“Expectation and Anxiety”: A front-line medic talks about two years of infection with the Covid virus
Years before this Sunday, Peter Atwood became Britain’s first known victim of Covid-19 at the age of 84.
He had spent weeks at Midway Naval Hospital in Kent struggling to breathe, although doctors initially put his death to bronchial pneumonia and secondary heart failure. Seven months later, an autopsy based on samples from his lungs found evidence of Covid-19.
While his family was grieving, the respiratory virus that was initially discovered in the central Chinese city of Wuhan was spreading across Europe. Hospitals in northern Italy have been pushed to the brink, with doctors forced to triage patients and more than 700 people dying a day.
In the UK, scientists looked nervously and ministers flicked off anti-epidemic strategies long shuttered in Whitehall offices. It was another six weeks before Boris Johnson ordered the country to “stay at home, protect the NHS and save lives”.
As the rest of the nation grapples with working from home and walking once a day, staff at Chelsea and Westminster Hospital in west London braced for a challenge on a scale they had never imagined before.
“We’ve done a lot of work over the years to deal with pandemic influenza, but Covid came and surprised us a little bit,” says Eileen Manderson, chief critical care nurse at Chelsea and Westminster NHS Trust.
“We were dusting off the plans we made, but we didn’t know much about the disease. There were a lot of questions we couldn’t answer.”
Manderson, 48, contracted Covid before the first national shutdown and spent two weeks in self-isolation. When she returned, the hospital was “completely transformed” as staff in intensive care were recruited from other wards.
“We were dealing with a great deal of uncertainty,” she says. “There was a constant flow of patients coming in through A&E and a lot of employee absences. You never knew from day to day how many employees you had.”
But she says nurses and doctors “come together” in a time of crisis.
We’ve never dealt with anything like this before. In my 30 years of nursing, I’ve never seen anything like this before.
“In London we are very used to major accidents, but this is a major accident ten times bigger than anything that has happened before and it has lasted ten times longer.”
Although the hospital’s intensive care beds never reached full capacity, staff morale has been bruised by weeks of dealing with Covid patients. At the same time, many were “worried” about getting sick.
“We spent a lot of time focusing on ‘psychological PPE’, which included preparing staff for how to mentally prepare for change.
“This might include a pre-shift briefing where we can split into smaller groups and there will be a team leader of four nurses and two support workers. We will give a brief at the beginning of the day and the end of the day.”
At the height of the first wave on March 30, 2020, a total of 883 people were admitted to London hospitals with Covid.
Later that year, on November 9, a ray of light emerged: The Pfizer vaccine was found to be more than 90 percent effective against severe diseases in clinical trials. Margaret Keenan, 91, will become the first British woman to receive her injections on December 8.
“The vaccine has changed the rules of the game for us,” Manderson says. “It was a very nice experience for our staff and there was a great deal of celebration.
“It makes a huge difference for those who enter critical care… In the past few weeks we may have seen huge cases but that has clearly not been reflected back in the number of patients admitted to the ICU.”
However, the early days of the UK vaccination campaign with the emergence of the alpha variant coincided with the darkest days of the pandemic in London. Hospitalizations peaked at 977 in the capital on January 6 – putting the NHS on the brink of collapse.
“It was a very difficult period,” Manderson recalls. “The number of patients in critical care was enormous…it was hard to see a light at the end of the tunnel.
“We used to send a picture of Charlie McKissie every Friday. A number of employees said they found a lot of happiness in receiving these messages. They found it helpful to remind them that things would be over.”
More than a year later, hospitals are still under pressure from the virus but vaccination has allowed a return to near-total freedom.
Although Omicron has presented a challenge, Ms Manderson said the number of patients in the intensive care unit has remained stable over the holiday period. “It all comes down to vaccination,” she adds.
For the past two years, Ms. Manderson remembers the lives lost in the hospital’s intensive care unit (ICU). She says her staff “felt every death like the first”.
“This is something that all of us who worked during the pandemic must come to terms with,” she says. “Although we did everything we could.
“I can’t even imagine what it felt like for family members who waved goodbye to a loved one in front of the A&E department and never had a chance to see them again.”
Ms. Manderson says she is “incredibly proud” of her staff for their efforts during the pandemic. As ministers talk about the virus entering its ‘endemic’ phase and something society will have to ‘live with’, it is all too easy to forget the efforts of British nurses, doctors and scientists.
“Doing it once is hard enough, but doing it for two years is great,” she says.
“They have seen some of the most difficult things you can see in a healthcare environment. And they have done so with grace and a desire to do their best.”