Working on the COVID-19 front line – an Interview with Dr Georgia Hardavella

Dr Georgia Hardavella is a consultant respiratory physician in Athens, Greece. She works in the biggest respiratory hospital in the country, Sotiria Athens Chest Diseases Hospital, which has more than 300 dedicated respiratory beds and is the National Referral Centre for Respiratory Medicine and COVID-19.

We asked to Georgia about her experiences of working on the front-line during the COVID-19 pandemic.

You have been working at the COVID-19 centre in Athens- what has that been like?

Stressful, challenging and rewarding. The pandemic found our health care system and my hospital in a vulnerable position due to shortages of staff, older medics and limited resources. So even though we did pretty well as a country, we were very close to reaching the limits of our available resources in the national healthcare system.

We are really interested to hear the perspective of a healthcare professional during the pandemic- How has COVID-19 impacted your practice? 

We went through two phases.

The first phase was February-March 2020 and the second phase was April-June 2020.

In February and March, we continued to provide regular care for all respiratory patients. In addition to that, we cared for most of the suspected and confirmed COVID-19 patients in the country.

Due to the increase of confirmed COVID-19 cases, it was decided that this was no longer sustainable, and from April onwards we became a dedicated COVID-19 hospital. This means we stopped our respiratory services, on site thoracic surgery was put on hold, and we only cared for COVID-19 patients. Chronic respiratory patients’ care was diverted to other hospitals. We only continued to deliver systemic treatment and end-of-life care for lung cancer patients. We also reduced other services to support the service we could provide to people with lung cancer.

How have you found the experience of interacting with patients while wearing the personal protective equipment (PPE)?

It has been a big challenge for patients and for us as healthcare professionals, especially if you take into account that facial expressions and body language play an important role in communication in Greece. Because of this, what I found particularly challenging was expressing myself while wearing the PPE. I empathized with patients while caring for them, but they could not see my face at all, and some of them, who sadly passed away, never got to see it.

PPE is quite uncomfortable, especially after wearing it for several hours in the Emergency Department or when seeing patients on the wards. It leaves marks on our faces; it is painful to move the muscles in my face after wearing the masks for long shifts and I can barely talk. We are soaked in sweat throughout the entire shift in these special uniforms.

Have you experienced any barriers to providing care to patients?

At some point, there was a national shortage of PPE which challenged us in providing care. To overcome this, we successfully approached private companies and charities and also self-funded some of our PPE.

Have there been any resources that you found useful during this time?

This was a paper boom period in medicine! I remember numerous COVID-19 papers being published daily, where colleagues from all over the world shared their experiences. ERS and ELF have been very proactive and have made available very useful resources that provide balanced information that I have been using during this time. The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), The European Centre for Disease Prevention and Control (ECDC) and the Greek National Organisation of Public Health provided useful resources too.

What have you found the most difficult/challenging and most rewarding during the pandemic?

The hardest parts were communication with patients and families, and also finding ways to support patients due to the lack of physical communication with their loved ones.

The most rewarding part was when patients were safely discharged. I remember seeing them for a follow-up in our dedicated face-to-face and e-health COVID-19 clinics and I was delighted to see them fully recovered and back to their normal activities, especially after all they had been through.

If you could provide yourself with one piece of information at the beginning of the pandemic, what would it be?

Stay calm and make full use of hand hygiene and PPE.

Is there anything else you would like to add?

Thank you for offering me the opportunity to share my experience and insights from working on the front-line of the pandemic in the National referral Centre for COVID-19 in Athens, Greece.