One hundred and eighty-one ENT practitioners filled in the survey completely, comprising of 63.5% female doctors and 36.5% male doctors. Ninety six doctors work in hospital settings and 85 in private practices. 32.6% of all doctors had 21-35 years of practice in this field. Risk level of contracting COVID-19 within the ENT specialty was perceived as high by 83 doctors and very high by 63 doctors.
A change in pattern was observed with respect to preparation of workplace to manage crisis at the time of first recorded cases of COVID-19 infection and current situation in April 2020 in Czech Republic (Figure 1). Similarly the same pattern was seen with regard to personal protective equipment (PPE) to ensure safe ENT care to prevent infection and spread of COVID-19 (Figure 2).
In response to the question regarding the items deficient at your current practice, doctors were allowed to select as many as applicable. Out of 181 doctors,18 selected disinfection and sterilization products, 57 had issues with PPE (respirators, shield, goggles, etc.), 75 were short of disposable aids (protective coats, gloves, surgical instruments, gowns, etc.), 15 were deficit of all of the above and in contrast 53 doctors reported no deficits.
With regards to other problems faced in the clinical practice, respondents were allowed to select more than one option; most of them had patient related problems (Figure 3). An alarming 42.5% of the practitioners were unaware of any support being provided by the individual establishments in case an employee contracts COVID-19.
About 37 individual comments were entered as other problems encountered during the situation, most were concerned with the economic and financial problems, some feel they were ill informed of the situation and lack adequate support from their respective employers, in certain hospital settings, sudden deployment in COVID-19 units has been unpleasant and the rest are concerned about the quality of care of patients with minimal co-operation from other medical units. A few extracts from individual responses are stated here.
Example 1 – from hospital practice
“completely reversed biorhythm - we exchanged to the red (COVID) zone, in addition to the consultation in the green (NON-COVID) zone, we practically do not have 2 days off in a row or only exceptionally. Chronic hypoxia when using a respirator after 5 hours, headache, skin problems from permanent wearing of 2 gloves, in the face from the respirator, in addition, a problem with dioptric glasses and discomfort from other protection aids”
Example 2 – from hospital practice
“dissatisfaction with the organization of care: care for COVID suspected/positive patients is adequate, but chronic and oncological patients who need medical help sometimes more than "COVID" patients unfortunately do not get it”
Example 3 – from a private practice
“I, myself, am in immunosuppression and still monitored for oncology, yet I worked from the beginning, despite the lack of PPE, when the import of PPE from China began, I was in bed with fever and viral infection ... now I am on medical leave”
Example 4 – from a private practice
“we lack FFP3 respirators - we did not receive any and are still unavailable to outpatients, the prospect of reduced income with a small number of patients. There are no algorithms for how to proceed with the gradual dismantling of care - is it possible to perform audio examinations in the cabin for asymptomatic patients? If they have COVID-19, you will not thoroughly disinfect the audio booth”
However 50.8% of doctors agreed that all (psychological counselling, medical and financial) services should be received by ENT staff in the time of crisis. And lastly, only 2 people thought the situation is resolved and in contrast, 108 concluded that it would resolve in a few months (Figure 4) in response to the length of time that the major difficulties associated with the pandemic situation might last, thus interfering with the performance of the profession.