Coronavirus: on the ground in Croydon

As the coronavirus (COVID-19) pandemic transforms the way optometrists practise, OT is sharing the experiences of optometrists across the UK and beyond. If you, or a colleague, is interested in sharing your story please get in touch by email.  

I lost a very good friend recently. She died suddenly of COVID-19 within a week of becoming symptomatic.

On Wednesday 27 May my friend was alive and well with no sign of any illness. She did everything correctly; social distancing, avoiding large crowds and wearing a face mask when necessary. Two days later she was admitted to hospital, and a week after her admission to hospital, she died.

My friend was a little over 60 years old with no underlying health problems and lived her life to the full. In 1999, during her year as president of our local Soroptomist Club, she opened our new building when we extended the practice premises. She and her husband were partners in a local business. As a keen fundraiser, she climbed Mount Kilimanjaro. In 2019 she took part in a 300-mile sponsored bicycle ride through Thailand, Cambodia and Vietnam, raising over £2500 for the Multiple System Atrophy Trust.

The very sad news of her death, alongside various discussions on professional forums, made me realise that we just don’t know who might be carrying this virus.

Someone could walk into our practice wearing a face mask, showing no symptoms, answer all sorts of questions truthfully but, unknowingly, be a carrier of this virus. We need to treat everyone we meet as a potential carrier.

We are a single, independent practice in a small parade of shops a few miles from Croydon. I retired from practising optometry just over a year ago, but still assist in running the business, together with my co-director Linda, who is a qualified dispensing optician. The practice would usually have two clinics running, with two optometrists, two dispensing opticians, two reception staff and one clinical assistant in attendance each day.

When optometrists return to seeing more patients while social distancing rules are still in place, I think it is most important for us to strictly follow the guidelines. In order to prevent the spread of COVID-19 all patients should be contacted by telephone on the day of their appointment to check that they are well, and do not have any symptoms of the virus.

Your staff are also potentially at risk from catching it from each other, unless they also practice social distancing from other members of staff. The fewer people in the premises at any one time the better.

Initially, we will be operating with just one dispensing optician and one optometrist, running a single clinic strictly by appointment only. They will not be using any heating or air conditioning and will open windows to keep the premises well-ventilated. They will not share phones or computers, and where possible will stay in separate rooms.

Appointments will be spaced out at hourly intervals. Patients will be asked to wear a mask if they have one, or be provided with one if they don’t. They will all be required to sanitise their hands on arrival. The entrance doors will be locked; people will have to ring the bell and wait to be allowed in. Patients will be asked to not to bring anyone else, such as a partner or children, with them to their appointment unless absolutely necessary.

It is frightening that something so small that it is invisible to the human eye has the power to affect the whole world and extinguish so many lives, not just the old, sick and vulnerable, but people of all ages

The optometrist will be wearing an apron, mask and a face visor, with a short-sleeved shirt so that she can wash up to her elbows. She will have her hair tied back with no jewellery and only nurses’ watches allowed. We have fitted breath shields to the slit lamps and positioned the viewing screens for our OCT and Optomap so that they can be viewed at a safe distance from the patient.

Once their examination is complete the patient will leave via the back door so that they do not cross paths with the next person. Between seeing each patient, the optometrist and dispensing optician will change their personal protective equipment (PPE), clean their visor and disinfect and wipe down any objects which the patient has touched. Used PPE will be disposed of in a separate foot-operated waste bin, double-bagged at the end of the day, and stored in another bin for 72 hours before being put into the refuse.

Linda will also wear gloves when handling new frames, or any old frames brought in for repair. If any of our stock frames have been tried on these will kept to one side, then disinfected before being put back on display. Any payments are telephone transactions or by contactless card where possible. We will not allow cash transactions.

These precautions can protect our staff to a certain degree, but we just don’t know if a patient is likely to succumb within the next few days. Anyone entering your premises could be a carrier of the virus without knowing it.

It is frightening that something so small that it is invisible to the human eye has the power to affect the whole world and extinguish so many lives, not just the old, sick and vulnerable but people of all ages. We all need to take great care to keep ourselves, our surviving friends, family, work colleagues and patients safe.