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Christian Wejse: A diary from the front line

It does not seem to matter where Christian Wejse looks, because all he seems to see is COVID-19 written in capitals. He is an associate professor at the Department of Public Health and also specialty registrar in infectious diseases at Aarhus University Hospital, and here he reports from a week where he has – as a medical doctor, researcher and now also expert in the media – attacked the corona pandemic from different angles.

 

Monday 20 April: Infection at the department

Today I have been the on-call doctor at the Department of Infectious Diseases at Aarhus University Hospital. I have answered telephone calls from other doctors in the hospital and in the region; some of them have been to do with COVID-19, others about completely different things. In fact, we do not have that many corona patients admitted to the department. We are a long way from our maximum capacity. Even though we have had some very serious corona cases, things have not gone as badly as we could have feared. On the other hand, one of our regular nurses is unfortunately infected with COVID-19, which is somewhat of a surprise to us. She is the first. Now we are looking into who she has been working with, so that we can track and stop any possible chain of infection. So far, no one else has any symptoms.

I have also been tested for antibodies. This is done by using a blood sample to drip a few drops of blood onto a kind of pregnancy test. I have not formed antibodies so I have not been infected with the coronavirus. Neither have I been ill, so that is what I expected, but it is still nice to get clarification. After all, we have heard of atypical cases and infection carriers who were mainly healthy.

 

Tuesday 21 April: Testing the homeless at Sumatravej

The weak and vulnerable in society have a special place in my heart. Over the last couple of weeks, we have been testing homeless people in Aarhus for corona, and today one of my PhD students was at the centre for drug and alcohol addiction at Sumatravej. The homeless are a particularly vulnerable group, who are often in poor health but are rarely in contact with the healthcare system. They cannot stay at home like we have been asked to, and they have poor hygiene – sharing a joint and drinking from the same bottle. This means that the corona epidemic can really hit them hard, and that worries me.

We tested fifty homeless today and have tested three hundred all together. All the tests have been negative, which is very positive. It is a fantastic project to be involved in. The cooperation between the City of Aarhus and Aarhus University Hospital works well, and I have taken the opportunity to include it in my research, so that we also systematically collect data when we test the homeless.

 

Wednesday 22 April: A chance to work on some research

Today I have a research day. I have spent time reading articles and following up on the new guidelines. I have also had supervision with a couple of students who are going to write a Master's thesis about COVID-19. It will be a study of literature on the clinical presentation of the disease with studies from all over the world. I have also had a meeting with a PhD student who had to put her research on hold because she was going to take part in the corona emergency response effort. Now she is back, but her intervention project on HIV-infected immigrants cannot really be resumed, because many activities in the outpatient department at infectious diseases have been closed down. We discussed how she should deal with this.

At Hvidovre Hospital, they have seen an unequal distribution of Corona patients. Here, a larger proportion of those infected have another ethnic background than Danish. We have not seen any obvious signs of this in Aarhus, but it is a relevant area of focus and it is important that we collect data. We have therefore established a little research project with two Master's thesis students. So one thing we can say is that the COVID-19 pandemic generates many exciting research projects.

 

Thursday 23 April: Journalists call – again

I have spent much of the day talking to journalists. I actually do this every day. During the last month I have probably talked to an average of five media outlets daily. From newspapers to television and radio including Berlingske Tidende, P3, Zetland, TV2, Jyllands-Posten, Radio4 and Ultra News on DR. The journalists have a fundamental difficulty understanding what a strategy is, and why there is such a big difference between Denmark and Sweden and the rest of the world. Global health is my field of research, so I am very happy to contribute with my knowledge. At the same time, the mathematical models have come into play during the corona pandemic. I have just started working on these following a period of study in Melbourne, so I also think that many of my colleagues refer journalists to me for this reason. Which is completely okay. I am happy to be interviewed, even though the whole experience has been really crazy. I have never experienced anything like it.

 

Friday 24 April: Holiday – but not completely

I am actually on holiday, but I have not left work completely behind. For example, I have prepared some teaching for the staff in the intensive care department who have a number of patients with COVID-19. Naturally, they have a lot of questions about things like the risk of infection and testing. I am really proud of our collaboration with the intensive care unit, and very pleased to see how well patients who have been transferred to intensive care are doing. In China, the mortality rate in intensive care was fifty per cent. It is far lower here.

Generally speaking, we have had very few infected people in the City of Aarhus with 301 positive tests since February. That is far fewer than I had expected. At the beginning of the epidemic, I feared that this would be extremely serious with many tourists returning from skiing in Austria with symptoms, and that we would end up with conditions like we saw in hospitals in southern Europe. Which would have happened if we had not closed everything down. The containment strategy worked. I am also very comfortable with the reopening of society. We are sending healthy children back to school, the healthcare system can keep up, and we are doing more and more testing – and fortunately, we are finding fewer and fewer infected people.

 

Weekend 25-26 April: A question of conflict of interest

I usually wake up early, around 5:00. Then I spend an hour on the computer before the family wakes up. Also at the weekend. I have spent a lot of time on a front page article for the Kristeligt Dagblad newspaper. The journalist wanted to know whether I was an adviser to the Danish Health Authority, and therefore had a conflict of interest as a researcher, because I have often made very positive comments about how the Danish Health Authority has dealt with things. The Danish Health Authority has received some political criticism for shifting strategy announcements, but in my opinion they have done things in the right way.

However, last week I had to declare a conflict of interest. I made some comments in the media about the reopening of the Danish continuation schools, which I thought was justifiable and actually also a good idea. But I also have a teenager at home who cannot wait to get back to continuation school. That kind of situation can cloud your judgement a little, but in the case of the Danish Health Authority, they have never actually asked me for my advice.

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