Manveer Rahi
Manveer Rahi is a junior doctor at the Western General Hospital in Edinburgh, working in colorectal surgery. He has previously worked at the Royal Infirmary of Edinburgh in cardiothoracic surgery. He also sits on the Management Board for Trainees in the Lothians, representing approximately two to three hundred doctors in the South East of Scotland.
Details
- Date of interview: 9 October 2020
- Archive reference: RCP/RES/2/12/12
- Interviewer: Daisy Cunynghame
Timestamps
00:38 - The effect of coronavirus pandemic on working hours and practices
03:45 - Comments on availability of medicines, medical equipment, and Personal Protective Equipment (PPE)
04:50 - Comments on how the pandemic affected role on Management Board for Lothian Trainees
10:07 - Complexities of treating coronavirus patients
12:51 - Complexities of treating patients with non-coronavirus health concerns during the pandemic
16:30 - Thoughts on the long-term impact of the coronavirus pandemic on medicine, surgery, research and development, and use of technology within the NHS
21:15 - Government response to the pandemic
24:39 - Public response to the pandemic
27:26 - Personal experiences of friends and colleagues contracting coronavirus
30:30 - Effect of the pandemic and lockdown on home-life routines
32:18 - Comments on wellbeing and mental health support for medical professionals during the pandemic
37:58 - Views on finding information surrounding the pandemic
40:47 - Closing comments on the importance of hearing stories about working and living through the pandemic from differing perspectives
Transcription
Interviewer:
So, if you could start off by please introducing yourself? Just telling me your name, your college membership status, your medical specialty, and where you work.
Manveer Rahi:
My name is Manveer Rahi. I'm currently a doctor at the Western General Hospital. I've been working in surgery for the last year, that's been eight months of cardiothoracic surgery over at the [Royal Infirmary of Edinburgh], and the last few months at the Western General doing colorectal surgery.
Interviewer:
Thank you. I'm going to start off by asking questions about how coronavirus has impacted on you professionally. Can you describe how the coronavirus pandemic has affected your working hours and your practice?
Manveer Rahi:
Sure. It's been quite variable actually. Between March and April I found the intensity of work and the working hours decreased dramatically. It's probably different to some other people, but I think that's mainly due to the fact that I was working in a surgical placement. I think if you spoke to my medical colleagues, they may have been more busy. So, during that initial period we were cancelling a lot of elective operations and therefore it had a knock-on effect of reducing our workload and we didn't really know how to fill the beds that we had or the time that we had. There was a bit of a vacuum there essentially with that time, but what we did end up moving to is we ended up becoming a respiratory ward. Because we were a cardiothoracic ward and our nurses were used to looking after kind of respiratory type patients, and because of the thoracic perspective of cardiothoracic surgery.
So, we actually became a respiratory ward, but we became a ‘clean’ respiratory ward in a lot of senses. We were looking after the respiratory complications outwith COVID. patients with asthma exacerbations, COPD exacerbations, pneumonias that were not related to the coronavirus pandemic. That was really between April and June we started to get a lot more busy as we turned into a respiratory ward and we had to look after a new challenging set of patients. It also put in an additional element of stress because I wasn't used to working with these patients who really just tended to get really quite sick much more quickly than the surgical patient that I was used to. And then kind of moving on into July and August we restarted most of our elective operating again, almost back up to pre-COVID levels, and so we phased out all of the respiratory patients and the respiratory ward and we became much more of a cardiothoracic ward once and again.
In terms of my practices, I ended up taking a lot more medical jobs. So, I ended up covering respiratory doctor's nights because what happened in the Royal Infirmary is that the second floor of the hospital became a purely COVID ward and the first floor—which is where I worked on—was the ‘clean’ ward. So, these were any patients without suspected coronavirus and all of the surgical wards tended to be there as well. And so, because a lot of respiratory doctors were moved up to the second floor to deal with the onslaught of the coronavirus pandemic, we ended up taking on a lot more respiratory nights in ‘clean’ wards.
Changing practices, so things like new PPE (personal protective equipment) requirements. At the start, [there was] a lot of mixed messages about PPE. Initially, no PPE was required, and then it became gloves and masks, and then now we've kind of moved on to gloves, masks, and apron for any kind of clinical environment. FFP3 (a kind of face mask), which was all over the news, that is now required for all what we call aerosol generating procedures. Between March and May, there was conflicting guidance about what was an aerosol generating procedure, as we found the boundaries and the evidence came out for what an aerosol generating procedure was. So, as our evidence developed, our PPE requirements also developed.
A nice change was transitioning to wearing surgical scrubs all the time. It's essentially like wearing pyjamas to work. It's fantastic, I would recommend it to anyone. So, I've essentially been working in pyjamas for the last 12 months, which has been great. From the management perspective, I sit on the management board for the Lothian trainees. So, I'm the representative for something like 200 or 300 doctors in southeast Scotland, and I sit on the management board for parts of the hospital. We increased our meetings for the Lothian trainee’s management forum from monthly to fortnightly. We were trying to push out things like wellbeing boxes, advocating for more rest spaces. We were increasing our hand washing and increasing the need for things like improved hand care in hospitals. So, there was a huge change to practice, from the very microscopic stuff all the way up to big organizational changes.
Interviewer:
Thank you. My next question you've touched on a bit already, but I'll ask in case you have more that you'd like to say. Have you experienced any shortages of medicines or medical equipment, including PPE? And if not, do you have any comments on the shortages that are being discussed more generally?
Manveer Rahi:
I'll touch on medicines first. At the start, before we really knew how bad the pandemic was going to be—so this is probably around mid-March time when the pandemic first started—we were told to rationalize things like paracetamol. So, paracetamol is commonly used for patients with fevers because it brings down their temperatures and reduces the potential side effects of having a high temperature. The thought of that is that we were really worried about the supply chain for paracetamol, most of our paracetamol comes from the Far East, particularly in China. We thought if there [were] local lockdowns or even a nationwide lockdown in China, that would affect the supply of paracetamol coming into the UK or into Lothian at least. Therefore, we were trying to conserve paracetamol for patients with simple pain that could be managed with other things like ibuprofen or codeine, and we were thinking about maybe saving those patients with fevers. That's probably the only medicine that I can think of in terms of shortages.
Actually, saying that there was a shortage of anaesthetic gases at one point, maybe not just in Lothian, but also in the UK, because we had a huge number of patients on ventilators. And those patients essentially need to be sedated and ventilated. So, we were running out of kind of common anaesthetic agents, propofol or anaesthetic gases. And there were some nationwide shortages of those for a wee while.
Now, I don't think I was ever really affected by shortages of PPE. I think the one thing I have to say is that for things like FFP3, I think the supply chain for that has been constantly evolving. So, to have an FFP3 mask, you have to go through a process called face fitting. Now, face fitting is where you wear a mask and there's a number of different ways that they can do it. But essentially, they're looking at whether any air from the outside is able to escape the seal around your mouth and nose. So, it's not a particularly pleasant process to go through, but it seems even to this day, actually, that the supply of FFP3 masks was changing constantly. First, it was the 3M masks and then it went to a different type of mask. What this meant was that actually you are only licensed to use the particular mask that you were face fitted for. So, I was licensed for a particular type of 3M (safety equipment company) mask and that went out of production, or we stopped supplying it in Lothian two weeks later, which meant that I had essentially only been licensed for that particular FFP3 mask for two weeks. And since then I haven't been licensed for an FFP3 mask. So really, I guess it's a relative shortage rather than an absolute shortage in terms of those FFP3.
That's been slightly difficult because when you, when we have gone to work on night shifts, you have to be face fitted because there's a much smaller team in the hospital. And actually, if you don't have the right FFP3 equipment, when you get called to see a patient who is in respiratory arrest, such as COVID patients, they tend to be on things like high flow oxygen, which is an aerosol generating procedure and for that, you need an FFP3 mask. Or if they were to have a cardiac arrest, you need to have FFP3 on because CPR is again, an aerosol generating procedure. So, whilst I've never directly encountered the side effects of not having PPE, there has been the potential there that if I went to an arrest situation on a night shift, I wouldn't have appropriate equipment to go into that arrest situation.
Interviewer:
Thank you very much. Without giving names of individuals, can you think of any particular patient's experience that you could share that kind of exemplifies the impact of coronavirus?
Manveer Rahi:
Yeah, I was thinking about this before the talk and I think the best way to split it up is into direct and indirect. With the direct effects of COVID-this is something that I wrote about on my blog, which was a particular patient who was post-operative. I was working on an evening shift, it was just myself looking after the ward with a senior who's covering both an intensive care unit, a cardiothoracic [high dependency] unit, and the cardiothoracic ward as well. Now the patient was on the cardiothoracic ward, and they started to develop a worsening respiratory picture. So, worsening respiratory saturations, increasing oxygen requirements, increasing respiratory rate, they became increasingly breathless, and I was more and more worried about them. I was asked to see them, I asked my senior to come and see them, and despite increasing oxygen requirements, they didn't really improve, their oxygen saturations didn't improve. Now I became quite worried about this patient, so I went in there, I gave them nebulizers to help remove any secretions, we got chest x-rays. We started taking arterial blood gases to look at whether the patient's oxygenation levels had changed within their blood, and they were within any particular type of respiratory failure. And despite being on the highest level of oxygen, so a 15 litre non-rebreather mask, this patient wasn't oxygenating particularly well after a few hours.
So, we had to call intensive care to come and see this patient. And it turned out that this patient had developed essentially acute respiratory distress syndrome. We took them to the intensive care unit, and they were developing fevers, worsening respiratory distress, and actually, it turns out that this patient had developed kind of coronavirus or some form of, essentially some form of COVID infection following surgery. Now that patient spent about two to two and a half weeks in intensive care. And it was really distressing to see because that patient went off so quickly. For me, as a junior doctor, it was incredibly scary, to see how quickly these patients can deteriorate. So that's the direct effects of coronavirus that I've seen.
Now there's been lots of indirect patients that I've seen. Again, I've written about them on the blog, and some of them have actually turned into case studies that I'm writing up for publication now, because actually we're seeing a huge amount of indirect consequences from delayed admission to hospital due to the pandemic. The most striking one was of a twenty-year-old girl who was admitted to A&E (Accidents and Emergencies) with a chest pain, shortness of breath, and pain in the arm and legs. She called NHS 111 ten days before, stating that she'd had some shortness of breath and some fevers, and they told her that she probably had COVID so to stay at home and to self-isolate. So, she self-isolated at home with her partner for about seven days and over that time developed worsening arm and leg pain. She spoke to the GP on the phone and the GP didn't really want to go and see this patient because she had respiratory symptoms and decided to prescribe this patient some codeine and some paracetamol, one to bring her temperature down and also to deal with the limb pain. So, this patient spent another four days at home and was admitted to A&E. At that point, she was admitted directly to intensive care with a cavitating pneumonia and an empyema. She was incredibly sick. She had she required intravenous immunoglobulin fluid resuscitation because she was hemodynamically unstable. Blood cultures on the second day grew a Group A Strep. And then ten days later, it was found that she had necrotizing myositis. Necrotizing myositis is incredibly rare, there are only about 100 reported case studies of it in the literature. And so, it's not a common thing that we see. But unfortunately, this patient needed five operations within five days to deal with both the cavitating pneumonia and to radically debride all four of her limbs, essentially. Fortunately, she's got preserved function in most of her limbs and she spent thirty-four days in intensive care and was discharged sometime after that. I spoke to her on the phone about two weeks ago and she's doing quite well, actually. She's in good spirits and I think most of the most of her recovery is down to a fantastic attitude.
There's been some other really interesting cases that I've seen. So that was it. The first case was on cardiothoracic. The second case that I'm going to talk about briefly is on the colorectal. It was a fifty-year-old with learning disabilities who presented with a perforated colonic tumour and necrotizing fasciitis. She had probably been sitting with this tumour for a long, long time and it perforated and it formed a huge abscess within her abdomen, which had essentially eroded through her skin and given her necrotizing fasciitis. And it was only picked up because she met with her social worker for the first time a few weeks ago, who saw the state of her abdomen and told her to go directly to A&E. She came directly to the operating suite at the [Western General Hospital]. And she's currently spent the last two weeks on intensive care. And so, yeah, those are some direct and indirect effects of COVID.
Interviewer:
Thank you. That was that was very interesting. And so, what do you think the long-term health implications of COVID might be? Do you have any thoughts on that?
Manveer Rahi:
I think there's going to be a few things. If we can break it down into the medical and surgical things. So, I think in terms of the medical things, there's going to be a lot more patients with complicated respiratory conditions from this long-term going forward. And we're going to need new services which are directed to deal with these patients. So, I do a lot of data work and research at the moment and currently I'm working on a project called ISARIC (global federation of clinical research networks), which is the UK's biggest prospective data set for COVID. So, we have something around 100,000 case-based data for patients. And one of the main things that we're looking at or going forward is going to be the rates of interstitial fibrosis, pulmonary fibrosis for these patients. We're going to need a lot more respiratory physicians or a lot more respiratory clinics to deal with the long-term effects of COVID. Again, we don't know all of the long-term effects of COVID. These are just hypotheses at this point. But I think there's going to be going to be the need for organizational change and restructuring of clinics to deal with this, the more long-term respiratory effects of COVID.
In terms of the surgical aspects, which is kind of where I've where my head's been at for the last twelve months, I can definitely see the effects of this. So, we have essentially cancelled the last six to eight months of elective operating across the UK, which means that we have relatively significant backlogs within the NHS (National Health Service) surgical backlogs. Minor operations have been delayed quite substantially in some cases and we're going to need increased surgical capacity to deal with that going forward, because at the moment, we're having to do much more deep cleaning of operating theatres between cases. Being intubated is an aerosol generating procedure, so the whole room needs to be cleaned much more thoroughly than it did before. That means whilst we have the same amount of time within the day to operate, we have fewer cases within the day, which means that actually we aren't dealing with that backlog as fast as it's coming in so that backlog is continuing to build up. And again, I think COVID also stunted research and development, there's been a lot of lost grants and a lot of research and study that's gone by the wayside because we've had to bring clinicians back from research. So, there's been a lot of research and development that is going to need to be picked up and grants going to need to be reapplied for, which is going to reduce the speed at which we have medical breakthroughs and medical research going forward.
There have been some positives, should we say, about the pandemic as well—that’s maybe—yeah, let's say positives. There's been the transition to using better technology within the NHS and I think that's one of the best things coming out of this. we still use fax a lot in the NHS, which I don't really understand why or how we do that, but we use with a single biggest user of pagers in the world and we're also the single biggest user of fax machines in the world. And the COVID pandemic has just forced us to transition into the 21st century with e-health and telehealth and virtual remote access clinics. So, we've transitioned much more of our clinics away from the traditional face-to-face clinics and much more to online virtual healthcare. I think that's positive because it means that we don't have patients coming into hospital during a pandemic. So, we have less mixing of people, which is great. It also means that it's much more remote for patients, which is better for access, but I think we also have to be cognizant that we might be widening health inequalities here because there may be patients who don't have access to the technology required for these clinic appointments. So, we need to be cognizant that actually you need time, technology, and a quiet space to attend an appointment within your own household and not everyone has access to that.
Interviewer:
Thank you very much. I'm wondering if you have any thoughts on the government's response to the pandemic? Either the UK government or the Scottish government.
Manveer Rahi:
I think at the start there was a lot of mixed messages. So, we came out and the government said we were moving towards herd immunity. That's fantastic, that works for some things, but for an unknown virus with unknown characteristics and unknown mortality statistics I think it was a tricky, tricky call to make. And we quickly abandoned that, but that delay of a week in the government's response may have had actually relatively severe side effects for mortality and morbidity that we're now seeing. So, it just pushes further along the curve, essentially, that delay in locking down the economy, shops, restaurants, etc, and the mixing of people, essentially.
I think total lockdown was the thing that we needed. If you look at countries who did quite well. Australia and New Zealand did quite well. They were very short and sharp in the intensity of the lockdown very early on before we'd started to see that exponential rise in the cases. And they had very few cases early on and they managed to delay the curve whilst we developed a better scientific understanding of how to identify patients with COVID disease, but also how to best treat these patients. I think the balance of opening up the economy versus trying to balance out the socioeconomic effects of the pandemic has been a difficult one. I think balancing the human cost alongside the economic cost is very difficult. I think that that is above my head and I think I will support the government in whatever decision they make because they have a huge body of scientific advisors who are much more experienced and know much more about this than I do. I was sceptical of the government's response early on, but I think they've been doing a fine job since then.
I think the difference between the English and the Scottish government's response has been interesting. So, I have family and friends down in London, who are still allowed to mix households. They've still been allowed to go to bars and restaurants, whereas in Scotland, those rules are changing and have been different to those in England for quite some time. I think from my discussions with my friends and my family down in London, it seems that they prefer the much more proactive, or seemingly proactive, response in Scotland to the pandemic and the lockdown compared to those in England.
Interviewer:
Thank you. As a continuation of that, I wondered if you had any thoughts on the public's response to the pandemic, following the regulations which are coming out of government and so on.
Manveer Rahi:
I think at the start, people tended to take the pandemic quite seriously and the rules quite seriously. I think as with anything, as time goes by, there's been a lot of early advocates who are tiring with the long, essentially lockdown, and how drastic a lockdown this is required in the past few months. So, I think that the amount of time that we've spent in lockdown is enough to wear anybody down. It's tough to not be able to see your family. It's tough to not be able to see your friends. And I understand the public's desire to try and just get on with life at the moment. I think the public has really kind of lost its fight now, not so much mask wearing, but socially distancing and following all the rules and regulations.
Personally, I had a lot of trouble with seeing senior politicians giving us one rule and then following another. I had a real problem with that. I think as a doctor working on the front line, seeing these patients, hearing that it's almost ‘do as I say and not as I do’, which wasn't the right message to be giving out to the public. Now, senior politicians down in England were following a different set of rules, apparently, whereas Catherine Calderwood, the chief medical officer in Scotland, seemed to misconstrue the rules also, but [that] tended to have a much more severe effect on her career compared to politicians, which again annoyed me. And I think doctors are held to high, seemingly higher standard than our politicians, the people who are creating our rules, and so I understand why the public are tiring because I'm tiring too.
Interviewer:
Thank you. The next questions I'm going to ask are about the personal impact of COVID on you. And just to remind you, if there is anything that you don't want to answer, please just feel free to say. Have you had or do you know of any colleagues, friends or family members, without giving names, who have personal experience of contracting coronavirus? And are you comfortable describing those experiences?
Manveer Rahi:
Yeah, that's fine. I've been lucky in that none of my family have been affected yet, touch wood. But colleagues and friends have been affected now. Going back to March, three of my friends who I had recently gone traveling with had contracted coronavirus, and they had contracted coronavirus probably a few days after we finished traveling. Now, this was very early March before lockdown had been instated in the UK. And we went to Berlin and one of my friends who was living in Berlin, his parents of doctors and he got tested because he wasn't feeling well after we after we left that trip. He'd actually contracted coronavirus and then two of my other friends went on to have symptoms of COVID but without being formally tested. And now they had developed symptoms of fever. But that was only one of my friends, the other two just developed relatively minor symptoms of loss of sense of taste and smell, which has taken months to come back really.
In terms of my colleagues, whilst I was working at the [Royal Infirmary], we had an outbreak on our ward. because we were looking for after respiratory patients, tend to be high-risk patients. Now we had maybe one patient who gave it to one of the nursing staff and within the space of a week we had fourteen staff of ill. Now we only have twenty nursing staff on our ward, so losing fourteen in a week is relatively dramatic because there are supposed to be six nurses on at any one point. So, it was a massive, massive loss to our department. I think that was particularly difficult because a huge amount of staff had gone off ill, but there had been no testing of asymptomatic staff. Now we know that a large proportion of patients with COVID are asymptomatic. I was an advocate that we all staff on the ward should have been tested regardless of symptomology or not, so that even if we didn't have symptoms, we wouldn't act as carriers or vessels for the virus. That was a frustrating moment, personally for me. And I think it's just one of a few personal entanglements with COVID that have been particularly annoying and distressful in a way.
Interviewer:
Thank you. Could you describe how your home life routines have been impacted by the pandemic and the lockdown?
Manveer Rahi:
Sure. I used to swim most days. I think with the gym closing, I lost my ability to go and work out. I had to take up running, which I hate. Previous to the lockdown, I said that I would only ever run if I was being chased by something and apparently a virus, a global pandemic was enough to get me running. So, I'd taken up running as a way to keep fit and I've also taken up cycling.
I used to use a lot of public transport. There's been some really fantastic schemes, the bike station [was] doing a ‘bikes for heroes’ scheme where they were giving away bikes to key workers. And so, I went and got a free bike, and I now cycle to work every day and I cycle around town, so I don't use public transport as much. So actually, my commute has changed dramatically, and my exercise habits have changed dramatically. I think, I haven't been able to travel and get out to the countryside or the Highlands, which is typically my favourite form of just getting out of the city to de-stress. And that's been quite difficult because that's put a lot of additional stress on the time that I have off. There's not been really a release personally for me until very recently when we've been allowed to travel again.
Interviewer:
Thank you. Given everything that you said about the impact on you professionally and personally, have you do you feel like medical practitioners are getting the mental health support that they need? And do you feel that there's a gap in increased sort of stress for medical practitioners?
Manveer Rahi:
I think this is a good question. As someone who has in the past struggled with their mental health, with depression and anxiety, it's been a struggle—when you can't go out and exercise, there's been a massive change to your routine. If you need to access a GP, it's become increasingly difficult to access GP services. [This] means that, people who are suffering the stress of isolation, whether that be confinement into your house, the inability to have a release or get outdoors, the additional stress of work, those people now can't access the same services that they once did. And so actually you can feel much more isolated, both from your health care practitioners and from your friends and family.
This has been one of the things that we focus most on in my management role, trying to look after junior doctors, understanding that this is going to be a huge time of transition for most junior doctors. So, making services available, in the hospital for the doctors in training we started up a weekly drop-in session with senior management staff. Any doctor in the hospital could come and sit down and talk to someone else about their problems. Whether that be the medical director of the hospital in some cases or whether that be the director of education or even clinical development fellows who are trained in listening to people to help them through some of their issues. Additionally, to that, we've had wellbeing boxes sent out to the wards. These have included things like hot chocolate and socks and things like that, just to get people feeling a bit better about themselves. It's been a nice treatment that come onto the wards.
Rest places have been a bit of a challenge. One thing that junior doctors always say is that we never have adequate spaces for rest. At the Western General, we still don't have a doctor's mess in the hospital. We're not allowed to eat in clinical spaces, and we're not allowed to eat in the doctor's offices, but we have no office to go to, so we're supposed to eat outside. And in Scotland, that's not always the most sensible thing to do, so either it's break the rules or wear a jacket whilst you're eating lunch. So, we've had to advocate quite strongly for better rest facilities and in some aspects, that's been actually remarkably successful.
At the Royal Infirmary, there was an initiative where furloughed airline staff would come into one of the big seminar rooms. And they would be there from something like eight o'clock in the morning, right up until 8:00 PM. They would do shift work, so four hours. And it would be a space that any doctors and nurses, clinical support workers, literally anyone working in a hospital could come to and have free hot drinks, free soft drinks. There was pizza at certain times of day that was funded by airlines. And it was just a great opportunity to chat with cabin staff. I chatted with first officers, second officers, pilots, everyone. And it was actually really nice to hear their perspective because I think sharing stories is incredibly powerful. And I think hearing the plight of other people was incredibly interesting. You know, one thing that I had no idea about, which was speaking to some of the Ryanair staff, were that whilst EasyJet and Jet2 staff had been furloughed and were paid by the government, I think it was Ryanair who had just before the pandemic were going into liquidation. Now they had three or four potential buyers lined up just before the pandemic hit and during the early stages of the pandemic. But because the government said they were going into liquidation and thought that they were not going to be a viable company coming out of the pandemic, they'd actually declined to pay any of the staff from Ryanair on the furlough scheme. So, there were pilots essentially from Ryanair, first officers, who were having to go on to universal benefits, which seemed incredibly challenging when you have a family of two or three children that you have to look after. I think it was interesting to hear the plight of other people, and it was just a nice space for us, all hospital staff to kind of mingle and chat about the experiences.
Interviewer:
Thank you. That was that was really interesting. This is my last question. Where do you look for accurate information on the pandemic and do you have any thoughts about the role of social media and the Internet in sharing information, either with medical practitioners or with the general public?
Manveer Rahi:
Yeah. Sources of information. For the blog that I've been writing about for COVID the sources I tend to go to have been the British Medical Journal, The Lancet, The Lancet Global Health, New England Journal of Medicine. I think looking for a mixture of scientific papers, opinion pieces, and editorials has been really useful. And the broadsheet newspapers have also been useful. So, The Guardian, The Telegraph have always run interesting series and opinion pieces. I think those have been my go-to sources of information. That covers a broad array, right from very scientific pieces to more political policy related pieces, and that's covered the whole spectrum of what I am interested in personally.
With regards to social media, I think social media can be an incredibly powerful tool. I think it's a fantastic avenue to reach out to people if used correctly, because for better or worse, there's no real filter between yourself and the public. So, if it' a well curated message from people in the know, then actually it can be a really effective tool for reading for reaching a wide array of audience or a huge audience in a very short space of time, in a very economical way. Because it doesn't require editing, it can be very up to date and in real time, which is great for the public. And actually, I know that I've used Twitter a lot as one of my sources of information, just for keeping up to date with, you know, developments and new papers that are coming out about COVID. I think if I was [one of] a public, I think it may be one of the first places that I went to as well would be probably Twitter. I think the most difficult thing about social media is being able to differentiate what is useful, reliable, fact-based, and scientifically evidenced information and what is opinion. And I think as a lay person, that's that much more difficult.
Interviewer:
Thank you. Just before we finish up, is there anything that you'd like to say that hasn't come up so far and you haven't had the opportunity to bring up?
Manveer Rahi:
Not really. I think we've covered most aspects, right from professional to personal. I think every individual that you'll interview will have a different perspective on COVID. And I think, like I said, stories are really powerful, so understanding the stories of the individuals is just as important as understanding the huge statistics that we can see from meta-analyses and scientific literature. That'll tell us one story, but I think understanding the stories like this is really powerful. It tells us a whole array of new stories. So, thanks for doing this.