CORONA FRONT LINE
»»Silence is eerie as »»Dedicated staff sick patients lie still are pushed to limit
STAFF rush towards us clad in white gowns and bubble hoods, pushing a stricken woman on a stretcher.
She is hooked up to a ventilator, with a web of wires and tubes attached.
“New admission, clear the way,” comes the command. It is one they have heard all too often.
I am inside the busy intensive care unit at University Hospital Southampton, where lead consultant Dr Sanjay Gupta and his team are fighting as hard as they can in the war on Covid.
Here, life or death hangs in the balance and patients lie comatose, unaware of vaccines being rolled out to save the world from a virus that’s killed more than two million worldwide.
Before the pandemic, the hospital’s combined ICUs had an average of 45 patients. Now, the unit has doubled in size with 85 patients – of whom 50 have the virus. Admissions to Southampton ICU have leaped from 680 in the first wave to more than 1,000 in the second. As we
Covid is real, it’s horrible... I will be disabled for ever now because of this – look at me ALAN PEARSON RECOVERING PATIENT SPEAKING FROM ICU BED
visit on Thursday, the grim news comes that the UK death toll has topped 103,000. By yesterday it stood at 105,571. Every bed here is full – yet Dr Gupta vows to keep accepting patients, including those from hospitals at breaking point.
“We are ready to take on more patients if we need to,” he tells me. “We have all we need. If necessary we will push to 105 beds – 160 nurses have already been deployed from non-essential services and more would come if we need to.”
I ask Dr Gupta what he thinks of those who break lockdown rules, risking further coronavirus transmission. He sighs.
“When people break the rules, when the ICU is full, there’s potential for their granny not to get their cancer operation, or their uncle not to have their heart operation.
“The pressure they place on the health service means that everything else suffers. I’ve got 50 patients here I shouldn’t have – which means these 50 nurses could be doing something else, like looking after cancer or heart patients.”
Dr Gupta is all too aware of estimates that cancelling operations, appointments and
GOING IN Medics sanitise and don PPE disruption to critical care could cause 28,000 extra deaths nationally. Every grim statistic is a daily reminder of this almighty challenge.
Before entering ICU I am fit-tested for a mask, visor and gown. A scented spray is discharged. I cannot smell it – proof the mask works. In virtually every bed patients lie motionless. It is eerily quiet – save for the ventilator beeps and a man groaning and coughing. He has been here for weeks and his muscles are wasting away. Yet the fact he can make a noise shows progress, Dr Gupta says. Medics carefully move another new patient, in their sixties, from stretcher to bed.
The patient – blue-lighted 125 miles from Medway Maritime Hospital – is one of 24 transferred from overflowing units in Kent, Surrey and Dorset since December.
“The hospitals are running out of oxygen, ICU beds, they’re having to open in unconventional areas like operating theatres, or they don’t have staff,” Dr Gupta explains. UHS can accept more patients thanks to a £22million ICU wing completed during the first wave. The youngest patient admitted in the second wave was just 22.
“He survived,” advanced critical care practitioner Lee Berry tells me. “We have patients in their thirties with us for weeks.”
Some lie prone – face down – to improve oxygenation in the lungs. Patients as heavy as 23st are turned every four hours. Members of the fire service are sometimes called upon to assist.
Alan Pearson, 59, gives us a shaky thumbs-up. He says he thought he was dying when he was taken to ICU on Christmas Day. The father of one had a tracheostomy and presses a valve to speak, telling the public to stick to lockdown. He croaks: “Don’t be idiots. It’s real. It’s horrible. I never thought it would happen to me.”
A train driver, he spent a week on a ventilator. “I’ll be disabled for ever now because of this – look at me,” he adds, gesturing to the tubes.
As we move on, Dr Gupta says: “He will pull through. Rehab continues after ICU.” But with a nod to the scene around us, he adds bleakly: “These patients will never be the same, whether it’s breathing, being able to walk up stairs or not waking up and dreaming about all this.”
The team here is under immense strain. One
Rule breakers heap pressure on NHS... I’ve got 50 patients here that I shouldn’t have SANJAY GUPTA INTENSIVE CARE UNIT CONSULTANT
ICU nurse is caring for two or three people. Pre-pandemic, there would be one nurse per patient. Shortages are plugged with staff from across the hospital – some have never worked in ICU and undergo a “quickfire induction”.
Matron Liz Middlehurst tells me: “You’re in turmoil because you want to give the best care but you’re stretched beyond your means.
“That’s the pressure you go home with, you might have done everything safely but not all the little things you’d like to do. It’s your own standards you hold yourself accountable to.”
While saving lives day in and day out, medics are only too aware that 224 colleagues in frontline health and care have died from coronavirus.
Across the UK almost 100,000 staff were on sick leave on January 6 – one in 10. Of those, 49,704 either had Covid or were self-isolating.
Ms Middlehurst believes some staff have PTSD symptoms, as just talking to colleagues “sends them into panic and distress”. UHS has a support team in place. Alison Pearce, lead consultant for Adult Clinical Psychology, says: “Staff are used to working with sadness but the pace and amount they’re managing – plus managing their own lives – has taken its toll. It’s all about prevention. We don’t want people to end up with PTSD.”
Nationally, the NHS has been stretched to the limit by 380,000 admissions since the first Covid patients were hospitalised in Newcastle a year ago on Friday.
Around 35,000 are now in hospital, 3,800 are on ventilators and yesterday’s death toll rose by 1,200. Daily admissions, thankfully, have fallen below 3,000 – down almost a third, week on week. In
Southampton, ICU staff do their utmost to bring a ray of light into a world of darkness. They scribble names on their gowns – sometimes with a smiley face – to make up for the fact they are hidden behind masks.
“It makes us that bit more approachable to patients and gives them that sense of familiarity,” says Rachel Burnish, a research sister redeployed to support ICU.
Three-quarters of staff have had a Covid jab and Dr Gupta says the vaccination rollout – with 8,378,940 million Brits jabbed – has “absolutely” boosted morale.
Leaving the unit, we head to the doffing area to remove PPE and have our equipment doused with disinfectant.
We join Southampton Hospitals Charity workers to deliver “wellness boxes” of treats for staff. It has also funded 45 iPads and 100 cordless phones for patients. One recipient is sister Marta Oliveira from the infectious diseases ward.
All 18 beds on her ward are full, yet redeployment for Covid means she is often down two staff members per shift. “I’m more stressed than previous years,” Marta admits. She has noticed non-Covid patients deteriorating quicker in the second wave and adds: “It could be because they were scared of coming to hospital and delayed getting help. They don’t need to be – we take all the precautions to prevent infections.”
You’re in turmoil... you want to give the best care but are stretched beyond your means LIZ MIDDLEHURST MATRON REVEALS STRESS STAFF ARE UNDER