London Covid-19 doctor says soon staff will be forced to choose whose life to save
Rosena Allin-Khan, the Labour MP for Tooting and an A&E doctor, is still working regular shifts. On Sunday she worked at St George’s hospital in her south London constituency. She explains how the coronavirus pandemic has affected staff:
I’ve been an A&E doctor for 15 years, and I’ve never seen anything like this before. The departments are quieter because people are staying away from hospital, but the patients are sicker.
We’re seeing a distinct rise in the numbers coming in with respiratory symp
toms, who are testing Covid-19 positive.
On Sunday, very early in the morning, the entire resuscitation department, where the absolute sickest patients go, was full to capacity with patients with breathing difficulties. We had to move other very ill patients to the paediatric resuscitation area to keep them safe.
This is only set to get worse. We’re seeing patients now who would have only contracted the virus two weeks ago. In the coming 10 days we expect the entire A&E department will be taken up with suspected Covid-19 patients.
Doctors and nurses are brave, and the A&E department is known for being on the frontline and high risk, but there’s a palpable fear among staff for three reasons. Firstly, they’re frightened for their own health and those of the people they love. When I finished my shift yesterday, which was Mother’s Day, I came back to the house and I couldn’t touch or hug my two little girls until I put all my clothes in the wash and had a shower.
The second reason is that staff expect, very soon, potentially to have to make heart-wrenching choices about whose life can be saved if we don’t have enough ventilators. That goes counter to everything you’ve ever learned as a doctor or nurse – to make lifeand-death decisions, where we could possibly have saved every one of those people, is unimaginable. This is what our colleagues in Italy are living through now.
Third, the patterns described thus far for symptoms of coronavirus are not what we’re now seeing in the emergency department. We’re seeing young, previously very healthy people, who are ill in hospital. Some are in their 30s, and they need ventilators to stay alive. Some patients are presenting with abdominal pain, which we hadn’t heard of before. A person can come in and say they have a stomach pain, and they’re put in the “green” area of the department – but then they mention they also have a cough. Everybody should be assumed to be Covid-positive until proven otherwise at this point.
There’s also a real concern among staff around the country about personal protective equipment. They either don’t have any, or if they do many feel it’s being rationed. It’s very hard to listen to some colleagues say that as a result of there not being enough equipment to go round, they’re resigned to catching the virus – it’s just a matter of when.
On social distancing, the messaging from the government hasn’t been clear enough. Angela Merkel, the German chancellor, has banned public gatherings of more than two people. It’s clear and easy to understand. There has to be no ambiguity in the language because people’s lives depend on it.
Some people are treating this as a holiday – but without correct distancing measures it’s a disaster waiting to happen. When we are faced in the coming weeks with choices about who gets the last ventilator and who doesn’t, it will be that young person who has gone out socialising, who has ignored advice, who get it. That means someone else’s mother may not.