The first wave of Covid-19 at Newham Hospital, as told by ITU doctor Zara Al-Faham
PUBLISHED: 07:07 06 July 2020
© Zac Macaulay MMXII
Many of you will have seen Newham Hospital hurtle into the spotlight recently following the news that it is one of the UK’s regions hardest hit by Covid-19.
As a junior intensive care doctor working at Newham Hospital, I want to share my personal experience of caring for the sickest members of a community hit by one of the highest Covid-19 infection rates.
On 12 March our first Covid-19 patient was put on a ventilator. Just ten days later, I had worked over 100 hours and felt overwhelmed by the sheer number of critically unwell patients being admitted to hospital.
I was amazed to see how our unit expanded, as the team I’d come to know and love across the preceding eight months increased three-fold. There were lots of new faces, bringing fresh energy, and we quickly all became comrades in the battle against Covid.
Nurses worked heroically in the heat of their personal protective equipment (PPE) for full 12 hour shifts.
Each day our bleeps go off, we don our PPE and race to the next Covid-19 breathing emergency in our full kit. Our role is to stabilise the situation when oxygen alone is no longer enough.
Often this required putting the patient to sleep in order to put them on a ventilator. As the last people to see patients awake, a special bond is formed.
I remember each and every one of their faces, their names, their stories and how they put their faith in me, a stranger in mask and visor.
Many Covid-19 victims were key workers, unsung heroes who were most at risk. We admitted healthcare assistants, nurses, paramedics, taxi drivers, TfL workers, security guards, carers, and consultants.
Of Newham’s total ICU admissions a large proportion were from a black, Asian and minority ethnic (BAME) background. While this in part is in keeping with the make up our local population, nationally, people from these groups are more likely to have worse health outcomes than their non-BAME counterparts.
Newham’s intensive care unit (ICU) went on to admit way over of its normal capacity during that first month; 60 per cent of our admissions were stabilised, then transferred to other ICUs across London, with many making full recoveries.
Those patients too unstable for transfer stayed on our ICU. Some are still ventilated to this day.
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Inevitably it is the sickest, with least reserve, who are at most risk of dying. There are emotional consequences for the carers when they lose patients, also known as ‘physician grief’.
I have witnessed more death in the last few months than at any other point of my career, and I am yet to know whether this has, or will affect me further down the line.
To help combat this grief, I’ve kept a close eye on the outcomes of all the patients we admitted.
Death brings the breaking of bad news. Having to do this over the telephone, to families who’ve been restricted from visiting their loved ones, has been very painful.
We can only allow a single family member to visit when the time comes to say goodbye. There is a surreal feeling when you greet that relative. Someone you have never met before, in an eerily empty hospital corridor.
You lead them through what at the time feels like an extended, sombre and almost ritualistic donning of PPE. Together you then walk into a hushed unit, to their loved one.
You try to act like this is something you are used to, ‘all part of the job’ etc. But in reality, each time has felt as distressing as the first.
We’ve introduced video communication, via tablets, for those who weren’t able to visit. This has been helpful for families to keep in touch with their loved ones while they are in hospital and also have a chance to say goodbye when the patient deteriorates.
For the members of staff present at these conversations, myself included, standing behind the tablet and hearing the emotional outpourings of family members — whether it be words, sobs, prayers — has been my privilege.
I’ve felt incredibly supported by my colleagues throughout the crisis. Sitting and chatting to members of my ‘ICU family’ at the ends of shifts often gave me more of a release than any catch up with my actual friends and family.
Members of the public have kept us fed, watered and motivated. We are extremely grateful for all of this. It has made a significant difference to my journey knowing how much support there has been for the frontline staff.
As the number of cases has fallen in recent weeks, I have had time to reflect on the adaptability, collaboration, perseverance and resilience of the people I have worked with over the last few months.
Every Covid-19 survivor means the world to us right now and continues to remind us that our efforts are worthwhile.
One thing I have learned, and that gives me hope is that Newham Hospital’s frontline team remain prepared to take on the second wave, if and when it occurs.
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