Paramedics helping an elderly woman, suspected of having been infected with coronavirus, who collapsed at Epsom downs racecourse in Surry England on 20 March. Dr Lilani Abeywickrama says medical services in the UK are overworked and morale is rock bottom.
Photo: LifeReportage.com / Shutterstock
In an opinion piece, Luxembourger and occasional Delano contributor Dr Lilani Abeywickrama, who has worked for the NHS, takes a sobering look at how the covid-19 pandemic is being tackled in the UK. There are lessons for everyone, she argues.
The British National Health Service has long learnt to work with its (often skeletal) resources. As doctors it was instilled in us to practice without burdening the system. This said the time for frugality is certainly not now. Not with a pandemic at our doorstep. “There are no resources”, “we have run out of PPE--and the tsunami of covid-19 has not fully hit us yet”, “there are simply not enough of us” are all versions of the same harsh reality. The BMJ reported as much as half of the NHS workforce was absent due to sickness last week and the measures to combat this have been rather alarming. Thankfully there have been thousands of volunteers--but the key issue here is medical staff.
Pulling final year medical students who have not yet qualified into this war zone and recruiting pensioned NHS doctors to fight covid-19 seems counterintuitive to say the least. Surely medical students haven’t as yet treated a single patient independently and those receiving their “12-week-stay-at-home” cards include the very same at-risk age group of retired NHS consultants we should be trying to protect?
After demanding that stringent measures for non-UK trained doctors to practice medicine in the UK be implemented, [secretary of state for health] Matt Hancock proposed fast-tracking refugee doctors to help the UK’s corona plight. Agreed the critical nature of the pandemic does require an “all hands on deck” approach, but when “some hands” have failed to pass their final stage exams for the past decade, the nature of their utility in such a situation becomes questionable.
Speaking to colleagues in the thick of this--it seems that the plan is one of no clear-cut plan. The time to act was the moment Italy locked down. Britain is trying to win the race against a slippery uphill slope that will cost the country lives--not through the fault of doctors and nurses but through a lack of resources and bad timing.
The Lancet editor-in-chief took a hard stance this week exposing the holes within a system on its knees. Reports of doctors’ heading to DIY stores for supplies is old news. It is sad to see nothing has changed. I recall having to go and get bolts from B&Q as a surgical registrar when “we ran out of them” in orthopaedics. My consultant funded this from his own savings. Masks being supplied in some hospitals are expired while staff have not been given adequate PPE training, if any.
For years doctors have campaigned about poor staffing. While new hospitals have been built in the UK, given the avalanche of patients and the severity of their coronavirus symptoms how will a single doctor manage to care for even two of these critically ill patients riddled with co-morbidities?
With a service already breaking at the seams, medical teams around the country are overworked. Their morale is at rock bottom as they sacrifice being near loved ones for fear of infecting them due to a lack of protective equipment and lack of corona testing kits. We know covid-19 disperses at an R0 of just over 2. So, one patient with covid-19 can infect another two people in close proximity.
Now imagine a ward of inadequately protected doctors, mixing corona and non-corona patients in a ward the size of the Excel in London. What method of containment is being used? Where is the contingency plan? Where is the leadership?
We know that everyone loves “our NHS” yet Saturday’s 8pm thank you clap was considered by many in the field as belittling and demeaning as they watched the public gather in parks earlier that morning and head to the countryside in groups the very weekend social distancing was enforced for their own health. “No-one cares about our safety, as long as we get the job done--even if we die doing so.” While the government struggles to pick up the pieces, our biggest weakness facing this pandemic is public denial. Some members of the public do not wish to adhere to the rules.
Consider the consequences when this all ends. We will have lost family members and we will have lost staff. We will no longer have trained doctors to cover next winter’s emergencies. Italy is proof--but Italy acted when it could. Britain saw the smoke and acted after it could. As an outraged French doctor bared the words “chair à canon” across his chest protesting to French media, his message mirrors what colleagues globally would describe as the phenomenon of “lambs to the slaughter.”
If this tragedy can teach us anything at all it is the onus of containing covid-19 is not on the doctors but on you.
Dr Lilani Abeywickrama is a Luxembourg ophthalmologist. Her main interest is advocating healthy living and precision technology within her specialty, and she is also pursuing an interest in the field of healthcare management.