We had a major -- I mean huge -- SARS update this morning, given by our chairman of the medical board. There were maybe 200 of us crammed into a rather small room, and comprising members of departments ranging from internal medicine, geriatrics, general surgery, orthopaedics, ophthalmology and the A&E department.
It was informative, and the general anxiety was palpable. I realized that all except one of the SARS cases was taken care of by my department, a fact that hit me hard. Of course, the scariest part was how these patients got past the ER in the first case -- not entirely the A&E's fault, if you hear the whole story. However, with SARS being primarily defined by "medical symptoms" like fever and cough, anyone with either of these gets shunted to us for evaluation. And although those down in the ER are the gatekeepers, those of us upstairs spend much more time with any individual patient, having to see them multiple times and take blood and other samples of bodily fluids as required. Why do you think 2 nurses here contracted the disease? I'm grateful for each day that passes where no doctor here gets hit by SARS. Let's hope that never happens.

Another issue brought up was about segregating doctors from different hospitals. But this is clearly not possible for doctor couples -- in particular, the married ones. A show of hands in this meeting alone had at least 4 who have spouses from other medical institutions. And let's not forget others who have boyfriends/girlfriends/fiances/fiancees/relatives scattered throughout these hospitals.
I'm not for it -- though I'm not affected by these restrictions -- because when you go to work and stare potential death in the eye day after day after day, going home to your loved ones may be the only thing helping you through this crisis. I don't support separating families/couples unless absolutely necessary. We can minimize this through simple personal hygiene and strict precautions at work.

Last night's call was especially distressing for those on duty. Apparently, all other hospitals declared that they had no more beds left, and cases were redirected to... you guessed it, us! We already have a strict policy against admitting people who were warded at other government hospitals within the last 21 days, but a man who was warded elsewhere only a week ago was still let through and sent up to our isolation ward, after the previous hospital rejected his admission there. If we think about it, you can't possibly admit a patient if you have no beds left, but if this situation continues, does this mean we're back to square one? The lady I signed up on March 30th -- who was later diagnosed with SARS and is cited as the one who spread it to her daughter-in-law and the nurse and housekeeping staff who had contact with her -- was warded here after being discharged from TTSH. This problem has "DANGER" written all over it, and it is my wish that it gets solved ASAP.

The protective gear load increases steadily. It started out with masks, then gloves, then gowns, and now, we have goggles! The N95 masks are giving some of us headaches and claustrophobia, not to mention difficulty breathing, allergic reactions and profuse perspiration -- one MO jokingly said it was giving him more blackheads. I work in a non-air-conditioned ward, and whenever the weather gets more humid than usual, I have to stop in the middle of the round ( which takes approximately 2 hours ) to take my mask off and dab at my face. Not fun.

On a programme on SARS screened over Channel NewsAsia this evening, a WHO official said, "If Singapore can't control the spread of SARS, no other country can." Encouraging words which are badly needed by all of us, and greatly appreciated.