Vaitele Clinic preparing for coronavirus

Tautalatasi Dr. John Adams is readying his private practice, Vaitele Village Clinic, for the arrival of the coronavirus even as he prays that Samoa’s prevention measures keep it at bay.

The paediatrician and private physician, who worked on the frontlines of the measles epidemic late last year, said he does not want to see the same mistakes happen in Samoa again.

Already in his waiting room and on the front door to the clinic, posters ask patients whether they have been abroad in the last 14 days. If they have, they must go back to their car, call reception and wait for a nurse.

“We learned a lesson from the measles epidemic,” the doctor said.

“We were seeing a lot of people in a very short time so my clinic was full and we were mixing kids with infectious disease with the normal population.

“Because it was busy, we just had to see the patients and slog it out. But now that we have this pandemic looming, we know how to prepare.”

Tautalatasi said, for now, Samoa has to get ready, while depending on its neighbours - Australia, Fiji, Hawaii and New Zealand - to defend its borders against potentially infected travellers. 

Border control remains the key, he said. 

“We want to make the coronavirus feel unwelcome, tell it: ‘Hey, we don’t want you here, by doing the simple things right all the time’.

“As individuals in Samoa, we are all in this together, from the oldest to the five year old kid. Simple things: hand washing, don’t touch your face, clean your hard surfaces, your doorknobs, if you are sick, stay at home.”

And should the virus actually arrive in Samoa, the Vaitele Village Clinic has two main responses in mind.

First, Tautalatasi wants to screen people outside his clinic, and reserve the actual site for non-infectious patients, who are more vulnerable to a severe infection of COVID-19.

That will either take place from the window of a suspected case’s car, or under the shade of an open air clinic under a tent established in the clinic carpark. 

“This is one way we can at least delay the spread, instead of people coughing and feverish sitting in here with the healthy people,” he said.

“At the same time, people need access to healthcare sooner rather than later. 

He said anyone who rings all three symptom alarm bells  (a cough, fever and a recent trip overseas or contact with someone who has taken one) will be referred to the Ministry of Health immediately

“If for some reason the virus gets to Samoa, I will move from prevention to containment. Containment is making sure the virus doesn’t spread, so we want to limit transmission,” the doctor said. 

That means identifying a suspected case of the virus also known as C.O.V.I.D.-19, testing them for the virus and finding everyone they were in contact with to put them in self-isolation while monitoring their symptoms at home. 

In their weekly education session on Friday, the General Practitioners Association discussed prevention and containment measures for C.O.V.I.D.-19, Tautalatasi said, meaning all private doctors are preparing in much the same way. 

He said he and his peers are looking at countries like South Korea, Taiwan and Singapore as models for clamping down on the spread of the disease, which tested broadly for cases, isolated and treated those who needed it and traced their contacts to quarantine them too.

Right now, Samoa has no tests available, but Tautalatasi said he understands the Ministry of Health and World Health Organisation are working to get them to the island.

“That is the only way to prove we have coronavirus in the country finding out the true number of cases we might have and how rapidly it spreads. I do hope we get the test,” he said.

“The 1918 Spanish Flu taught us about the importance of good border control. The measles epidemic taught us the importance of a good primary care system. Both were infectious diseases, both were preventable.

“If anything, this virus is teaching us to go back to basic hygiene practices we were taught as kids: cough into your elbow, don’t touch your face, wash your hands. We need to do a little bit more.”

Last week, the doctor gave a presentation to the nuns and nurses of the Mapuifagalele Home for the Aged, where he practices, where he recommended families be stopped from visiting their elderly loved ones in their rooms. 

“What happens is, families who just got off their plane go straight to the rooms, because they want to see their mother, grandmother or aunty. But now the protocol the nuns are instituting is to meet in the big fale and keep some distance.

“All those little things count but we have to prepare, we have to expect it. It may not come, it may come next year, but we are all in this together.”

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