Tragedy and tears... but the front line holds firm
THEY have fought on the front line of the Covid-19 pandemic for almost a year.
Now the NHS heroes battling to save lives at Scotland’s superhospital have told of the terrible toll on staff and patients – and how they are struggling to cope amid rising cases.
The Queen Elizabeth University Hospital (QEUH) in Glasgow admitted its first positive Covid-19 patient around 11 months ago. Its wards now house 244.
Consultant Alan Whitelaw, the clinical director of the emergency department (ED), disclosed that patient numbers are down overall – but coronavirus cases have risen again over the past week.
He said: ‘We had a fair number of
‘Staff have mental and physical fatigue’
properly sick young people with Covid, people who are not in the target demographic for the vaccine at this time.’
He added: ‘It’s important to say that if your presentation here is not life or limb-threatening and you could access treatment elsewhere, you should do so, because there is a lot of Covid here.’
For the ED team, one of the main differences between the first and second waves of the pandemic is the rise in patients with mental health problems.
Dr Whitelaw said: ‘Patients are still a bit afraid of Covid and large swathes of the population are doing what they can to avoid coming to the ED.
‘But there’s no doubt that alcoholrelated attendances and trauma-related attendances have gone back up. We’re definitely also seeing the mental health effects of such a different world.’
The mental health and wellbeing of NHS staff have also suffered during this pandemic and doctors and nurses are exhausted. To help, British Airways set up in the QEUH a Project Wingman centre, where airline crews help staff relax on rare breaks.
Dr Whitelaw said: ‘There is mental fatigue. We also have physical fatigue from running around in layers of PPE all day. The true cost of this and the true burden of this is unknown. But the public should be reassured that while it has clearly taken its toll on the staff, the level of care is still exceptional.’
Nurse Petra Gladwin has endured a baptism of fire in her first year in the job.
Her surgical receiving ward became a specialist assessment and treatment area (SATA) for Covid patients.
She said: ‘At the start I was scared. But if we’re all scared then who’s going to look after the patients? So we just motivate ourselves and get on with it.’
Miss Gladwin said the sudden death of a patient is the most difficult thing to cope with. ‘It is emotional,’ she added.
‘You see patients coming in and they are quite unwell with Covid but not to the extent of dying.
‘Then they deteriorate and you have to phone their family and let them know this is their end.
‘We have seen that quite a lot. Phoning the family and explaining this has happened is quite distressing because they are not able to see their family members and you’re telling them that they are near the end of their life.’
During the first wave of the Covid crisis, which began in March, everything except emergency and urgent surgery was stopped across the NHS.
Now, non-essential services are back up and running and patients are again being called for cancer screenings.
But there is a fear that people with symptoms are avoiding seeing their GP. Helen Dorrance, a consultant colorectal surgeon at QEUH, said: ‘We’ve not caught up yet with the first wave and I’m quite worried that there are people out there with things that we really should know about, but they don’t want to be a nuisance.
‘Actually, we are here and please do come and bother us.’
She said that the most difficult change in her clinics has been when communicating with patients. Before Covid, patients could have members of their family with them, but now only one relative or friend is allowed in to provide support.
Dr Dorrance said: ‘It is a much more difficult conversation for people because they have less support. Or you’re trying to explain over the phone that someone’s loved one is profoundly unwell.
‘Or you find yourself in the position with a family where perhaps their parent is dying and it’s very difficult for the family to appreciate that not everyone can come in [to visit], in the way we would have done beforehand. It’s very uncomfortable.’
Over the past year, medical science’s understanding of Covid19 has grown considerably and, with this, patient outcomes have since improved.
A widely used steroid, dexamethasone – known for its anti-inflammatory and immunosuppressant effects – is now given to Covid patients, along with oxygen treatment and proning, which is turning the patient onto their front.
Fiona Finlay, a consultant in palliative medicine, is based in the QEUH working with patients who are at the end of their lives.
Her caseload has increased from 60 patients on average at any one time to around 90 because of the numbers dying from Covid pneumonia.
She said: ‘One of the things I have found very difficult personally is, sometimes, when somebody is dying quickly they can be well and they have a lot of oxygen on and they are working hard with their breathing.
‘And often there’s not time for their relative to be able to come up and spend time with them.’
Patient Alan Jackson, 61, had just spent his first night in hospital, having been brought in by ambulance the night before.
Struggling to breathe, he was shocked to find himself in the SATA ward. He wanted his case to serve as a warning to others to be cautious. Mr Jackson, a funeral limousine driver from Rutherglen, Lanarkshire, had no symptoms of coronavirus, so was surprised to be contacted by Test and Protect – and stunned when a test came back positive.
He marked his tenth day of isolation on Tuesday and had expected to feel normal.
Instead, his condition deteriorated and his sister-in-law told him to phone the emergency services.
He said: ‘I had severe aches in my side, back and head, heaviness in my chest. I couldn’t sit or lie.’
Mr Jackson, who had been otherwise fit and well, added: ‘This virus doesn’t take any prisoners.
‘No matter how strong you are or what age you are, it will go for you. If it can find a way in, it will go for you.
‘People have to start taking it seriously.’
‘In the beginning I was scared’