Written by Michaela Abela

With the arrival of the COVID-19 vaccines in Malta, came the need for trained individuals to distribute them to the population. With the hands of most medical professionals being full with the ongoing pandemic, the health authorities turned to medical students to help out. As always, the Malta Medical Students’ Association (MMSA) with great responsibility, keenly accepted this request and quickly gathered and is coordinating about 170 medical students who were very eager to help out with this vaccination process.

Medical students across all 5 years, are currently volunteering at vaccination hubs at the University of Malta, MCAST, SCSA St. Venera, Naxxar and Aurora Gozo.  Here, the students are under the guidance and supervision of various medical professionals and entrusted with various roles including the preparation and administration of the vaccines and vetting of patients. Students have the knowledge to answer questions posed to them by the public, debunk some myths and give reassurance about the safety of vaccines.

Vaccination Process

In preparation, students were given access to an online training course to provide them with more information regarding the vaccine, its preparation and administration. This was  then further strengthened with in person training and supervision to ensure everyone is sufficiently trained to safely administer the vaccine.

For some time, a number of preclinical medical students were also helping out at Mater Dei hospital with some administrative work and in other areas as required.

Sharing Experiences

Coordinating such voluntary opportunities takes lots of time and effort to organise and carry out, however, we are very grateful for them and are always more than happy to support the health authorities in any way, wherever possible. The response from students for such opportunities is always overwhelming so we asked two students to tell us all about their experience.

Sam Fleri Soler- 4th Year

After my great experience last year at the COVID Helpline, which was equally as fun and fulfilling, as the new opportunity to volunteer at the vaccine hubs was announced, I definitely did not think twice before signing up. Prior to starting, we were given access to online training which thoroughly explained how to prepare and administer the vaccines, which was then strengthened by training given by experienced tutors during our first shift. This opportunity has been very satisfying since we are directly involved in the whole vaccination drive and are helping hundreds of people per day to become vaccinated. Besides this, it has helped me to further improve my communication skills, practical skills and especially my ‘bedside manners’ when dealing with people who are afraid of needles or debunking myths that people have read online and putting their minds at rest. All in all it has been an invaluable experience so far and I am looking forward to the shifts to come.

Gerard Zammit Young – 1st year

After MMSA introduced us to an opportunity to volunteer, I felt a sense of duty to help out. From helping with administrative work behind the scenes, to administering the vaccines myself on the frontline, I feel that this opportunity has taught me valuable lessons in working in a clinical environment. With the training given and constant supervision provided during the vaccination process, as well as the buddy system introduced, I felt quite prepared to give the vaccine. As a pre-clinical student, the chance to come in contact with patients at such an early stage has greatly improved my communication and people-oriented skills, all while fulfilling a duty to help out during this once in a lifetime situation.

Concluding Words

MMSA has been helping out through such voluntary opportunities since the beginning of the pandemic in Malta. Over the past year, we helped out at the 111 helpline, 112 control room at Mater Dei, Situation Monitoring at MDH and also at swabbing centres.
(Michaela Abela, Jonathan George Grima and Gerard Zammit Young are coordinating the vaccination voluntary opportunity for medical students.)

More on MMSA’s COVID-19 Volunteering Experience here!

(Photo courtesy of MMSA)

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Written by Karen Louise Stoner

Laundering is essential to stop our clothes from becoming vehicles of infection transmission. Textiles are used throughout a hospital setting. Be it as a uniform for practioners, bedding, patient gowns, towels, and many other uses. It goes without saying that with exposure on the daily to different pathogens, textiles become contaminated.

Cause of infectious disease to healthcare professions lead by the hospital environment is the third leading cause of spread. According to a scientific review of 1,022 outbreak investigations throughout hospitals. this includes hospital linen and healthcare worker uniforms.

In the midst of a pandemic, healthcare professionals have a duty, to take extra caution not to further spread infection. Having such close contact with patients, the Faculty of Health Science and allied health care workers are all taking extra precaution to protect their uniforms. They keep them solely for their place of work for their protection, the patient’s and the community. However, there are other infectious diseases that they are protecting the community from, not just COVID-19!

How is Infection Spread?

Healthcare workers come into contact with blood, skin, urine, and many other bodily fluids and tissues. These substances contain a high number of microorganisms which inevitably contaminate such textiles due to the nature of close contact.

In studies by Fijan et al., (2005), Perry et al., (2001), Hota et al., (2004), after laundering hospital worker uniforms, traces of surviving microorganisms were still found including MRSA and Acinetobacter baumannii, and many more.

MRSA

MRSA is one of the most commonly spread microorganisms through clothing. It is a branch of staph bacteria, resistant to many antibiotics making the spread difficult to control and infection difficult to treat. It is spread by skin to skin contact and touching contaminating objects. Thus, making it easy to transmit via clothing.

How to Launder Potentially Infectious Textiles

Detergent and laundry additive can be used for effective laundry procedures. The water temperature should be the warmest that the textile’s instructions allow for (never below 60˚C.) If HCPs wash their uniforms at home, Riley et al. recommends washing uniforms separately from other clothing items and after every shift. You can minimize further spread of infections by always carrying out proper hand hygiene, another vehicle for the fast transmission of infection.

Conclusion

Whilst all healthcare workers wear their uniforms with pride, it is essentially a protective barrier to all the aforementioned microorganisms. The pride that a uniform can bring to a job should be mirrored both in the way that the HCP works and the way they act responsibly in the community.  Nosocomial infections (hospital acquired infections) take up a permanent residency in the hospital. It is up to the dutiful healthcare worker to diminish all risks to the best of their ability for them, for me, for you.  

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Written by Jessica Bonnici

When the COVID-19 pandemic hit home, the Malta Medical Students’ Association received a number of requests from the health authorities to help out in various areas, both inside and outside Mater Dei Hospital.

MMSA accepted all these requests willingly and whole-heartedly as we felt it was our duty as medical students to contribute to this world-wide fight.

The response received from our medical students when these volunteering opportunities were shared with them was truly overwhelming and we asked some of them to share their volunteering experiences.

111 Helpline

Around 150 medical students here acted as 2^nd line callers. They would receive details of people with a medical query, call them back and take a proper history. Then, after discussing with doctors, they would inform the person whether or not to go for a swabbing test and advise accordingly.

Once MMSA informed us of the possibility to volunteer at the helpline, I immediately signed up and offered to work as much as possible. I volunteered for many hours at the call centre and I even did a couple of night shifts. This experience gave me an opportunity to improve my communication and history taking skills, all while getting great satisfaction of helping out during such difficult times

Samuel Fleri Soler, 3^rd year

When MMSA contacted us with an opportunity to volunteer and help out, applying was one of the easiest decisions I’ve ever made. From helping confused citizens to talking to those who are lonely, I got the opportunity to not only help others but to help myself as it got my mind off the negativity of the situation

Julia Zahra, 3^rd year

112 Control Room at the Emergency Department

Here around 45 4^th year medical students helped answer emergency calls in the 112 control room. Medical students assist the nurses who take these calls and are asked to input the data given by the caller into the 112 system and dispatch an ambulance according to severity – blue, orange, or red codes.

“The moment University announced it will be closing its door for the foreseeable future, I instantly felt a sense of claustrophobia and helplessness since as a fourth-year medical student, there was not much I could do to help but stay at home. Therefore, when there was a call for volunteers, I did not think twice before signing up.”

Martina Spiteri Bailey, 4^th year

“I chose to volunteer as I felt that my contribution to society as a medical student during a pandemic was a once in a lifetime opportunity. This experience taught me that in such difficult times it is essential to remember about the people who have other conditions and other needs.”

Rachel Hammett, 4^th year

Situation Monitoring

The role here is to daily update a live dashboard used at Mater Dei Hospital with new data received regarding the number of swabs carried out, and which of these were positive on each particular day.

“As preclinical (second year) medical students, we chose to volunteer as we felt that it was our duty to help the health care system during the COVID-19 pandemic in any way we could. Our role was to set up an efficient Excel template, as well as a step by step set of instructions which other volunteers can use to help us analyse the new data received and update this dashboard.”

Elizabeth Grech & Katya Bartolo, 2^nd years

Gozo Swabbing Centre

Medical students here undertake administrative roles and sometimes assist in the actual swabbing wearing the required PPE, under the guidance of doctors.

“When the COVID-19 outbreak arrived in Malta, a sense of frustration began building inside of me as I thought of the hundreds of healthcare workers on the frontline whilst self-isolating within the comfort of my home. The opening of the swabbing centre in Gozo gave me and fellow Gozitan medical students Elyse Mercieca and Matthew Tabone the opportunity to humbly offer our contribution in this fight. It felt immensely gratifying to give something back in these challenging times as part of a dedicated team working towards a common goal.”

Peter Sciberras, 3^rd year

Something a little different from what has been described above, and which surely shouldn’t go unnoticed, is The Diacono Family Project initiated and run by one of our own, Michael Azzopardi.

“Considering I come from a family of chefs, and my grandmother is an incredible inspiration, I decided to channel her passion for cooking. I started contacting family and friends and before I knew it I had a bunch of talented home cooks and professional chefs ready to prepare hundreds of meals in an instant. I set up a schedule where I would pick meals up and deliver them to Mater Dei hospital 3 times a week. I never expected to grow so fast, but over the span of 3 weeks we managed to deliver over 450 meals to healthcare workers. A big thank you to my family, friends, AMC, Victory Butcher, Manouche, Father Claude Portelli and most of all my amazing grandmother, who continues to cook and inspire at the age of 92.”

Michael Azzopardi, 4^th year

Although each and every one of the volunteering opportunities requires time and effort, both to plan and to actively carry out, as a medical students’ association we were and still are more than happy to offer our contribution and support to the health authorities in any way that we can.

Here, we would like to take the opportunity to thank them for giving us such opportunities as well as thank all the healthcare workers for their admirable commitment and courage in the fight against COVID-19.

cover image: source

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Written by Daniela Chatlani

The WHO (World Health Organisation) declared the COVID-19 virus to be a pandemic on 11th March 2020. The internet is the source that most people are referring to during the crisis. While there are reliable sources, there are also sources that hold misinformation and it can be seen that some people are still struggling to differentiate between the two. But what is actually the Coronavirus?

Coronavirus is the name given to a family of viruses. This particular strain at the centre of this pandemic was discovered in 2019 and is known as SARC-CoV-2. The disease that is caused by this virus is known as COVID-19. However, Coronaviruses usually don’t cause severe symptoms (e.g. high fever, shortness of breath) in humans but only mild symptoms (e.g. runny nose, sore throat, cough, congestion). As can be seen, the symptoms normally given sound very similar to the common cold, however, these two are unrelated as the common cold is caused by rhinovirus, which comes from a different family of viruses. COVID-19 isn’t the first strain to give fatal symptoms. The SARS outbreak in 2002 was also part of the Coronavirus family.

COVID-19 has been reported by the WHO to have a fatality rate of 3.7%. However, this could actually, in fact, be lower as there may be many asymptomatic carriers of the virus who continue living their lives normally without reporting. 

How does SARS-CoV-2 cause disease?

Viruses cannot live on their own, they require a living host. The SARS-CoV-2 attaches itself to the cells, usually in the lungs and enters them. In the cell, the virus is able to replicate, using the cell’s own machinery, and create more copies of itself. The viruses are then released from the cell, destroying it in the process.

The body can detect damage being done to its cells and so an inflammatory response occurs in the region of infection. As a result of the inflammation, the capillaries surrounding the infected site will become more dilated, stretching the cells making up the capillaries, and forming spaces between the cell. Consequently, the capillaries become more porous and so plasma will flow out and fill the space between the lung tissue and the capillaries. The fluid surrounding the lung tissue will cause it to compress. As a result, air cannot fill the lungs properly and so the person will experience shortness of breath and trouble with breathing. 

The inflammation in the lungs will cause two things to happen. Firstly there is the destruction of viruses but also of other cells in the lung. Debris will settle in the lung which the body tries to get rid of by excessive coughing. Secondly, the chemicals released during inflammation will travel to the brain and cause it to raise body temperature, resulting in fever.

In severe cases, sepsis may occur. During sepsis, the blood pressure drops severely and so organs lose their blood supply, resulting in multi-organ failure and death.

Overall the most common symptoms seen in COVID-19 patients are:

• Fever
• New dry cough
• Shortness of breath
• Fatigue
• Muscle pain
• Headache

Some less common symptoms reported are:

• Diarrhoea
• Runny nose
• Nausea

Prevention of COVID-19

As the old saying goes, prevention is better than cure. The COVID-19 virus has a reproductive ratio of 2-3, meaning an infected person can infect 2-3 people they come into contact with. This can be decreased with proper preventative measures.

• Wash your hands frequently: The virus can spread via the faecal-oral route, meaning that after going to the bathroom, the virus can be on your hands which can infect someone. It is therefore extra important to wash your hands after using the bathroom
• Maintaining social distance: Stand at least 1 metre away from any person who is coughing. The virus can also be spread through sneezing and coughing, up to 1 metre away.
• Avoid touching eyes, nose and mouth: The virus can enter from these areas
• Cough or sneeze into your elbow: This prevents the virus from travelling in the air
• If you have been abroad or have come into contact with someone who has been abroad, please quarantine yourself for 14 days: If you have been infected the symptoms may take up to 14 days to start manifesting

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Those enrolled in medicine, nursing, pharmaceutical, applied biomedical, physiotherapy, chemistry, and radiography courses have all been contacted to see how they could be of assistance. The work requested of them varied from assisting at Mater Dei Hospital or helping with 111/112 Helplines.

Medicine students have been approached to help with 3 main things on a voluntary basis, MMSA board members informed The Third Eye. MMSA were asked to gather volunteers to help with the 111 Helpline as well as the 112 Helpline (since officials expect the number of calls to increase). Medicine students, mainly 5th years’, have also been asked to aid at the swabbing center.

MHSA executive members also informed us on the number of students called to help from health science courses.

Nursing students from both second and third year and both diploma and degree courses have been called in to be employed on a part-time contract and are paid at varying rates each. The contract is ulterior to the students’ studies and does not contribute towards placement hours.

Applied Biomedical, Physiotherapy and Radiography students were also asked to help on a voluntary basis, be it in labs or on the 111 helpline. Finally, pharmacy students were also approached via an email sent on 15th March to the pharmaceutical technology students requesting them to help prepare mixtures of handrub at Mater Dei Hospital.

Malta Chamber of Pharmacists have issued the process that needs to be followed by the students assisting in this situation.

Whether students are paid or otherwise, the hours spent helping will not be compensated as placement hours.

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Written by Ms. Gabrielle Grixti and Ms. Daniela Chatlani (SCOME Team)

On the 20th of February, SCOME, the Medical Education Standing Committee within MMSA, organised their annual Research Conference. Over 100 members of MMSA were present, showing enthusiasm for their own search for research!

There were various sessions within this conference, delivered by a series of professionals. The first speaker was Prof. Julian Mamo, who gave a short introduction as to what research really is, and then gave a very interactive session regarding Case-Control Studies. He encouraged all the students to find their own personal area of interest within the medical field and start their own research projects, to start branching out into the world of research.

Dr. Beatrice Farrugia then spoke about what Qualitative analysis is within research, by giving us a series of examples and sharing with us novel studies. Following this, there was an interactive workshop conducted by Dr. Alexander Clayman, who explained what Ecological studies are. He then provided the students with a series of case studies, to analyse the best research techniques which should be used if they were conducting the research study.

The Minima Medica magazine

One of the highlights of SCOME’s Research Conference was the official launch of the Minima Medica magazine.

Minima Medica is MMSA’s research journal, which was revived this year, the last edition being that of 2016. This magazine acts as an opportunity for medical students to start branching out into the vast field of research. The magazine consists of both literature reviews and clinical cases.

This magazine will be published on HyDi to be made available for all university students to access. Having Minima on HyDi makes it recognisable for the FY program, which is excellent for the students who took part.

The editors of Minima described the lengthy process of the magazine. Every author who wrote an article for Minima gave a short 5-minute presentation describing the research that they conducted, how they wrote their paper, and why they choose that field, to engage the rest of the students present. The students also had the opportunity to ask the authors questions about their work.

To access our Minima Medica 2020 Magazine, click here.

Congratulations go to the writers for their dedication:

• Ms. Charmaine Cordina
• Mr. Miguel Vella
• Dr. Kimberly Hallett
• Ms. Gabriella Debono
• Ms. Hannah Xuereb
• Mr. Adam Al Gededi
• Mr. Mark Miruzzi.

A SCOME and SCORE collaboration

During the Research Conference, there was also a collaboration of SCOME with the Exchanges-Out Team regarding Research Exchange (SCORE) opportunities for medical students. Students who have gone on exchanges in the past few years shared their experiences to encourage students to go on such a great learning experience. Finally, the Intercalated Year was discussed by Mr. Peter Sciberras, where he shared exactly what this additional year as part of the medical course entails, and shared his own experience, about how this year provided him with the opportunity to conduct his own professional research in Malta.

The conference was a great success, and we hope that all those who attended were inspired and encouraged to become more involved in research throughout their years as medical students and their professional lives. Research truly is a tight rope walk, but no rewarding challenge is ever easy.

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