Diary of a (secondline) clinicianOne of the many ways in which organisations have attempted to slow the spread of COVID-19 is by preventing the entry of the people with active fevers from entering certain buildings. This is largely achieved through checking the temperatures of all who enter, barring entry to those who fail the thermometer's test. Of course there's a lot to say that this may be ineffective, due to the significant presymptomatic and asymptomatic transmission of SARS-CoV-2, the virus that has caused us so much pain these last few months. But this is not what I'm interested in today. "This is achieved by checking the temperatures of all who enter, barring entry to those who fail the thermometer's test." My hospital has been no exception to this, closing all but two entrances and stationing a nurse and security guard at each armed with infrared forehead thermometers, cool demeanours, and eerily identical small-talk repertoire: "Staff or visitor?" "Staff" [waving my tag] [reading the thermometer] "All clear, have a lovely day!" "You too!" Of course this bottleneck to entry meant lines of up to 30 people during peak hour waiting to be scanned to get in. It was a rare day indeed when I didn't overhear someone nearby in the line (spaced by social distancing markers on the ground 1.5m apart of course) make a joke about needing Aldi checkout operators (the German supermarket chain renowned for its ruthlessly efficient checkout system). "a nurse and security guard at each [entrance] armed with infrared forehead thermometers, cool demeanours, and eerily identical small-talk repertoire" This was, until one day two weeks ago, when despite arriving at work at my usual time there was almost no one in line. The reason became clear when I had to choose between two thermometer armed nurses (I chose the one on the Right because just like the right main bronchus she was more directly in line with my path, I daren't say whether either of the other two comparative features of the Right vs. Left main bronchi were present). What a great idea I thought, double staffing at peak times to manage demand, who could have thought such a thing possible in a public hospital? "despite arriving to work at my usual time there was almost no one in line" So imagine my surprise when last week my traversal of the hospital entrance was as unimpeded as a Livian's travel to contiguous Spain. A questioning glance at the lobby now devoid of nurses and manned by a lone security guard was met with a gesture upwards and a muffled phrase through his facemask "Infrared mate". Now this was technology! Sure Singapore's Changi airport's been doing it for at least 10 years from what I remember of transits through it, but even so, unencumbered entry and protection from febrile people couldn't be any better than this. It wasn't until the third day of this that I overheard a nurse at the visitor registration bay, at which of course I'd never had to stop, mention that her colleague had picked up some screening shifts at The Austin, a nearby tertiary hospital, because "we had no work for her anymore". And there it was, in the space of a few weeks we'd recapitulated hundreds of years of human history. A new market identified, technology invented to service it that requires labour, rural to urban migration to provide the labour, boosting productivity, then further technological advancements that disrupt the industry and obviate the need for labour at all. Or perhaps I was reading too much into things, a fever dream. Maybe those infrared thermometers need checking...
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