Why NI medics who took to social media to warn us about danger of Covid-19 are still urging caution
Early in pandemic, health professionals used social media to warn us what was coming and issue advice on how to curb spread of virus. Linda Stewart finds out what life has been like for them as cases surged
‘It’s frustrating that people are floutingtherules … they’re putting others at risk’
Dr Julia Courtney (47), from Co Down, is a consultant respiratory physician at the Ulster Hospital at Dundonald. She is married with three children aged seven, eight and 10. In March she issued a video clip urging people to stay at home and it made headlines across the UK.
Looking back on what prompted her to make such a public intervention, she says now: “Early in March we were seeing the pictures coming from Italy — that was probably the biggest realisation that this was coming our way. It just hadn’t hit us yet.”
Dr Courtney became concerned over the lack of awareness of the measures needed to curb the spread of Covid-19.
“I was chatting to one of the guys from church — we were talking about people not socially distancing and he asked would I do a video for the church. We were probably not seeing a huge amount of social distancing other than people beginning to get a bit nervous, and at that time we were beginning to realise that people needed to stay a bit away from each other,” she says.
“The hospital recognised this was going to be a potentially huge problem and one where we were trying to advise people that now was the time to begin to isolate a bit from each other and not be close to each other.”
The first few weeks of lockdown were intense, she says, and the thought of what was on the way was daunting. Routine work had to be cancelled and numerous doctors and nurses had to be retrained to deal with a predicted surge over Easter.
“There was concern about whether there was going to be enough PPE and that was a huge worry at the time,” Dr Courtney says. “But there was always capacity within the NHS, which was one of the purposes of lockdown, along with trying to protect the most vulnerable.
“Because people in Northern Ireland did adhere to the rules and largely did what we asked them to do, then we did have capacity within the hospitals. We never got to a situation where we were having to make decisions about beds between patients. We were able to give people the care they needed.”
She didn’t go home on the days she had been working in the Covid-19 ward.
“My husband was the main child carer because I was at work most of the time. Homeschooling didn’t really happen particularly — he was trying to manage work and there was the fact I was away a lot of the time,” she says.
“My main concern was that the children would be kept happy and not be anxious. And they were, partly because of the fact that we weren’t doing a lot of homeschooling — they were just enjoying life. They loved being off!”
Dr Courtney says she’s been on high alert, constantly washing hands and cleaning her phone.
“My phone doesn’t work any more because I’ve cleaned it so much. When you go home to the children there’s always a degree of alertness about getting infected at work and bringing it home to your family and that has added to the intensity of all that,” she says.
She admits the intensity and strain has taken its toll and she remains frustrated with people flouting the rules, concerned that it could lead to another surge in cases.
“The people that are flouting the rules are probably going to be okay but it affects others that are around them — they’re putting other people at risk,” she says.
“People who are not socially distant are putting a lot of people at risk, including vulnerable people and a lot of NHS staff and their families.”
And it remains vital to continue good hygiene and social distancing as the lockdown rules are gradually eased, she says.
“I think that people have to try and get back to some degree of trying to function and that is going to pose increased risk, so that is why it’s so important,” she says.
“You can’t have people in lockdown for months and months — there has to be a degree of relaxing things.”
Dr Damian Fogarty (55) is a consultant kidney physician and clinical director in the regional nephrology (kidney medicine) and transplant unit at Belfast City Hospital, now Northern Ireland’s first Nightingale Hospital. He is married to another doctor and both have been heavily involved in the coronavirus epidemic. They have three children.
Dr Fogarty posted a tweet in late January about “this novel viral pneumonia” and charted its progress.
“In March I noticed that Ireland paid more attention than the UK — stopping the St Patrick’s Day parades, for instance, whilst the Cheltenham races occurred days beforehand,” he says.
It was around that weekend in mid-march that he approached a research colleague Dr Ciara Keenan about setting up an automated twitter account that takes new information from scientific studies and websites and then posts them into the output for their @Covid_evidence account.
“We were both really struck by how interested people were in this — it had 1,000 followers within 24 hours and 2,000 within a few days. It was a clear sign of the public’s interest in this new illness and emerging epidemic,” Dr Fogarty (above) says.
“In the end, however, we could not keep curating this and doing our other day jobs too.”
As Covid-19 cases started to appear, he was concerned about the lack of public awareness of measures needed to curb its spread.
“I remember going into a supermarket around St Patrick’s Day and being struck by them letting in so many people shopping in groups too. There were so many people milling about,” Dr Fogarty says.
“I think it was only really when it was in Italy and London that people started to take it seriously.”
His unit stopped doing kidney transplants mid-march due to the threat to immunosuppressed transplant patients, although
‘My worst time was watching patients die emotionally and physically alone’
transplants began again on April 17 for patients on dialysis, with no evidence of Covid-19 in either recipients and donors.
“Because almost all the other UK transplant units were closed, we were offered more deceased transplants in the next month than we usually are in a few years combined,” Dr Fogarty says.
His workload became extremely intensive as the NHS reconfigured itself to deal with the crisis, including cancelling appointments, putting together contingency plans and even building a new ventilator area in the dialysis unit.
“My worst experience was watching patients dying, albeit palliated with pain relief but being emotionally and physically alone, despite the great work and attention of our nurses,” he
says. “Our nurses were wonderful as usual, but this reminded me of the power and purpose of being at home as much as possible when medicine can offer no cures,” he says.
At the peak of the surge, Dr Fogarty says, the Belfast Trust was caring for around 140 hospitalised Covid-19 patients spread across wards in the Mater and City hospitals, with 20 patients ventilated in the ICU.
“We’re now well down to single figures in the hospital,” he says.
“Because my wife and I were working with Covid-19 patients, we tried to keep quite separate at home during April. I would shower here, at work, and again when I got home. It was hard to relax otherwise.”
He feels Northern Ireland probably got the timing of lockdown about right. “My worry is now that if we are too slow in releasing lockdown, people will die of other diseases because they present too late,” he says.
Dr Fogarty believes the clever way out of lockdown would
be to open most businesses with social distancing while retaining age-related rules to protect those who are most vulnerable in age groups over 60 or with underlying conditions.
While the media has focused on packed beaches, he warns that the greatest risk of asymptomatic spread is indoors, in business meetings, in nursing homes and crowded spaces inside.
“The more we can educate people, the better chance we have of targeting any resurgent cases,” he says.