Critical care ‘very close In hospitals was to collapsing’
HOSPITAL critical care in Wales was “very close to collapsing” at the height of the second wave due to the sheer volume of patients coming through the doors, one doctor claims.
Dr Raja Biswas, a consultant physician at the Royal Glamorgan Hospital in Llantrisant, said the vaccination rollout and the decision to return to a full lockdown just before Christmas came at just the right time.
He said while NHS staff across Wales were better prepared in the second wave and had built up a far greater understanding of Covid-19 and how to treat it, hospitals ended up being “inundated” with patients to the point where there were very few available beds.
During the festive period, bed occupancy for the most seriously unwell patients was as high as 140%, with several health boards having to divert patients elsewhere after reaching maximum capacity levels.
“Every day at 7.30am we when they were powerless would start with a meeting against the spread of the to assess how many virus. patients were coming in “There was a feeling and where the beds were,” among the general public Dr Biswas recalled. that there was something
“And most days [during wrong at the hospital and the second wave] we were that’s why the outbreak in the red, meaning that was happening,” he we hardly had any beds added. left. So we were in a situation “But a hospital is very where we were very, much a closed area with very close to the whole many unwell patients in system collapsing due to close proximity to one the sheer number of another. You cannot stop patients coming in. it spreading. It is simply a
“A lot of it I suspect, reflection of how much although I cannot prove it, prevalence of the virus was to do with the fact there is in the community. infectivity was much “The nurses worked so, higher in the second wave so hard and to be told they than the first.” were somehow not doing
‘‘ Dr Biswas said one of the biggest challenges in the second wave was the significant coronavirus outbreak at the Royal Glamorgan Hospital which, between late September and December 14, 2020, led to 348 positive cases and 95 deaths.
He said it was incredibly disheartening to witness staff at the hospital being subjected to abuse by members of the public
enough to prevent the spread – or not caring enough for patients – was so demoralising.
“They had to take abuse from a lot of people which was very disheartening.”
Dr Biswas described the first wave as “like a tsunami” coming towards him, with staff ill-prepared for what they were about to experience.
But the second wave last winter saw upwards of 120 patients with confirmed or suspected Covid at the Royal Glamorgan – a figure he described as “huge”.
“Everyone was working flat out and it was a horri
A hospital is very much a closed area with many unwell patients in close proximity to one another. You cannot stop it spreading
- Dr Raja Biswas
ble, horrible time because you hardly got any time to really unwind or switch off,” he added.
“One thing perhaps people do not understand is getting into the full PPE gear in between seeing patients; taking it off, putting it back on, examining people. It’s incredibly time consuming and is physically and mentally stressful.” While members of the public were falling ill with the
virus, so too were NHS employees and their families which put an added strain on the clinical workforce.
Dr Biswas, who contracted Covid-19 himself towards the start of the pandemic, said it took him a while to recover from the virus.
“I had a lot of heart palpitations, tiredness and fatigue, but I did try to ignore it and come back to work after two weeks because when you see your colleagues working so hard I felt I couldn’t just sit at home and wait until everything is better. You just feel obligated to come back.
“That was not just me. That was everyone. Everyone came back as soon as they could.” The experienced medic added that it was vital for nurses in particular to be given a pay rise to reflect their growing responsibilities and skills.
The Royal College of Nursing (RCN) in Wales is calling for a 12.5% pay boost and described the UK Government’s offer of a 1% rise for workers in England as “pitiful and bitterly disappointing”.
Wales’s Health Minister Vaughan Gething said in March that the Welsh Government had “not tried to set a ceiling” on any proposed wage increase and is instead waiting for the outcome of the independent pay review body.
“Most nurses don’t come into the NHS for the money. They come in because they love nursing,” said Dr Biswas.
“But no matter how dedicated you are, if your work is not recognised in your pay you do feel very disheartened. Nurses’ pay is really terrible and I have such respect for them. The kind of hard work they do, day in day out, I don’t think I could do.
“However, during the pandemic there has also been a positive response to the NHS, and I think that might encourage young people to come into the service in various roles.”
According to latest figures from Public Health Wales, more than half of people in Wales have now received their first dose of the coronavirus vaccine.
In Dr Biswas’s health board, Cwm Taf Morgannwg UHB, demand was so high for the vaccine that the “reserve” list for those aged 40 to 49 crashed. It is understood that 13,000 people tried to access it at the same time when it first went live.
“The vaccination rollout has been the most outstanding achievement of governments and the NHS,” he added.
“No-one knows if we will have a third wave or not – I sincerely hope not – but if we don’t a lot of the credit will go to the vaccination programme.
“I think people still have to be sensible. Even if you have had the vaccine it does not make you immune to the virus, and I think that’s a message that needs to be understood. Vaccination reduces your risk but it doesn’t take it away completely.”
Dr Biswas also said it was vital to reach out to those in minority ethnic groups, where take-up is typically lower, to dispel myths and untruths around the vaccine.
He added that the biggest challenge over the coming months will be to try and tackle the growing backlog of NHS appointments and procedures which needed to be halted for many months during the pandemic.
“Every patient coming into hospital now needs to be screened for Covid, even though the numbers are quite low, plus you need to have socially-distanced areas of the hospital,” he said.
“We are living in a different world now compared with what we were doing pre-february 2020, and it’ll be a big challenge to restart services very quickly. But there is a lot of work going on behind the scenes, believe me, and we are also trying to do as many virtual consultations as possible.”