I am a British Doctor. We Are Going Into The Abyss.
Ten days ago, I was asked to see the patient. I m a respiratory specialist in an intensive care unit at a London hospital, so it s no surprise that patients nee...
Ten days ago, I was asked to see the patient. I'm a respiratory specialist in an intensive care unit at a London hospital, so it's no surprise that patients need a ventilator. This seems very typical. But the patient originally had a coronavirus, the first case in our hospital and one of nearly 2,000 people who have tested positive in the UK so far. I don't wear a mask. Soon I coughed.
Although I had neither a fever nor dyspnea, I was told that I would be isolated for 14 days. That is my self-isolation now. I am not the only one in the hospital. After only one Covid-19 patient, one quarter of our junior staff members have no cough and snoring, which is what we usually need to do. A case of coronavirus has caused severe damage in our hospital.
This is the epitome of the future. The UK has fewer intensive care beds than most other European countries. The occupancy rate is high, and every day efforts are being made to release enough people to make room for new patients. Even if we have a bed, we don't have a nurse to arrange it. Ten years of layoffs and insufficient funding have exposed us to dangerous exposures. This is the eternal winter of the NHS
For the past week, I have been watching. Watching my colleagues prepare for the way forward, take breaks when possible, strengthen procedures for managing infected patients, train each other, develop disease plans and isolate families. Watch out while planning to cancel non-emergency care and move staff to the front line.
Everything is on the deck. Rotation of new department and hospital has been cancelled: I will continue to be in intensive care, and doctors from other departments will join me. My part-time plan has exceeded expectations. But this is my profession-we will never be doctors. When we were asked to strengthen, there was only one answer.
Hospitals will be pushed to their limits when people with the coronavirus flood. Britain is a rich country and may perform better than others. However, due to insufficient funding for many years, the NHS has fallen into a gap. Successive Conservative government cuts have deprived services of resources. Staff morale is low and retention rates are low. We are already doing our best.
When our hospitals are overwhelmed and we have to decide how to allocate scarce resources, how do we choose who to ventilate and who not to ventilate? Italy is approaching this point, with more intensive care beds per capita in its medical services than in the UK. Do I have to tell someone that we can't treat loved ones because we don't have a ventilator, oxygen, tubes, masks, hospital, staff? Then, will we set age limits, as some hospitals in Italy are considering, or will some of the concepts of "deserved" work?
The government's strategy is to quell the peak of the epidemic, while ensuring that the public does not abandon self-isolation at the wrong time and looks directly at the storm. Therefore, unlike some other countries, we have not completely closed. After a week of fever in the cabin, I can understand that I don't want to force isolation too soon.
But I worry about how we know where we are on the trend curve. Have we tested enough people? What if the lock is too late? Are we overwhelmed too early? Corridors and canceled surgery patients are available throughout the NHS throughout the winter. How many people will die because we worked too long on the brink of collapse?
I am not an epidemiologist. I don't pretend to know the right strategy. But if Britain goes through anything similar to what we have seen elsewhere, then we are going to tragedy.
To be sure, there are already 100,000 vacancies, and the NHS will not be spared without protecting and respecting employees. In 2018, two-thirds of doctors in the second year of training chose not to take up professional work. We were asked to do more with less compensation, while colleagues were left to dry out because the system failed them. To increase insulting harm, we provide outdated masks to protect ourselves.
We already know that our colleagues in Italy, China and elsewhere have given their lives for the profession of their choice. For years, health care workers have warned that the National Health Service (NHS) is in crisis-calling on the government to provide more funding for our hospitals and better working conditions for ourselves.
As the coronavirus crisis intensifies, we must be empowered to protect ourselves and our patients, especially the most vulnerable. We deserve transparency. We demand honesty. Without these, I don't know how many people will stay with me after all this.
And now it feels like we are heading into the abyss.
News References: https://www.cnn.com/2020/03/17/opinions/tuesday-democratic-primary-results-commentary/index.html