I am an internist-pulmonologist in Manila.

My days now barely resemble any routine I have established for the past seven years in practice. Each day changes as we adapt to the new normal. This is like attempting to change the wheel of a moving tricycle, on a rough road, while inside it, and in a PPE (personal protective equipment).

For a doctor, learning never stops as the new coronavirus disease (COVID-19) ravages on, and we need to learn which strategies work and which do not. We cannot just give patients bananas. I tried to compile everything in an accessible public repository, https://bit.ly/covidPH, and update the resources when I get the chance.

Aside from hospital duties, I teach at the University of Santo Tomas (UST) Faculty of Medicine and Surgery. I am also part of the UST Educational Technology team of e-Learning specialists who assist and train teachers on tools for online teaching and learning. It’s a university-wide group, and I head the Medicine contingency team.

e-Learning for clinicians

With the code red announcement, we needed to shift practically overnight to completely online teaching. I was in charge of getting the entire Medicine faculty online and continuing learning activities despite the community quarantine.

The task includes getting everyone to maximize the use of our learning management system. For years I had been wanting to get everyone online, and this is just a “be careful what you wish for” moment.

Understand that it is not easy for a seasoned clinician to suddenly shift to online teaching. Nontechie senior faculty members exerting all-out effort to learn how to deliver online lectures is enough push for me to keep going.

As for our students, even if there is only one left willing to learn despite the situation, all our efforts will not go to waste.

For the authorities, learning about the enemy is the first and most important step. All the preparations, manpower and effort will go to waste on the wrong policy and interpretation. A policy or a government action without the science is a recipe for disaster.

I was a biochemist before I became a physician. They say that in every disaster movie there was a scientist that they didn’t listen to. It is very frustrating when policies are done on the basis of popularity and financial gain rather than science. Policies are imposed without consultation, then they wait for the backlash rather than consult from the ground up.

Educating the public on what it means to flatten the curve rather than just imposing restrictions that they do not understand will help with compliance. The public ought to be given the right amount of knowledge to be vigilant, but not too much to cause blind panic.

Regret

When I get home from hospital duties, I take a shower in the garage. My clothes get laundered separately. My shoes and other items from outside get sprayed with disinfectant.

I consider myself infectious and isolate myself. I wear gloves and a washable mask whenever I go out of my room to protect my family members. We strictly follow rules of social distancing, as well. What I regret most is not hugging them enough before all this.

For a breather, I get to spend online time with my #Philpulmo group, lung specialists who are also advocates of technology in medicine. We share best practices and find ways to better use technology in this pandemic.

The last duty made me realize a lot of things. I went to the COVID-19 ward when one of the members of the team got admitted and needed ventilator support. Our chief resident was already there doing an excellent job despite the situation. She was taking care of one of her own.

That moment when I could barely see through the sweat-covered goggles due to the heat buildup inside the PPE, I realized we are at the mercy of the integrity of our protective gear. Any breaks and we could end up needing the care we are giving now. It was heartbreaking that right in front of me were our graduates fighting COVID-19 at the front lines as doctors, and one of them is now a patient.

I am both proud and scared to see them in this situation. My students at home now need to learn what they can because they will be our doctors when their turn comes. It is not about the grades or the honors that they will get when they graduate. What matters is how they will become doctors who are competent, compassionate and committed.