Coronavirus will remain the all-consuming theme impacting our lives, families, communities, nations and world for the foreseeable future.

For emergency doctors at the frontline, it may feel as though we have already run a marathon, with our involvement in planning, preparations and responses contributing to significant additional stress and workloads.

Some excellent work has been done and it will all contribute to giving us the best possible chance of meeting the ongoing coronavirus challenges. We should all be proud of the energy, professionalism, collaboration, innovation and inspiration we have contributed so far.

However, we still have a long way to go. The pressures, stressors, concerns, and trepidation felt by many of us are significant. We are only human, and to feel this way is completely natural. The important thing is that we continue supporting each other, promoting kindness, compassion, expertise and resolve in our ongoing interactions with our colleagues and patients. Every single one of us is under pressure, we need to make sure we try not to externalise that stress in all our interactions with others.

With so many variables in the current environment, the College is here to continue supporting you, working for trainees, fellows and other members on all the issues affecting us; working with (and in some cases speaking daily to) national CMOs, other Colleges, politicians and the media.

A key component of this is the release of the Clinical Guidelines for the management of COVID-19 in Australasian emergency departments, which are now available on the College website.

These guidelines are the result of the intensive efforts of FACEMs across Australia and New Zealand as well as College staff, in collaboration with Safer Care Victoria. As the situation evolves, so too will this document, and I encourage you to regularly familiarise yourself with it, as well as the other updated information, centrally housed on the College’s dedicated coronavirus website.

While the situation is fast-moving and changing, there are elements which remain constant.

Key among these is the need to keep our frontline medical workforce safe. As we have distressingly already seen, the risks of exposure to, and potentially contracting, COVID-19 are not insignificant.

This is deeply worrying, and again reminds us that there is no patient emergency more important than the safety of our healthcare workforce. Our systems cannot function without us, and we have put it in the strongest terms through official and public channels that the safety of the frontline healthcare workforce must be an urgent priority.

A crucial aspect of this is ensuring the ongoing, adequate supply and security of personal protective equipment (PPE) for frontline medical staff, as well as guidelines for, and ongoing training in, its effective use. A webinar with representation from the Australian Government’s federal taskforce has been planned to proceed on Wednesday 1 April at 3pm (Canberra time), with a focus on PPE amongst other things. You can access the webinar by following this link.

We are all aware that PPE must be used judiciously in the current phase of the response to COVID-19, but it is also important that, as the situation evolves, protective equipment continues to be used in accordance with clinical best practice; and that supply of PPE does not dictate how healthcare workers are protected and patients are treated.

ACEM is committed to working with governments and all jurisdictions to address these issues. It is increasingly urgent that emergency clinicians are provided with the necessary reassurance.

As we continue to stress the importance of compassion and supporting each other, it has been extremely distressing to hear reports of the behaviour of some patients towards frontline medical staff. This includes reports of patients spitting, ripping off masks and generally behaving aggressively towards staff who are only trying to do their jobs.

This is outrageous, completely unacceptable, and in some cases amounts to assault. As a College we will continue to call this out and will seek that, where necessary and appropriate, law enforcement authorities take the necessary action.

In the intense environment in which we are operating, I want to reiterate the importance being mindful and looking after our own wellness. I know it can be tough, but please try to find some time for yourself; exercise, stay nourished and hydrated, and stay in contact with your friends, families and networks. Try to do what you need to do; remember this is a marathon, not a sprint.

The College is a key part of your network, and I would like to remind members and trainees that we have a Wellbeing Network from which you can access resources, a discussion forum and information regarding the Converge International assistance program for coaching and counselling. In addition, staff in the ACEM Membership and Culture team can connect you with external resources, initiatives and advocates in your region. You can contact the ACEM Membership and Culture unit via [email protected].

The development of our structured faculty communication tool (based on Microsoft Teams) to streamline communication and information sharing is also progressing, and we expect to have more information on this to share with you this week.

I continue to meet daily with the College’s executive leadership team as we stay up-to-date and respond to the situation. As a College we will continue to communicate with you, and do everything in our power to reassure and hopefully relieve some of the anxiety and uncertainty our trainees and other members may be experiencing, particularly in relation to College education and training activities.

While we acknowledge the complexity and uncertainty of current circumstances that are requiring some difficult decisions, it is important to reiterate that such decisions are guided by two key principles.

One is that the health, safety and wellbeing of our members, trainees and staff is paramount. The other is that, as far as possible, we seek to minimize the disadvantage to trainees whilst ensuring the integrity of the FACEM Training Program.

To that end, members of the College’s Council of Education and Board are continuing to monitor and explore various initiatives that can be applied to all elements of the FACEM Training Program. We are acutely aware of the impact uncertainty and disruption has on trainees and are doing our utmost to mitigate it as much as we can.

Acknowledging the fast-moving and uncertain nature of the current situation, we will continue to endeavour to provide you with as much information and notice as possible in relation to any further developments.
Please be assured that our commitment remains to supporting all members and trainees during this extremely difficult time.

Thank you all for your ongoing efforts. I have faith that by sticking together and supporting each other, we can continue meeting the challenges ahead.  It is going to be tough, but we can and will beat this.
Kia kaha – be strong
Nga mihi nui
Dr John Bonning
ACEM President