Advertisement

I told my hospital I'm not willing to work in a Covid 'red zone'. Doctors aren't being protected in Australia

<span>Photograph: William West/AFP/Getty Images</span>
Photograph: William West/AFP/Getty Images

Recently I sent the most disappointing email of my career as a doctor, informing my immediate bosses and regional directors that in the likely situation where Covid-19 starts to spread in the community I am not willing to work in the “red zone”.

The reason was the clear evidence that our infection control systems and PPE guidelines are inadequate, representing several risks that I find unacceptable. The purpose of this decision was not to sneak off and avoid danger but to drive change to the point where all staff can continue to provide care to all patients without fear.

For me there are several different fears.

Related: Victorian doctors disturbed at patchy supply of PPE for Covid health workers

First, in the race of life, always back the horse named self-interest. It would be disingenuous for me to say I did not fear catching coronavirus, with the associated risk of passing it on to my family. My partner is also a frontline doctor and our children are young. They remain my primary responsibility.

Second, the health service I work in is small and remote, meaning the risk of it being overwhelmed is real. Our workforce was nearly rendered unable to cope with only a tiny spread of cases earlier this year. We can see from the situation in Victoria that healthcare workers make up a large proportion of cases.

I have heard arguments that healthcare workers are a higher percentage of cases because they are more exposed – but this is unreasonable. Where frontline workers have the protection they need, they don’t have greater infection rates.

In Australia the healthcare workers who are getting sick are either catching it from patients or from each other. I don’t want to be part of a system that is an accelerator of the problem. All this could mean is more chance of our service struggling, leaving us unable to care for our normal high caseload of patients let alone any Covid cases. If we suffer, the community we serve will suffer.

People may wonder about my sense of duty ... But I have no duty to serve regardless of circumstance

But it doesn’t have to be this way. There are places in the world with no healthcare worker infections. Emulating these success stories should be bread and butter for the leadership of the organisation I work for. Why it isn’t remains a mystery to me. Or perhaps it isn’t a mystery. I feel the narrative is that this is a deadly virus and that healthcare worker deaths are unavoidable. And as long as people continue to show up to work in what we know is an unsafe environment the situation is unlikely to change.

I am relatively young and otherwise healthy, with no underlying medical reason to avoid Covid patients. Some of my colleagues do, and indeed I have encouraged them to consider the risk, regardless of their desire to “step up” rather than run. My immediate senior colleagues are the main reason I love working where I do. I have no desire to leave them to carry the load.

Two days after writing the email I was called in the early hours to assist. I wasn’t on call, but they needed help. They don’t wake me up for no reason. I don’t hesitate to help, just as I don’t hesitate to call them when I need help. To feel I could let them down at some stage is awful.

Related: 'Real risk at the frontline': how Australia's health workers are getting Covid-19

However, there is another version of awful that I want to avoid: the death of a friend who caught Covid-19 just because they were trying to do their job. For me to say nothing, carry on arm in arm, is implicit consent to the current system.

The closest examples for us are the UK and Victoria, where large numbers of healthcare workers are infected. Their infection control and PPE systems are analogous with ours – and they clearly don’t work effectively enough. Victoria has more than 1,000 healthcare workers who are active positive cases, with an unknown number of contacts in quarantine. There are no reported deaths yet, like there sadly have been in the UK and elsewhere, but with those numbers it is impossible to think there won’t be.

People may wonder about my sense of duty. I am fully aware I get paid well. But I have no duty to serve regardless of circumstance. Rather, my organisation has a duty to provide me a safe workspace – that is not up for negotiation.

I have since received correspondence to my email promising that my fears have been heard and that there would be a review of the situation. But should Covid-19 arrive tomorrow, nothing will have changed. The obvious course of action would be to model our system on a place that has achieved better outcomes then we have, rather than pontificate about possible infection routes and guidelines.

Sending the email didn’t make me feel bad, it made me feel sad. It would be foolish to think this was my first correspondence on the subject or that I am the only one concerned – many of my immediate colleagues have raised concerns but none have achieved anything meaningful.

Whether others choose to join me remains firmly their personal choice. But other than wholesale refusal of a system that has proven elsewhere to be inadequate, I can’t see a pathway forward.

• The author is an Australian hospital doctor