More people are coming into A&E and we’re not able to save them
Scots medic on NHS emergency frontline reveals how battle to beat Covid is on a knife edge as second wave is worse than before
THERE is a real concern among all of us in the NHS that it is going to be a close-run thing to see if we run out of bed capacity in the next four weeks. It’ s the biggest thing keeping me awake at night.
I don’t want to panic people, but it’s worth getting the message out there that this second Covid-19 wave is worse for Scotland than it was before – no doubt about it.
We are not exaggerating. We need people to follow the lockdown rules fully. People might think that is what they are doing now, but we need to go that step further and return today to what it was like in the lockdown in March and April last year.
I drove to work last week at 7am and the M77 up to Glasgow was as busy as any normal day and that certainly was not the case in March.
I would say to most people who are abiding by the rules: ‘Thank you and well done. It’s been a long year but, please, stick with it because you’ve been doing the right thing up to now’.
But if others don’t change their behaviour now, there’s no doubt we will have more cases and we may well test our NHS to destruction.
The vaccine will save everyone in the medium-to-long-term, but unfortunately it’s six weeks too late. We’re already looking at more than 2,500 newly confirmed cases a day and we know that 5 to 10 per cent of people who test positive are going to need admitting to hospital. We are heading towards 200 admissions a day again – which is what it was at the peak of the pandemic in mid-April last year.
Last week at Holyrood, First Minister Nicola Sturgeon said it was the most anxious she had felt since last March and that we are four weeks behind London.
Back then, we locked down and managed to stop getting to the levels that the city was experiencing. I’m not sure that is going to be the case this time.
What we are experiencing in emergency departments across the country is already different from last time and it would indicate that the disease is far more widespread than it was last spring.
From speaking to my colleagues UK-wide, they agree it’s worse this time around and what they are describing in the south east of England is so, so worrying. They are literally running out of oxygen in hospitals; coronavirus patients are being put in rooms which are not quite kitchens, but close to it, and there are children’s wards where sick youngsters have been sent home and replaced by adults who are receiving non-invasive ventilation by way of oxygen masks.
It’s not that bad here yet, but we are seeing more people coming in who are deteriorating suddenly and we’re not able to save them.
It’s the speed of the deterioration that we’ve never seen before. First time around, we’d see someone with suspected Covid coming in, they would be admitted and get worse over a number of days and later, sadly, we’d find out they had died.
WE didn’t see people coming to us who were already so sick we weren’t able to save them in the emergency department. Usually, if we get you in when you’re talking, we’ll normally save you.
But we know Covid causes blood clots and we’re seeing more people coming in breathless and with chest pains. Their oxygen saturation is low and they go downhill fast.
These are not people who have delayed coming to hospital and it’s hard when you’ve talked to them and started that doctor and patient relationship only to see them deteriorate, no matter what you do and they don’t make it.
Some will have a massive blood clot on the lung and, despite us starting treatment immediately, we lose them.The staff on the wards are more used to seeing people die from Covid than us in the Emergency Department. Now it is happening to us before they can even be admitted. I know some people have decided they don’t want to follow the Tier 4 rules. A whole period over the summer where cases dropped and, now, a social media campaign saying it’s all a hoax, have not helped.
I think it will take learning some hard lessons for them to comply. The public only got a fright last time once they started to see people of all ages they knew dying from the virus.
I’m not giving up hope, however. It is going to be bad in the weeks ahead but I saw how well my colleagues stepped up to the plate first time around, how much people worked together, how much we were able to get done, and that inspired me.
We’re going to try to do it again but we want everyone to be on our side like they were last time.
Please, don’t listen to the ‘Covid deniers’. Every time we see that, it’s a blow to all of our hearts in the NHS. That sort of misinformation is doing more to decrease the morale of NHS workers than anything else just now.
What would help us most is meaningful action and people abiding by the rules and seeking to avoid any other forms of behaviour that might see you end up in accident and emergency. It’s going to be a tough six to eight weeks, so we need to roll up our sleeves and get to work. More British civilians have died from Covid than in the entire Second World War. This is our Blitz, don’t let us down.