Coronavirus: Front-line Fighters

Coronavirus: GPs set aside their own fears to fight on the front line

A family physician, a contact tracer, and a nurse from the National Centre for Infectious Diseases tell their stories as unsung heroes on the front lines of the battle against the coronavirus.

With almost 30 years of medical experience, Dr Leong Choon Kit has seen it all: Sars, Zika and H1N1.

So when the coronavirus hit Singapore's shores, he knew what he had to do. "I told my family that if I see a suspect case, that day, I'll make sure I don't come into contact with them. They must be mentally prepared," he said.

The 52-year-old family physician at Mission Medical Clinic is just one of many doctors who are Singapore's first line of defence against the virus. His years of experience allow him to take a cool-headed approach to the outbreak.

He said: "I'm not scared. We've all gone through quite a few of these outbreaks. We're not complacent, but it gives us some confidence.

"Of course I worry (about infecting my family). But worrying doesn't change a thing. We take our own precautions."

For Dr Leong, these precautions include showering once he reaches home, and washing his clothes separately from his family's. "This is reality - we want to be doctors because we want to help people, and we know there's a chance we might get infected and succumb to it."

However, he acknowledged that the fight can sometimes feel like a lonely one for private practitioners.

The head of a primary care network, Dr Leong said he has seen younger doctors venting their frustration over the situation.

"As a solo practitioner, you're very much alone. Sometimes they may feel very depressed or defeated, because it feels like they're fighting the war alone," he said.

Dr Leong said he sometimes texts junior doctors or talks to them privately to try to reassure them.

The Singapore Medical Association (SMA) and the College of Family Physicians Singapore (CFPS) have stepped up to help as well.

 
 

"Private practice GPs (general practitioners) are especially vulnerable, as many of them run solo or small practices, with limited resources," said the SMA's first vice-president, Dr Tan Yia Swam.

Both SMA and CFPS supported front-line doctors through the initial days of mask shortage by obtaining their own supply of masks, which they then sold to the doctors.

Now, Dr Tan said that among other efforts, SMA is linking up food delivery services with major hospitals, and setting up a website where doctors can get relevant information on the virus. SMA's council members are also supporting GPs through informal chat groups.

Meanwhile, CFPS' measures include a hotline that doctors can call to ask questions about practising medicine during this time. It is also keeping doctors updated with regular circulars about the virus.

Dr Wong Tien Hua, CFPS' vice-president, said: "The current situation is highly stressful and uncertain. Aside from logistical issues, there are also personal fears, worries about staff getting infected. So we try to address these."

The Government said last week that it will distribute one million face masks to private clinics, including GPs and specialists.


People queueing to get their temperature taken before entering a clinic in Clementi Ave 5, on Feb 12, 2020. ST PHOTO: KELVIN CHNG

Some doctors, like Dr Tan Liat Leng, 38, are also facing a heavier workload. "Last week, I was working virtually every day from morning till night," said the GP at EH Medical Clinic.

He has seen a 30 per cent to 40 per cent increase in patient load, as many are presenting themselves at the earliest sign of a cough or runny nose.

 
 

This is exacerbated by a lack of locums, many of whom are concerned for their own safety and that of their families, or have to stick to one healthcare institution to reduce the risk of spreading the infection, said Dr Tan.

More time is also needed to reassure patients who are concerned about the virus. But Dr Tan sees this as part of his duty as a doctor.

"We have to treat not just the disease but the dis-ease as well. As a doctor, there's a responsibility beyond just trying to cure," he said.

Dr Tan, who was a doctor during the H1N1 outbreak but not the Sars one, said he too is worried about the situation, but puts aside his own discomfort to reassure his patients.

"We're all human beings and suffering through this together, and I believe an empathetic word is important. As doctors, we know that our words carry a certain weight with patients, so we need to help address their concerns," he said.

 
 

Unlike Dr Tan and Dr Leong, Dr Raymond Ong, 33, was too young to be a fully fledged doctor during either Sars or H1N1. But this does not stop the GP at Intemedical 24 Hour Clinic from setting aside his worries and putting in extra hours to fight the virus.

Dr Ong has seen a 20 per cent to 30 per cent increase in patients at the clinic since the outbreak, as well as twice the usual number of patients using teleconsultation.

He now works seven days a week to keep up with the higher numbers.

But he continues encouraging his patients to use telemedicine instead of going to the clinic, even though it means a heavier workload for him, as this helps reduce the risk of them infecting other patients.

And though he does worry that he might fall sick, it is because he is concerned about his patients' peace of mind. "If the front-line people are down, that'll severely impact the confidence of Singaporeans," he said.

"It's tiring, but it's a duty, and someone's got to do it. If a fire breaks out, the fireman will feel tired, but that's his duty… no matter how tired you are, you will do it."

 
A version of this article appeared in the print edition of The Sunday Times on February 16, 2020, with the headline 'GPs set aside their own fears to fight on the front line'. Print Edition | Subscribe