At least I’m safe. Not everyone we treat is so lucky

In a weekly dispatch, an intensive care doctor charts the brutal reality of NHS Scotland’s war against Covid-19

Another week passes and they begin to feel normal – 13-hour shifts day or night, weekday, weekend or public holiday.

They blend into one, with lives and routines on hold.

I struggle to remember what day it is, never mind the date when it needs recorded on a death certificate.

The Intensive Care Unit runs at over 200% capacity every day, but our well-honed teams have become ever more efficient as those new to ICU find their feet and get caught up in the never-ending procession of patients and the interventions that keep them alive.

This week has signalled a change, though.

The 6,000 excess deaths announced during the first week of April is a stark reminder of Covid’s virulence. But only 60% of these deaths are related to Covid.

Probably the most terrifying of all facts we’ve seen during this outbreak is a warning that although Covid is causing many excess deaths – as we see with winter flu every year – the government advice, isolation and economic implications may now be causing significant deaths from other causes.

People staying at home, adhering to government advice but ignoring their bodies’ cries for help. The minor chest tightness, the sore finger, the cough, the mild raised temperature, are all symptoms of other significant medical conditions that will progress, deteriorate and need to be treated.

We have had several patients admitted to ICU with non-Covid-related pathology, conditions and symptoms they have sat on and tolerated at home until they were so unwell there was no surgery, no medication, no ICU that could save them.

These patients may have stayed home despite Covid and their outcomes may have been no different had they presented earlier but as one of them died lonely and alone in the

ICU, with a condition we rarely see so advanced and nothing more we could offer, I can’t help but think this was nothing other than a Covid-related death.

These patients have got me thinking, why is the data showing excess deaths in non-white races and the lower social classes?

I think back through the patients we have treated and most have been of lower-income families, delivering frontline services like us: bus drivers, supermarket workers and taxi drivers, to mention a few.

I think how lucky we are. Despite the lack of PPE at times, I’ve not seen a patient for the last three weeks without full PPE in place.

I may be surrounded by virus day and night but I am protected, I am as safe as I can be, and it’s not doctors I am treating in my unit.

This is the story of the untold masses, delivering essential frontline jobs that we all need or there would be no NHS.

They are the folk who encounter hundreds of people every day with no protection, no guidance no help. We know 50% or more of people will have the virus and be asymptomatic – that does little to protect these individuals.

So I leave you with a few thoughts. The people dying in ICU are not only Covid patients and life still continues. There are other medical conditions and emergencies occurring every day and none of us is immune.

We must still stay home to protect the NHS but remember the other individuals running essential frontline services. Think of their health.

Most of all, we only have one life. Think of your own health and well-being. Do not ignore symptoms. Don’t blame coronavirus for everything.