reminded me why I decided to join the profession in the first place.”
Dr. KONG says her decision to join the team was partly influenced by her family. “My dad, who is also a doctor, worked with SARS patients. I was only seven years old then. Now that I’m an intern doctor, I want to do my bit like he did.” Even though their reasons for volunteering to serve COVID-19 patients differ, they share a staunch commitment to caring for those in need and saving lives.
PWH has three wards for confirmed or suspected COVID-19 cases, two of which are high-specification negative pressure isolation wards. At the peak of the crisis, the hospital admitted 40 patients a day. Due to a lack of manpower and to reduce the usage of protective gear, every doctor on duty – whether experienced or junior – handled admissions, patrols, inquiries, inspections, blood tests and set up drips on their own.
Despite taking every possible precaution to protect themselves, there is always an element of risk when treating patients with highly infectious diseases. Drawing from the SARS experience, Dr. CHOW constantly reviews the team roster to ensure each doctor has enough rest.
He recalls that one night when he was jogging home a practice he has adopted to recharge – he suddenly remembered he had discarded a beloved fountain pen with his protective clothing. He had earlier put in about five continuous hours at the hospital. “I realised I had worked too long and fatigue had made me forgetful. I had just lost a pen this time. This just shows that if I were to become negligent again, I might forget to follow the proper procedures when taking off my protective gear, risking my life.”
The work is arduous and stressful. When they are on shifts they often skip drinking water and meals or sometimes forego rest and sleep to attend to patients. But despite all that, they all agree the experience has been positive and fulfilling.
Dr. Fion LUK (MBChB 2017), a second-year resident Medical Officer, says she is grateful that, although still a junior, everyone has been very encouraging. She is impressed by the team spirit. “Working with senior doctors and learning from them has been an immense confidence booster,” she says. “When a patient’s condition is unstable or deteriorates, I tend to get worried. That is when the varied expertise of everyone on the team comes into play.”
Intern Dr. Adalia WONG (MBChB 2019) adds, “I am training to be a surgeon so the opportunity to practise internal medicine is a rare and valuable experience.” Dr. CHEUNG, a more senior doctor, echoes this sentiment, saying they are not only giving but also gaining a great deal. “I deeply appreciate how our team works together and serves with humility. Being on the frontline again, I encounter different new cases and continue to learn.”
Having practised medicine for 25 years, Dr. CHOW says he has already become an “old ghost”. “I’m happy to be at the forefront again, teaming up with younger doctors, and for the chance to learn, especially in the area of infectious diseases and antibiotics.”
While the teammates make sure they take care of each other, family support and encouragement are also crucial. Dr. WONG is grateful for her family’s understanding. “I live in a dormitory and rarely go home. They are worried, but they never put pressure on me. When I miss them, we do video calls.”
Their isolation is shared by their patients, who have had their family visits suspended when the disease began to rapidly spread. “Having experienced the pain of not seeing my family, I empathise with patients in the isolation wards who’re also longing to see their relatives,” says Dr. WONG.
Dr. CHOW regrets that the disease has increased the distance between doctors and patients, not only because of the protective gear they must wear but also because tight resources sometimes demand they consult with their patients over the phone. “When everyone is wearing a mask, you can’t see their expressions. I miss seeing people’s smiles.”
Dr. KONG reveals that although her father served on the frontline during SARS, he struggled with her decision to volunteer. He finally came around. She sighs, “I have only seen my dad once in the past two weeks and, when we finally met, I didn’t dare get too close. He passed me a bag of oranges at arm’s length and reminded me to eat more fruit. I was so touched.” Asked what they would like to say to their families, Dr. LUK pauses for a second. “I hope they won't worry and trust that I will take every precaution possible. I hope to be able to have dinner with them one day soon.” Dr. CHEUNG, whose voice quivered with emotion, says: “My family is always very worried, but they are also truly supportive. All I want to say is, sorry and thank you.”
There is a moment of silence, her colleagues nod in support. Despite their surgical masks, a range of emotions – from guilt to understanding – is visible across the faces of the team of compassionate warriors. What is most obvious, though, is their strong determination to serve, to fight and to win the battle against COVID-19.