Covid diary, end of the first week

We are in an eerie place at the moment.

Australians have been watching the crisis unfold in front of our eyes – first in China, then in Europe and now in the US. It feels close to us because of the frightening numbers escalating every day in the news, at first 100 felt like a benchmark, then 1000, but now we are almost numbed by the numbers and their inevitable increase.

Let me tell you something from the frontline. There is nothing like something is real, until you see it with your own eyes.

It is only real when you stand, for the very first time, face-to-face with a patient infected with Covid-19. When you see them coughing, when you see them wiping their mouths, when you realise that their respiratory droplets are not just near you, but on you.

When you realise that you are shielded from the virus behind just a piece of plastic, or a corner of a gown, that is when it is real.

When you need to tell them that you have to put them on a ventilator to help them breathe, when they ring their families crying and saying goodbye to them for potentially the last time, that is when it is real.

When you walk out of the room wondering if you had put your gear on right, when you think maybe I am going to be one of the infected healthcare workers in the news, that is when it is real.

For the vast majority of the public, the coronavirus is still something that is happening to somebody else. The people going to the beaches and having house parties make me so angry. When I went into that room to be with a Covid-infected patient for the first time, for the second time, and then for the number of times that I cannot even count, I am not just “doing my job” as people would expect me to. I have a sense of professional responsibility to these people, this is what I am trained to do. But I am appalled by the behaviour of those people who put themselves at risk, who knowingly increase the burden on the health system with a nonchalant attitude of “it won’t affect me anyway because I am young”. Do these people not have parents, grandparents, friends and neighbours who will be affected by the virus? Do these people not wish for their loved ones to receive health care when it is needed? How little disregard do they have for the wellbeing of healthcare workers who are risking themselves to help the community?

There has been just a slow trickle of patients this week, one here and one there. The rate of admission into the ICU is slow enough that we have time to pause and reflect on our practices, trying to finetune everything so we know what to do when the rush of patients arrives. We have been preparing for weeks and the preparation itself is mentally exhausting. It feels deceptively slow right now, the ICU cleared of patients in anticipation for the tsunami that hasn’t hit. I found myself even wondering at times if we over-reacted, but just a quick glance at the news shows that the tsunami is real in other places. We are just on the flat part of the curve, and we desperately hope our social isolation measures have been enough.

It has now been a week since I left my family in Sydney and quarantined myself. I feel a huge sense of social responsibility towards them, and I have decided not to go back to Sydney until I know for sure that I will not be giving them the virus. That means I have to wait for one of three scenarios to arise 

 

(1) The covid-19 crisis is over and numbers of infections have ground to zero

(2) I contract covid-19 and recover to gain immunity

(3) I or one of my family members becomes critically ill with covid-19 and we have to say goodbye.

The methodical analytical part of my brain has spat out these scenarios, but none of them feel real right now. The coming weeks will be a huge physical challenge if we must work massive hours, and an even greater emotional challenge being in social isolation and dealing with the stresses of work. I have never thought so hard about my self-care ever. 

I have also never been imbued with such a strong sense of survival – every fiber of my being is screaming I want to survive! I want to stay physically well and mentally well. I want to come out of the other side of this and chalk it up to another disaster I have experienced and learned from. I look so much forward to that day when we are talking about all this in the historical sense.

But right now, we must live one day at a time.

Covid diary, day 1

I've had the last 10 days off since my friend E was visiting from Toronto. We had many things planned but it all fell apart when Trudeau's wife tested positive and Canadia started to crack down hard on Covid. When Trudeau made his speech imploring all Canadians to go home, E went home early (a lot of stress involved indeed). I then spent the next few days in a reverie, doing some gardening in my dad's garden and tidying up my things.

At the end of the reverie I said goodbye to my family. I had decided already that I would not return home, because I could not risk infecting them. It was heartwrenching to tell them that I would see them again only when it was all over, or if I had been infected and had immunity, or if any of us were gravely ill and it was to say goodbye. I felt like I was never going to see them again. 

I knew that I would be jumping straight in the deep end of the covid crisis, and I tried to mentally brace myself. But still I did not feel prepared to walk in in the morning, straight into a patient who required intubation for mechanical ventilation.

Being the most risky time of the ICU admission by virtue of the greatest aerosol generation risk, I knew it was going to be a tricky exercise. Ordinary folks in the community might think the government has given us all the gear to cope with this, but with the very first intubation of a known Covid-positive patient in my ICU, we already had equipment shortages. It was depressing to think of what will come in the coming weeks.

Putting on the PPE (Personal Protective Equipment) took almost an hour for the whole team, and the actual intubation task itself was short. An audience of around 30 doctors and nurses gathered to watch, though I wasn't sure what they were watching! It was theatrical and psychologically taxing, I felt like I was in the Big Brother House. Overcoming my own Impostor Syndrome at that moment was hard, but I managed to hold it together.

My current stressors are that we will run out of equipment (though I know we actually can't cross that bridge till we get there) and the fact that our PPE is vastly different to what we see on television, and what our colleagues have used overseas. One only has to turn on any TV channel to see doctors in hazmat suits with full body coverage and proper fitting goggles. We have to make do with a knee length gown which exposes our lower legs and neck. Even with balaclavas that we sourced from theatre, there was still a good amount of skin exposed. Our goggles are poorly fitting and my goggles fogged up which made me question whether my mask was fitted well. I scrubbed my face to drynses with soap afterwards and felt that I was not satisfactorily protected. Afterwards, every person I spoke to said something along the lines of

1. The government decided this
2. All the hospitals get the same gear
3. There is no evidence for more gear anyway

The more times I repeated my concerns about infection, the more frustrated I felt as everyone repeated the same official standpoints. One of my colleagues thanked me for being the "guinea pig", which did not help. Eventually about 3 hours after the intubation, I completely crashed and had a cry at work, not something that happens to me very often. Then my other colleague told me that the only way I can protest is by refusing to work or quitting my job.

All in all, it has been a very emotional first day. I coped by going for a walk, getting to the supermarket and realising I forgot to bring any cash or a card to pay for groceries, watering my own garden and cooking a healthy vegetable soup to nourish the soul. I'm still thinking about my own death, and I guess I will be thinking about this for the next few months...

In my kitchen: March 2020

Fires, Floods and Coronavirus.. what a 2020 we are off to! In between times, at least we can appreciate the IMK project around the world.

How I love hotpots! My dad's partner has a secret family sauce which comprises sesame paste, chilli and a secret leek flower ingredient she brought in from China. It's so secret that I didn't get to see it being made. This hotpot was a real treat for my dad's birthday.

I do like my random sourdough projects but I had never thought of making a sourdough cake till I realised the baking powder in my house had solidified into a giant rock. So I used Barney to raise this fruit cake for my dad's birthday cake. It worked surprisingly well!

We are also using sourdough for all Chinese yeast related projects, such as these delicious steamed  pork buns.

And these pan fried pockets stuffed with chive and egg. With a crispy outer, a soft bite (apparently the trick is hot water in half of the dough) and a delicious savoury filling, we couldn't stop eating these!

The garden has been a bit on the quiet side this year, possibly relating to air pollution from the fires? Our choko vine died in the extreme heat of early January and it doesn't look like there will be any chokos this year.

We do have lots of snake beans that we are fighting to save from animals that keep munching them through the night, and some of these lovely gourds that resemble zucchini in a lady like form.

And lots of okra for stir fry and for teas (Chinese traditional medicine says it's good for diabetes - who knows!)

Since moving to Newcastle I've also brought some tomato plants across from my dad's garden. Once they settled in I even got a few cherry tomatoes!

Onto the Food and Music series



I made these shallot pancakes using sourdough (of course) for a Chinese dinner we had. Rolling these out and studding the dough with shallots was super fun. These were crispy, flaky and just the right amount of chew.



Our Chinese dinner of steamed bream (left), tofu with mushrooms (top), garlic & chilli prawns (bottom right) and stir fried garden weed with snow peas went down a treat. We ate these with Schubert's Rosamunde, which came into my head one morning after a dream. We also played some reverse piano trios with me on cello and the cellist on piano - Haydn's Gypsy trio and Beethoven's Op 1 No. 3. Playing the cello is super fun and challenging!

Another piano duet, another plum tart! Stone fruit has been really good this year. We ate these with the next instalment of the Beethoven project (we are playing all the Beethoven string quartets arranged for piano 4 hand), the Op 18 No. 5, as well as a selection of modern dances.



I'll finish with one of the best loaves I've produced lately. This had a lovely rise and a golden colour with nice open crumb. I think sourdough teaches me to be patient and understanding of what the dough needs - pretty much a good philosophy for self care. I'm sending this to Sherry who hosts the IMK series - thanks Sherry!