It’s a long, long way to go
Stephen Cornelissen, Group Chief Executive Officer of Mercy Health has reflected on the heartbreaking battle against COVID-19.
A few people singing under their breath, a couple who are wildly and happily out of key and one or two trilling perfectly in tune: these are the glorious melodies of an ageing community choir lost in a wartime tune. These songbirds, though, are aged care residents at a Mercy Place home in metropolitan Melbourne that has recently come out the other side of a coronavirus outbreak. Their celebration is warranted. For more than a month, the Victorian home, much like its home state, has been in a state of emergency — alert, alarmed and in the fight of its life.
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The quiet of the crisp wintry morning is broken by a call to the home’s manager from one of her longest serving team members, a carer who enjoys a cheeky joke and a chuckle with residents and who always puts her hand up for difficult-to-fill shifts. The voice on the end of the line croaky and verging on tears: “I’ve woken up with a sore throat.”
For a split second, the manager stops breathing. All she can hear is the thudder of her heart.
Her residents, her staff — how will she keep them safe? What about her residents with other health problems, how can we protect them? And how about the three residents she was already worried about — they are already so isolated, so lonely. How will they cope when we have to close the home to visitors? Our families — they will be so worried. And they will have questions. How did the virus get in? Could others be infected? Could I? All of a sudden, she is thinking about another home — her own home, her children, her husband. What happens now? This is life during wartime with an invisible enemy.
Sixty minutes evaporate. Time is the companion enemy of the virus. She must let neither get away. The war room: a conference call with the Mercy Incident Command System (MICS) team, the group of people tasked with keeping their finger on the pulse of all of Mercy Health’s aged care homes in the case of an outbreak or any emergency — but is there any emergency like this or any foe that can rival the virus? No one can recall anything that frightened them as much before all of this.
The manager runs through every bit of information she has at hand. Then come the rapid-fire questions: When did the staff member first have symptoms, are they OK, when did they last work, what shift, who with, how many close contacts is that, how many residents on that floor, how many residents in total, are any residents unwell, who is on shift today, how many gloves do you have, how many gowns, how many bins do you need, how soon can the deep clean begin, do you have email addresses for family members, who can make calls, who will tell residents, who will tell the people who love them and who are not allowed in to see them… by the time the call ends, she is as prepared as she ever will be. She picks up the phone to the Department of Health. We have had a report of a case. Not an outbreak, just one notification.
Within days, regular activity at the home has been upended. Common areas are abandoned and the home is eerily reconfigured for one purpose: this war effort. There is a constant,coldly reassuring smell of chlorine from regular deep cleans, a smell that lingers after the sob and clubbing of the heavy wet mop and bucket. The pathology company arrives next with their ordinance — hundreds of swabs — at the ready, staff and residents present for a brief moment of discomfort and then 24–48 hours of watching the clock, waiting for results. Staff drift around the home like ice blue ghosts in masks, face shields, gowns and gloves, worried eyes peering out from under sweaty brows that they cannot wipe. Each time they leave a resident’s room, they have to change. On, off, on, off, on, off — all day long. On meal breaks they sit in far corners of the tearoom, masks off just long enough to eat, drink, scrub their hands clean and get back on the floor. Another charge on a seemingly endless battlefield within a battlefield.
Behind closed doors, residents sit anxiously in their favourite chair, listening to the occasional muffled noise outside their room. Some knit, others read or watch television, but many more spend hours with their eyes gently closed, memories and imaginations an essential distraction for the days and weeks of monotony that lie ahead. Bright moments arrive with phone or video calls to families, coordinated by lifestyle, pastoral care or quality staff armed not with observational tools but digital tablets — a kind donation from the Mercy Health Foundation to help loved ones stay in touch. The first few calls on these sleek field radios are blurry — not the technology, but rather the tears of relief from seeing loved ones. It may not be the same as wrapping your arms around a squirmy grandchild but for now, it will do. For now, isolation is the price of safety.
Meanwhile, the daughter at the other end of the call says goodbye for the day and puts her phone down. Mum, I just want to give you a hug, she thinks. I don’t know what I would do without you. The weather, indifferent, turns to spring, but the daughter does not feel the watery sunshine or see the early blooms. All she can see is her mother in her room, watching the door, her papery hands clasped tight in her lap as friendly staff come and go for a check-in and a chat. They provide comfort and company, but none of them is the daughter she cradled as a child and made into the woman and mother she is.
A few weeks later, the battle takes a turn. The home has had more staff and residents test positive and the manager is on another an urgent call with the MICS team. They are worried; two residents deteriorated overnight. She has been on the phone to families all morning, talking through options for medical care, advice from the residents’ GPs and any other precautions that could be put in place. She enlisted as a young woman and has worked in aged care for decades. She has supported numerous families through the grief of saying farewell to a loved one, but this is different: residents and families cannot be together. She can hear the pain that residents and families have in their hearts, even if they do not have the words: I didn’t think the end would be like this.
Later that day, a staff member knocks quietly on her door. No words are exchanged, but the manager knows why she is there. Softly and humbly, she puts a hand to her heart and closes her eyes, the words choking as they begin: one of the residents has died. She was old, but she has gone before her time. She waits a moment and then picks up her phone.
Each night is merely a segue from one battle day to the next, without ceasefire. In every home, in every community, countless of these repurposed soldiers rise to each day remembering they enlisted to provide comfort and care to the elderly — and they are now fighting for that very freedom.
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Six weeks later, the residents launch into another chorus of their chosen song, a wartime favourite, It’s a long, long way to Tipperary. The battles fought in World War I are a distant memory but the current ones are wearying too. One line of the chorus lingers, a few eyes in the room catch one another:
It’s a long, long way to go