Assiut University has entrusted intensive care units to a very large number of its doctors to provide all means of care for patients in the region. Assiut University Hospital played a major role in combating the pandemic and reducing the number of new cases. The number of care beds in the clinic was approximately 30 beds, supervised by anesthesiologists, who spared no effort to provide all means of care for patients. This intensive care was supervised by a number of specialists from the Department of Anesthesia and Intensive Care. Assiut University Hospital provided all the agreed-upon medications according to the international medical protocols in treating cases.
About 70 doctors from the Department of Anesthesia and Intensive Care at Assiut University Hospital participated in this great work. COVID-19 cases continue to overload the emergency rooms, in-patient rooms, and ICUs, thus overwhelming the healthcare resources. At those challenging times of uncertainty, the world desperately saw anesthesiologists as airway experts, respiratory physicians, and intensivists, and even led them to assume leadership roles amid unknown and unclear scenarios, in addition to doing their conventional roles as perioperative physicians.
Having a vast skill set, anesthesiologists are extremely valuable to the COVID-19 management team, but the procedures they perform also make them face dangers (endotracheal intubation, open suctioning, and nebulizer treatments, which generates the highest risk for droplet exposure). Moreover, the emotional talks they have with patients whose families are not allowed to visit, family discussions on end of care- life goals, and the risk of contagion to their own family members are all emotionally draining and certainly take a toll on anesthesiologists. The heavy workload and discomfort of wearing personal protective equipment for long durations make the situation worse. However, anesthesia colleagues have connected globally through social media and new videoconferencing technologies to share information, offer advice and support, which is commendable.
As more COVID-19 patients required ventilatory support (high-flow oxygen therapy, non-invasive ventilation, invasive mechanical ventilation, and extracorporeal membrane oxygenation), there was never a dearth felt this badly of anesthesiologists. Even freshly passed anesthesia residents are coveted, which only accentuates the importance of the specialty. This pandemic has laid its shadow on the current practices: frequently changing protocols, newer equipment, use of PPEs, induction of telemedicine in pre-anesthesia evaluation and pain clinics, use of video laryngoscope with replaceable blades, and regional over general anesthesia are the new normal. Role of anesthesiology societies and organizations has also broadened: formulating protocols, testing of newer equipment, conducting informative webinars, and dissemination of information using various social media platforms and journals, along with providing psychological support for front-line anesthesiologists.
Many anesthesiologists assumed leadership roles at various institutes around the globe: occupying roles that did not exist before COVID-19, solving problems that we have never faced before, developing clinical innovations, supporting each other, and setting up new patient care services in record times. Anesthesiologists are also working on ground zero, at various containment zones, quarantine, and isolation centers, providing basic and necessary emergency care. The challenges thrown by the pandemic were bravely met by anesthesiologists; their hunger and interest for learning about COVID-19 became so evident, and when the American Society of Anesthesiologists recently released a new COVID-19 program on its website, the site crashed temporarily because of the overwhelming number of members trying to access it. Anesthesiologists are at the forefront of the public health crisis. Hailed already for their critical role across the spectrum of patient care, and the leadership potential locally, nationally, and globally, anesthesiologists have indeed achieved prominence.
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