Rizal Faisal

As the second wave of the COVID-19 outbreak in the country began to gain momentum last year, the Ministry of Health (MoH) called for retired doctors and private healthcare practitioners to take part in the pandemic response.

Dr Faye Idris, a senior assistant professor in Clinical Academia at Pengiran Anak Puteri Rashidah Sa’adatul Bolkiah Institute of Health Sciences (PAPRSB IHS), Universiti Brunei Darussalam (UBD) was among those who stepped up.

“Most of the doctors of PAPRSB IHS, including professors who have been out of clinical practice, were more than happy to help,” she said.

She felt it was a duty to participate in pandemic response because it is a professional obligation as a doctor to render aid in times of crisis, as well as to show solidarity with others in the field. “It is only natural to feel responsible for our patients,” she said.

In late August of 2021, PAPRSB IHS, UBD became one of the vaccination centres in the long fight against the second COVID-19 wave.

“The most effective way to combat the COVID-19 pandemic is through mass vaccination,” said Dr Faye. Thus, the medical school found itself playing host to those wanting to get their shots as the efforts to inoculate the entire Brunei population intensified.

“PAPRSB IHS proved to be an ideal centre for vaccination due to its strategic location, qualified staff, available space and facilities.

“We received vaccine supplies, equipment for storage and consumables from the MoH in addition to certain medical equipment and medications,” she said, adding that all team members, including non-medical personnel and students, worked together to ensure that the vaccination centre ran smoothly and effectively.

Bru-HIMS support and access was facilitated by the MoH, with technical expertise from the Information Communication Technology Centre in UBD, staff and students from the university and Politeknik Brunei were quick to volunteer for tasks ranging from patient screening and registration to data entry, while the doctors, pharmacists, nurses, paramedics, IT technicians, security and estate personnel were designated to their professional roles.

Dr Faye was one of the nine doctors who volunteered at PAPRSB-IHS vaccination centre.

“We provide clinical expertise in the assessment of patients’ suitability in receiving the COVID-19 vaccines offered, specifically their indications or deferments of vaccinations, by consulting the patient and cross-checking patients’ health information in their records from Bru-HIMS,” she said.

Such assessment was important to determine patients who were contraindicated to receiving vaccines, such as those with acute illness, Guillain-Barre syndrome, and those who had solid organ or stem cell transplant within the last three months, she said. They also turned away patients who had a medical history of allergies and have had to be referred to the hospital to receive their vaccinations.

Other common encounters of people who are not able to be vaccinated normally included patients with cancer, cardiovascular diseases, autoimmune diseases, immunocompromised states, patients on warfarin, blood-thinners, hormonal therapy, immunosuppressants
and chemoradiotherapy.

Dr Faye said doctors at the vaccination centre worked closely with nurses and paramedics to watch for patients requiring medical attention, particularly post-vaccination.

Some needed to be referred to the hospital for further management, she said.

Each day, four paramedics, who are also qualified nurses, were placed on duty in the treatment room and observation area of patients. The treatment room was equipped with essential medical equipment for vital signs monitoring as well as support facilities such as intravenous fluids and medication.

“We noticed a common occurrence of symptoms such as syncope, dizziness, headaches post-vaccination, which can be a psychogenic response to needle injection or immediate effect of the vaccine, while a few cases developed neurological signs such as visual disturbances and paraesthesia,” she said.

“For most cases, we managed them adequately in the treatment room of PAPRSB IHS vaccination centre as most of the patients recovered after rest and stabilisation of their vital signs, and referred those who required follow-up in their clinics. We also reported these symptoms to MoH,” Dr Faye said.

She added that doctors also administered the COVID-19 vaccinations to patients when needed. This was particularly important when it came to special needs individuals.

To facilitate those with special needs, she said the centre worked together with other stakeholders to allow those in this group to come in as walk-ins, prioritise their arrivals and their registration process.

“We administered the vaccinations in private areas, as more time was required to coax them into vaccination or to give allowance for sensory modifications they may encounter
during vaccination.

“From my experience, communication skills and reassurance are important to ensure they are comfortable and consenting of the administration of the vaccine, as special needs individuals can get quite anxious prior to the procedure.

“This occasionally required distraction techniques or gentle restrain to ensure the vaccines were administered safely,” she said.

Overall, Dr Faye had found the experience rewarding, and that working at the vaccination centre allowed her to reinforce the important altruistic values as a clinician.