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Two issues that have percolated to the top of our College’s list of priorities in the last month are the safety of our healthcare workforce and our desire to allow trainees to keep moving through the training program. Worryingly high numbers of COVID-19 cases in Victoria, as well as persistent clusters coming out of New South Wales and some new cases in Queensland continue to remind us of the insidious and entrenched challenges this virus presents.
In addition to increasing fatalities in Victoria, it has been very concerning to see more healthcare workers in hospitals, medical facilities and aged care homes becoming infected and falling ill, some seriously so. Last week we were deeply saddened to learn of a trainee colleague from Melbourne, becoming gravely ill with COVID-19. Our thoughts and deepest sympathies remain with the doctor concerned, their family, friends and colleagues, as they are with all healthcare workers affected by this terrible virus.

As a College we must continue to find ways to support each other as best we can, as we acknowledge that this is an incredibly trying time for our entire emergency medicine community.

We have long known of the significant COVID-19 infection risks, and significant safeguards have been taken within our hospitals and emergency departments. In our ‘new normal’, this virus looks to be with us for the long haul, and we will continue having to manage it in one form or another, continuing to work out how to live with the evolving challenges.

As the situation moves rapidly, we are again reminded of the need to remain vigilant throughout both our countries, and continue taking all necessary precautionary measures, while reviewing, adapting and improving approaches as the situation requires. We wait for a vaccine, however effective that may be.

Throughout this pandemic, seeking to ensure workplaces are as safe as possible for frontline healthcare workforce and patients has been a key focus of ACEM’s advocacy efforts with governments, health departments and chief health officers, and will continue to be so.

There are immense challenges, including, but not limited to, losing large segments of the medical workforce deemed to be close contacts with COVID-19 cases to self-isolation for weeks, and difficulties in relation to the movement of staff, many of whom work at multiple sites across and beyond lockdown zones, and across state and territory borders.

Finding solutions requires creative, innovative thinking and ongoing commitment to ensuring the safety and sustainability of already-strained frontline medical staff. This all needs to occur while infection control standards are maintained, or improved, and continue to be informed by the latest evidence and experience. Ultimately it cannot be left to individual clinicians, hospitals or districts to come up with individual solutions to their immediate needs. We need the ongoing support of systems, leaders, governments and our communities to help get us through.

As a College, we continue to raise these issues at the highest decision-making levels, ensuring voices from emergency doctors and our emergency departments are heard, as we push for transparency, consistency, coordination and cooperation, as well as clear communication from governments, departments, hospitals and healthcare systems.

Compounding the challenges is the sheer length of time we have been contending with this virus and the increasing certainty that it will not go away any time soon. Across our states, territories and countries, we are at different stages. Nevertheless, we have all been on high alert, remaining ever vigilant, alert, and responding, for many months now.

While stress and anxiety levels fluctuate depending on immediate situations, additional pressure has been a near constant presence throughout most of this year. This takes a toll.  Clearly, Victoria is particularly under the hammer currently, with the rest of us looking on with sympathy, realising it could be us.

Amid it all; coming to terms with new ways of doing things, additional workload, the potential for cognitive and bad news overload; focussing on wellbeing has never been more important.  Particularly as we experience longer-term periods of high stress and risk, we encourage all who may need support to please reach out.

Finding time to care for ourselves is so important. Please think about what works for you; reach out to colleagues, friends and family, take some alone time if you need it, try to switch off, exercise, cook, read, whatever works for you. At this time, the way we interact with others matters more than ever. We need to remain as self-aware as possible, and above all embrace kindness; kindness to ourselves, our colleagues and patients.

This can be difficult and, given all that is happening, as part of the support the College offers, we remind members and trainees that ACEM has an assistance program for those who need it. A range of peer-reviewed resources and initiatives are also available to support both workforce wellbeing and individual welfare, and the College Membership and Culture team can be contacted via [email protected].

Along these lines, it’s also great to see the nominations are now open for the third annual ACEM Wellbeing Award, and the inaugural ACEM Diversity Award until 24 August.

In addition to the significant additional pressures we are all facing in our work, another significant contributor to anxiety is the uncertainty the current situation represents.

The College is keenly aware that our trainees have been feeling the additional pressures of that uncertainty in relation to College exams. Throughout this pandemic, the College has been at pains to communicate regularly, openly and transparently with trainees in an effort to provide as much clarity and certainty in relation to the College exams as possible, to the extent that the current situation allows.

At the heart of our significant deliberations has been seeking to ensure the decided upon course of action is a fair as possible to all trainees, current, past and future, and that all possible options to allow exams to proceed as scheduled are considered.

The College’s Council of Education (COE) and the Education and Training team are working very hard towards a workable solution to make the 2020.2 examinations occur on the scheduled dates previously communicated through COE Communiques. Although COE met on 29 July, they will again be meeting on 5 August and it is envisaged that further details will be released as soon as it is possible after that, following the final approval channels.

The College appreciates and is aware of the significant ongoing challenges we are all facing in response to the ongoing COVID-19 situation. As always, we are eager to support members and trainees as best we can.

If there are things you need, or ideas you have about how the College can continue to support you, then please do get in touch with the College’s Faculties Team as we aim to support you as best we can.  I am forever awed at how our Fellows and trainees continually roll with the punches and come back fighting, for better systems, advocating for better care for our patients and conditions for our colleagues.

Thank you again for your ongoing work during what has now become an ultra-marathon. It can sometimes be hard to see and acknowledge through the tiredness and anxiety, but all that you do is deeply appreciated and more crucial than ever.

Kia kaha – stay strong.
Dr John Bonning
ACEM President