When I woke up this morning, like most people do nowadays, I switched on the television to watch the news. These days, the coronavirus pandemic dominates the news, and regardless of the type of media you consume – electronic, traditional print newspapers, television or radio stations, one will hear or read about the novel coronavirus, SARS CoV-2, and its associated 2019 coronavirus disease (COVID 19). On the Cable News Network (CNN), there were alarming statistics reported, as has been the case for the last couple of weeks, with more than 1.5 million total cases of COVID-19 of whom about 83,000 had died and counting upwards. In the meantime, on the World Health Organization (WHO) website, situation reports show that there were over 7700 confirmed cases recorded in the Africa region including 347 deaths, as of April 8. Even though this is a world-wide pandemic, a review of the daily WHO situation report shows that some countries are more affected than others either numerically or by proportion of deaths relative to confirmed cases. These include Italy and Spain which have already registered 15,000 and 12,000 deaths respectively already. The United States, now the country with the greatest number of cases in the world, has registered 436,969 total cases with 15,706 deaths and has since surpassed China’s case total by far, the country where the pandemic began. Learning about these frightening numbers of deaths impacts me uniquely as a physician. At first instance, my heart races and I feel deeply heartbroken and sorrowful as I ponder on them. I feel particularly burdened as every single number reported represents a unique human being! A grandparent whose love, care and wisdom is lost forever, a caring mother or father who, on occasion, leaves behind young children to fend for themselves, a spouse or newlywed person leaving a grieving spouse or even dying together and their chance of enjoying life and growing old together as well as contribute to society evaporates, an adorable child whose life is prematurely cutoff, or a kind and loyal friend. These could also be a family breadwinner whose departure from this earth would result in excruciating suffering and deprivation for their family after the grieving period. In addition, compounding the painful experience is the isolation that these individuals face in their last moments driven by the infection control precautions taken to prevent the spread of the disease. Paradoxically, it is in these painful end of life moments, when the disease is winning the battle over the human body’s defense mechanisms and defies medical treatment (even where there have been remarkable scientific advances), that is the time that one needs friends’ and family’s physical presence including holding of hands, their support and prayers. This virus has deprived dying patients a chance to have that last-minute basic human emotional connection and comfort. On the other hand, infection control and prevention measures, including social or physical distancing and self-isolation that have been enforced worldwide, are critical and necessary to hopefully stop the spread of the virus or at least slow it in a way that changes the pandemic curve with less new cases occurring over time. With these measures implemented and observed, only essential workers are allowed to go to work while other people are requested to stay and/or work from home, allowing the health care workers to care for the already sick and hopefully control community spread of the virus so as not to overwhelm them or the healthcare systems. As a physician, I also worry about the nightmare scenario where healthcare providers are unable to help dying patients due to limited hospital bed capacity and intensive care units as well as scarce ventilatory support devices. As the number of people infected with COVID 19 increases, which will invariably occur, the number of patients with moderate and severe disease will also increase resulting in a large number of people needing hospital care or even intensive care to survive. In resource-limited settings like ours, with a limited number of ICU beds and respiratory support devices as previously mentioned, it is imperative therefore, to prevent the widespread of virus by all means necessary and as early as possible. I, therefore, implore everyone to abide by the recommendations from the government and other public health authorities, follow their guidance on social distancing and restrict unnecessary movements. Let’s all stay home, stay safe and save lives! The writer is a consultant physician in Internal Medicine and a Nephrologist at the University Teaching Hospital in Kigali (CHUK) where she runs the dialysis unit. The views expressed in this article are of the author.
