Looking back on the first few months of the COVID-19 pandemic

Dr Sophia Steyaert

Friday 13 March. It is late in the evening when hospitals receive the government guidelines that prohibit all non-urgent operations and consultations as well as all visitors from Saturday 14 March. ‘Things moved very fast,’ relates microbiologist and hospital hygiene specialist Sophia Steyaert, ‘but the rate at which potential coronavirus patients were arriving after the spring break was unprecedented.’

When did you realise that Belgium was not going to be spared by the COVID-19 pandemic?

Dr Sophia Steyaert: ‘As a microbiologist and hospital hygiene specialist, I had been following events closely since the first reports from China. It was to be expected that the virus would spread quickly, but nobody knew that it would be this fast! Everybody remembers the first patient who was placed in isolation in the St Peter’s Hospital in Brussels. In the first few weeks, we were still able to follow government guidelines and refer patients to referral hospitals. It was the return of holidaymakers from ski resorts (weekend of 7 March) that made for a real tipping point. Lockdown was imposed soon after, and from one day to the next hospitals suddenly needed to be able to admit and care for patients themselves.’

How did you manage to do so?

Dr Sophia Steyaert: ‘Fortunately, we have a pandemic plan that originates from the time of the swine flu in Mexico in 2009. We had also worked with the Technical Department and the emergency plan coordinator previously to determine which wards would be turned into cohort wards, what routes patients would follow through the hospital etc. This planning exercise had been recorded in writing and has been a very helpful tool for us. ‘Continually developing our understanding” is the expression that has come to typify this crisis: We have continually had to adjust to the virus and the phases of the epidemic. Fortunately, we were also able to learn a lot from those countries where the virus had spread before. The first studies were being published and we knew at least something! A special mention goes to the dedication, hard work and commitment of the many key players in our organisation: They have given their all to ensure that our policies could be implemented smoothly.’

What were the key moments for you in the past few months?

Dr Sophia Steyaert: ‘So much has happened in the past months... I had a quick look at my notebooks that I used for notes and reminders, things that I thought of while doing something else or that woke me up at night. What I will never forget is the hectic pace at which the hospital organisation was adjusted to the influx of patients with potential COVID-19 infections. In the initial phase, the scarcity of personal protective equipment and testing materials caused a lot of concern. Another pivotal moment was the introduction of proactive checks at the hospital entrances. Specially trained gatekeepers assisted patients and visitors in cleaning their hands and checked them for COVID-19-related symptoms like fever. The hospital-wide introduction of masks was another important moment: since then, each employee, patient and visitor wears a mask from the moment they enter the hospital until they leave. I think this felt uncomfortable for many people in the first few days. And finally, a memorable moment for me as a microbiologist: the launch of COVID-19 testing on 19 March.’

Many patients appeared to be concerned about going to their GP or to hospital. How do you ensure a safe environment?

Dr Sophia Steyaert: ‘This work takes place on different fronts. From the beginning, we have stressed the importance of basic principles such as hand hygiene, cough etiquette, maintaining distance and avoiding the touching of mouth, nose and eyes. A highly motivated cleaning team keeps hygiene standards in the hospital at a high level. A dispenser for hand sanitising and a scanner for checking body temperature are provided at every hospital entrance. Everybody wears a mask covering the nose and mouth at all times and throughout the hospital. Very important: (potential) coronavirus patients are immediately kept strictly separated from other patients. To this end, we test not only potential coronavirus patients for COVID-19, but everybody who spends more than one night in the hospital. The outpatients clinic schedules consultation slots further apart and we ask that patients are not accompanied by another person unless strictly necessary. Before their arrival, patients receive the required guidelines and are asked by telephone about COVID-19-related complaints and quarantining measures as part of contact tracing.’

Testimony of a patient after recovering from COVID-19

‘After having suffered chronic lymphocytic leukaemia a few years ago, and as a care provider, I was concerned about being vulnerable to the coronavirus. When one of my patients notified me that they had been infected with the virus, I immediately took the necessary precautions. In this way, I was able to prevent my patients from falling ill. After a few days however, I started to feel increasingly fatigued myself. From that day onwards, my symptoms deteriorated fast. A lung scan and blood tests at A&E confirmed the severity of the situation. I was admitted to a COVID-19 ward at Maria Middelares General Hospital that I shared with an amiable farmer who coughed and sneezed a lot. In my estimation he was in a far worse state than me, but nothing could be further from the truth. After a few days my legs no longer supported me. I was transferred to Intensive Care and started to hallucinate: “Why don’t I read from right to left?”; “Why is my heart no longer in the same place?” My children visited me twice, but I don’t remember anything at all about a single visit. I still find that difficult to deal with. Thanks to the excellent care of the physicians and care staff, I managed to pull through. I only realised just before I was discharged how seriously ill I had been and how close I came to not making it. What is certain is that I am very grateful for the care I received. Grateful to the dietitian who offered alternatives for food that I found unpalatable. Grateful to the physicians who took the time to explain things to myself and my family. And grateful to the staff members who really listened and made me feel safe. That’s what makes the difference.’

The interviews about the coronavirus COVID-19 were conducted mid May. Due to the fast-changing circumstances and publication times, the most recent information will not be included in this article. Thank you for your understanding.