By Geralyn Edward
She has become the face and voice of the local medical fraternity, unafraid to challenge policymakers as she advocates for homegrown responses to the deadly COVID-19 pandemic now gripping the island.
She is Dr Lynda Williams, a medical practitioner in general practice. But her passion and advanced studies has been in the specialised area of epidemiology. Dr Williams is a Masters’s degree graduate of the University of London School of Hygiene and Tropical Medicine.
Williams is among the school’s distinguished alumni, who include Dr Tedros Adhanom, the Director General of the World Health Organisation (WHO). Other graduates include Dr David Heymann, the WHO’s Assistant Director-General for Health Security and Environment.
For the layperson, Williams explains that Epidemiology is very much interconnected to, and directly impacts the specialty of Public Health.
“I am always prepared for a crisis. If I see something that needs to be done, I switch very quickly into crisis mode. For example, I have for years been involved in hurricane preparedness and I’ve been on teams to Grenada after Hurricane Ivan and I’ve generally got in involved in anything that required crisis planning,” she revealed.
So, when Williams, who is also president of the Barbados Association of Medical Practitioners (BAMP) was asked to lead the fraternity’s Task Force on the COVID-19 pandemic in March last year, she quickly agreed and sprang into action.
“I said yes immediately! And I brought along Dr Tanya Sargeant as my co-chair. From that moment, we started examining all the evidence . . . It was an all-consuming thing – COVID-19 – trying to absorb all that was going on, reading and digesting the information – the science,” she recalled.
The family physician and epidemiologist was excited to return to an area she had studied and worked in for some time, before going to general practice.
She told COVID Weekly: “For many years, I worked with the George Alleyne Chronic Disease Research Centre (CDRC). The first study that I worked on was the Barbados National Cancer Study, as the clinical director.”
After completing advanced studies in London, she came back home and joined the CDRC, helping to establish the Barbados National Registry for Chronic Non-Communicable Diseases (BNR).
But today, her battle is far from the non-communicable lifestyle diseases, whose onset may take years. She now grapples with helping to craft a response to a highly contagious illness, that has killed millions of people around the world. Williams is very worried about the number of deaths each week here from the disease since the beginning of the year.
“We are all on the frontline. The frontline for COIVD-19 is not just Harrison Point or other isolation facilities. All the island’s doctors whether in the public or private sector, face exposure to COVID-19.”
As she related what life has been like for members of the profession, Dr Williams pointed to some simple things that have become complicated. She had a sad bemusement about complaints from Barbadians when they are required to wear masks.
She revealed: “We are trained in putting on and taking off protective gear. But working in that gear is really quite difficult. It is hot, and sometimes you are wearing it for hours.
“There are people who have anxiety attacks from wearing a mask. But I wish they would give a thought to the doctors and nurses who must wear a mask from morning to evening, plus the face shield, and the gown, and the gloves, and the booties. That is very stressful.”
She also wished people who refuse to wear masks would consider how their choice would affect others.
Williams lamented too, how difficult even simple medical procedures have become while wearing all the bulky personal protective equipment (PPE).
“If you wear glasses, they fog up, and you can have trouble doing things like taking blood or putting up drips or doing a procedure that you would normally do without batting an eyelid.
“Then you have the doctors taking swabs for testing, who are wearing all this gear, and sometimes wearing them outdoors and under tents where it is really hot.”
Williams also recalls a period when sourcing PPE became exceedingly difficult for local doctors in private practice, and BAMP stepped in to secure the vital equipment.
“All of that added to the stress of the pandemic. When you get into medicine you assume a certain amount of risk, but this is above the normal risk level that we face every day. It takes a psychological toll on you,” she added.
After a relatively tight rein on the disease by authorities and commendations heaped on local health care workers, Williams observed a change in attitude as the number of COVID-cases rose on the island.
The claps and cheers began to morph into an increasingly unpleasant situation.
“I am hearing from young doctors on the front line, who at first when patients came in, everybody was incredibly grateful and thankful for all of what the doctors were doing. That was when the numbers were low. But now, people are becoming more abusive and agitated, and the young doctors have to face all of that.
“Regularly they get abused verbally in the hospital setting. Things take longer in a hospital and patients get frustrated with the length of time they must wait. But the medical teams are just trying to do the best they can while under the stress of it all,” Williams related.
The BAMP President observed that the pandemic has also uncovered some positives. Among them is a greater level of teamwork. Not just among doctors and nurses but the entire support staff who complement the various medical teams across the island.
Of her own motivation for staying in the COVID fight, the medical doctor said it is her love of country. With many of her relatives living overseas, Williams understands the chasm that is created when relatives and loved ones are unable to be present to comfort those in hospital and those struck by the viral illness.
“That is one of the cruelest things about COVID,” she observed.
The separation and heartbreak that COVID-19 causes, are not the only things that saddens the BAMP president. A strong advocate for a healthy lifestyle, she abhors the amount of money people spend on junk food because she witnesses the results every day of rampant NCDs in our population.
With COVID-19 posing a death threat to NCD patients, Williams is worried that the combination of COVID-19 and NCDs will overrun our health care system.
The epidemiologist’s fears peaked during the last three months of 2020, as she saw the winds of a possible catastrophic storm building.
In the first phase of the disease, between March and September, she said Barbadians did well to protect themselves, largely following the protocols, and staying at home.
“But then we all as a nation got a little more casual, a little complacent. The COVID-19 messaging stopped being as aggressive. There was a level of normalcy coming back in. People were rushing around on the streets again. We had a by-election. We stopped wiping down our groceries and we felt like everything was okay,” she reflected with sadness.
Williams told COVID Weekly: “Because I am a part of a team of 20 doctors from a wide range of specialties, who worked day and night, looking at what is going on, examining the numbers, looking at what is happening at the borders and the systems for quarantining, I knew that from about October, once we started to see those numbers of visitors increase towards the end of the year, there were questions about whether our systems would be able to handle the increasing numbers.
“Our systems worked well for a while because Barbadians were very compliant. But once we put additional pressure on the system with tourists coming in, who now had to follow the same rules that we were following, like quarantining for the required length of time to prevent transmission of the disease, that is when I started to get very worried again.”
The medical practitioner recalled how things went further South.
“We had the tourists coming back, and we also had more relaxation by Barbadians, and then we also had pressure on the laboratory and testing systems, the quarantining systems, and then the possible introduction of the British variant – it was like a perfect storm.”
Now that the island has found itself in a most precarious position with COVID-19 spreading at a dangerous rate, Dr Williams said the strong and deliberate advocacy role she and members of BAMP played in sensitizing the public, and in some cases irritating some policymakers, must continue.
She is now a member of the Government’s COVID-19 Communications Unit, tasked with designing and getting effective messages out to the public.
“BAMP was vocal from the beginning of the pandemic in March. We started writing to the Ministry of Health and Wellness. We wrote recommendations regarding how people would manage private practices and several other protocols including recommendations for communication with the public. We wanted to have better communication with us as doctors also. We just wanted to be included in what was happening because, frankly, we felt excluded,” she outlined.
“Then suddenly we got included. We were invited to the Health Emergency Organising Committee (H-EOC). And then even though we were included, we felt that we needed to continue to be advocates because being included does not always mean being heard.”
Dr Williams and her team at BAMP continued to push for changes in things like travel protocols, using social media and traditional media to get their messages out, sometimes to the chagrin of some in Government.
She added: “We just kept on saying the things we were saying – mandatory mask wearing, geo-fencing, contact tracing, quarantining for a minimum of five days. We spoke about many things, but we kept saying them over and over. Thankfully, some of our recommendations have now been adopted.”
The BAMP President made it clear that local doctors were not seeking to compete with WHO or the Pan-American Health Organisation (PAHO), in advising the Government of Barbados on how it should handle the pandemic.
The BAMP President explained: “A Government can choose to listen to anyone. It is their right. Our position was that we saw the science, and we knew the local perspective. What we were worried about most, was our capacity.
“I don’t think PAHO was saying anything different from what we were saying. They give general advice and then they tell governments you have to tailor what we give you based on your capacity. And that was pretty much what we were saying too.
“It is the Government’s right to govern and choose who they listen to at any time. But we believe that local voices should gain some respect because we have a good understanding of conditions on the ground.”
Today, Williams is focused on the way forward – getting Barbados out of the grips of COVID-19.
She urged: “We have to get out of it, and we can do so by being honest and accepting where we really are. There is no point downplaying a pandemic because even if things are going well today, it can flare back up if we have not really conquered the situation.”
Williams said local doctors and health care workers were “putting their shoulders to the wheel” and doing all they could to win the battle against COVID-19.
This article appears in the first issue of COVID Weekly. See link here to read the publication. https://bit.ly/2ZldNq2