With a brother in New York — a state which has recorded more than 29,000 coronavirus-related deaths — and parents in the UK, Dr Jane Davies knows all too well how devastating the impact of COVID-19 can be.
- On Friday, COVID-19 restrictions in the NT will continue to ease
- Although there are zero active cases, health workers are urging people to be cautious
- Ward 4B, where Darwin’s coronavirus patients are first admitted, is on “COVID-19 watch”
“Our constant family joke at the moment is that I am in the safest place in the world, certainly their experience has been very different,” said Dr Davies, the co-director of infectious diseases at Royal Darwin Hospital (RDH).
Dr Davies said even though she had been working on the COVID-19 frontline, she was grateful to be doing so in the Northern Territory, which she says is in a “unique position”.
But with restrictions set to ease further this Friday, allowing Territorians to travel into most remote communities, drink at the pub without a meal or get a tattoo — Dr Davies is nervous.
“This is not a time for relaxing,” she said.
“This is a time where all those things that we’re preparing and talking about in the last three or four months, that’s when they’re going to be tested and we need to maintain that vigilance around social distancing and not going to work when you’re sick. It’s far from over.”
Inside Ward 4B at RDH
Unlike other Australian jurisdictions, everyone diagnosed with COVID-19 in the Territory was admitted to hospital and remained in the care of health authorities until they returned two negative COVID-19 tests within 24 hours.
Not even the patients with the mildest symptoms of the virus were allowed home to recover.
At RDH, COVID-19 patients were first admitted to the negative pressure isolation rooms in Ward 4B, under the watchful eye of clinical nurse manager Heni Hongara.
While some COVID-19 patients only stayed there for a few days before being transferred to another part of the hospital, others stayed weeks.
The NT’s first confirmed case of coronavirus, a 52-year-old Sydney tourist who tested positive while in Darwin, spent 28 days in the same small hospital room waiting to be clear of the virus.
When he finally returned two negative tests, staff were so thrilled they went into his room, clapping and cheering.
That was a moment of joy during a testing period for the ward. At the beginning of the pandemic, Ms Hongara’s staff dropped from 39 to 30, with most people leaving because they were pregnant or vulnerable — although some asked to be moved because they were scared of getting COVID-19.
Three of the remaining nurses on Ward 4B were only three months into their careers.
Ms Hongara said despite now being free of coronavirus patients, the ward was still on “COVID-19 watch”, which meant it was always ready for the next confirmed case.
From 4B to the Lorraine Brennan Centre
Carol Mackrow is the clinical nurse manager at RDH’s Lorraine Brennan Centre, where some of Darwin’s COVID-19 patients were transferred after leaving Ward 4B.
There, patients had a little verandah to themselves and were able to soak in the fresh air and sunlight — from a safe distance.
“You could see the physical relief on their faces being out of that strict clinical setting into that more relaxed-type setting for the first time in weeks,” Ms Mackrow recalled.
It was a difficult time for mother-of-three Ms Mackrow, who spent five long weeks sleeping in a separate section of the house to the rest of her family to avoid the possibility of spreading the virus.
“We had a barrier in the corridor and I was allocated one part of the house and they were allocated the other,” she explained.
Ms Mackrow, a born and bred Territorian, said it was a sacrifice she was happy to make to keep her patients — and her family — safe.
“This is what we have to do, we have a choice, we just have to do it. As a nurse, that’s my role, that’s what I love to do, I love to help people who need help,” she said.
COVID-19 an ‘evolving catastrophe’
In her 27 years working with NT Health, Ms Mackrow said nothing could have prepared the Territory for coronavirus. She remembers first hearing about the virus on the news, and watching in horror as it spread across the world, eventually finding its way into the Northern Territory.
But despite the very real risk, Ms Mackrow still went to work every day — pulling on a face mask, goggles and full waterproof gown to visit each patient, a stifling uniform in the hot Darwin climate.
“I remember going home one day after working late in the afternoon and thinking: ‘jeez my face is really sore’, and it’s because I was smiling so much, making sure [the patients] could see that smile, that it would reach my eyes,” Ms Mackrow said.
And now that coronavirus restrictions are continuing to ease, Ms Mackrow admits she is nervous about a second wave.
“This is a marathon not a sprint, and we need to encourage everyone to keep going,” she said.
‘We may have further cases’
Looking back at the last few months, Dr Davies said the Northern Territory’s situation could have been very different.
RDH, the NT’s largest hospital, has just 12 ICU beds fitted with ventilators, equipment which many critically sick COVID-19 patients need to survive.
The NT also has a very sick and transient population — with Australia’s highest rate of Aboriginal and Torres Strait Islander people, many of whom live in remote communities and have complex, pre-existing health conditions.
As co-director of infectious diseases at Royal Darwin Hospital, Dr Catherine Marshall explained that it was this group of people whom health workers feared for most.
“We have very vulnerable populations, where there’s significant overcrowding, potentially poor health literacy, poor access to healthcare, people in a remote setting where we felt this infection could be devastating,” she said.
Without a vaccine, Dr Marshall said COVID-19 was “unlikely to just go away” but the team now feel more prepared than they were at the outbreak of the pandemic.
“As the borders open and restrictions ease, we may have further cases,” she said.