COVID: Lessons for me, lessons for the world  by Kethaki Prathivadi Bhayankaram 

“You have power over your mind, not outside events. Realise this and you will find strength” – Marcus Aurelius, Meditations

These words of the great Stoic philosopher Marcus Aurelius feel particularly relevant for the current situation. With the announcement of the first national lockdown in March 2020, we entered a period of uncertainty, in terms of understanding a new disease that has spread worldwide as well as its impact on our daily lives. However, this extended lockdown has also given us time to reflect, adapt and ‘find strength’ as we face a slow and gradual return to a ‘new normal’.

This last year has taught me to seize every opportunity rather than take things for granted. However, I have also learned the importance of taking appropriate breaks for my mental and physical wellbeing. This pandemic has definitely been a test of everyone’s mental health, particularly for female healthcare professionals who have experienced burnout since COVID-19 started (1). Thus, knowing when to say ‘enough is enough’ is important in order to avoid burnout.

As a society, we have learned to adapt through the use of technology. As governments asked us to ‘stay home, protect the NHS and save lives’, March 2020 saw a rapid increase in the use of online tools. For instance, Zoom grew from 10 million daily users worldwide in December 2019 to over 300 million in April 2020 (2). Educational institutions also had to suddenly move their teaching online. Whilst this was initially a shock to the system, staff and students learned to embrace online learning, with some particularly enjoying not having to travel in for lectures (3,4). The overall experience of this year has demonstrated that technology can enable us to access learning from anywhere in the world, and I learned about its benefits and challenges by organising some webinars for MWF. However, the pivot to online learning also exacerbated students’ mental health worldwide and raises questions for the sustainability of online learning long-term (5, 6, 7). It appears that a mixture of online and face-to-face teaching would be the most optimal balancing public health guidance on reducing COVID transmission and reducing mental health issues.

I also took the opportunity to research about telemedicine, which has seen a rapid increase this last year. A study evaluating its use during the pandemic states that it has helped to maintain continuity of care whilst maximising patient and healthcare worker safety (8). Telemedicine has also improved patient satisfaction since patients can now have a telephone or video appointment during their working day instead of having to miss work or school for their face-to-face appointment. However, the main drawback of telemedicine is not being able to examine patients or their lesions face-to-face. Another issue is the transfer of patient images between GPs and secondary care physicians via non-secure platforms such as generic email addresses and SMS messages (9). This highlights the importance of developing secure online systems if telemedicine is here to stay long-term.

COVID-19 has also shone a light on inequalities in our society and how some policies may fail to take this into account. One article has suggested that female researchers at early career stages have been the worst hit (10). This may be due to the burden of care responsibilities and highlights the need to develop a more equitable sharing of such responsibilities. Another article has highlighted the issue of ‘masculinity’ in procuring PPE, which appears to have been designed to fit the ‘average white male’. Therefore, many female healthcare professionals have had to adapt the masks for their fit (11). COVID-19 has made us aware of these flaws and provides an opportunity for change to ensure that society’s unmet needs are addressed for all and that health inequalities are not further exacerbated during such pandemics.

A particular aspect of disproportionate impact on the BAME community is that many of the healthcare workers who unfortunately died from the virus were from a BAME background. This has provided a call for change in the healthcare system and we have a duty to be more inclusive and anti-racist towards our patients and colleagues. Increasing our knowledge of presentations and conditions affecting all populations will also minimise misdiagnoses, and organisations such as the British Association of Dermatologists are aiming to achieve this by including images of patients of colour in the BAD Dermatology Handbook (12).

Whilst COVID-19 has cost over 2 million lives and disturbed everyone’s lifestyle worldwide, it has given us time to reflect and has raised awareness of the benefits and flaws in medical care and education so that we can strive for it to be even better once the pandemic ends. I will also use the new knowledge and skills I have gained from the COVID-19 pandemic to become an even safer and better doctor in the future.

Word count (excluding references) = 799

References:

  1. Danet Danet A. Psychological impact of COVID-19 pandemic in Western frontline healthcare professionals. A systematic review. Med Clin (Engl Ed). 2021 Mar 19;
  1. Turk V. Zoom took over the world. This is what will happen next. Wired UK [Internet]. 2020 Aug 6 [cited 2021 Feb 13]; Available from: https://www.wired.co.uk/article/future-of-zoom
  1. Guiter GE, Sapia S, Wright AI, Hutchins GGA, Arayssi T. Development of a Remote Online Collaborative Medical School Pathology Curriculum with Clinical Correlations, across Several International Sites, through the Covid-19 Pandemic. Med Sci Educ. 2021 Jan 20;1–8.
  1. Bączek M, Zagańczyk-Bączek M, Szpringer M, Jaroszyński A, Wożakowska-Kapłon B. Students’ perception of online learning during the COVID-19 pandemic: A survey study of Polish medical students. Medicine (Baltimore). 2021 Feb 19;100(7):e24821.
  1. Baloch GM, Sundarasen S, Chinna K, Nurunnabi M, Kamaludin K, Khoshaim HB, et al. COVID-19: exploring impacts of the pandemic and lockdown on mental health of Pakistani students. PeerJ. 2021;9:e10612.
  1. Safa F, Anjum A, Hossain S, Trisa TI, Alam SF, Abdur Rafi M, et al. Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students. Child Youth Serv Rev. 2021 Mar;122:105912.
  1. Nurunnabi M, Almusharraf N, Aldeghaither D. Mental health and well-being during the COVID-19 pandemic in higher education: Evidence from G20 countries. J Public Health Res. 2020 Nov 17;9(Suppl 1):2010.
  1. Temesgen ZM, DeSimone DC, Mahmood M, Libertin CR, Palraj BRV, Berbari EF. Health Care After the COVID-19 Pandemic and the Influence of Telemedicine. Mayo Clinic Proceedings. 2020 Sep 1;95(9):S66–8.
  1. British Association of Dermatologists - COVID-19: Clinical guidelines for the management of dermatology patients remotely [Internet]. Bad.org.uk. 2020 [cited 4 January 2021]. Available from: https://www.bad.org.uk/healthcare-professionals/covid-19/remote-dermatology-guidance
  1. Gewin V. The career cost of COVID-19 to female researchers, and how science should respond. Nature. 2020 Jul 20;583(7818):867–9.
  1. Al-Hadithy N, Penfold R, Knight K, McLachlan G, Magee L. Covid-19 highlights the gender imbalance in leadership and the imperative to address it [Internet]. The BMJ. 2020 [cited 2021 Mar 14]. Available from: https://blogs.bmj.com/bmj/2020/07/03/covid-19-highlights-the-gender-imbalance-in-leadership-and-the-imperative-to-address-it/

Chiang N, Verbov J. Dermatology: A handbook for medical students and junior doctors [Internet]. 3rd ed. 2020 [cited 5 January 2021]. Available from: https://www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=6595