COVID-19: working together in the NHS
I’m not meant to be here in London today; I shouldn’t be packing away my FRCS revision and receiving refunds from cancelled courses. I run past closed restaurants, pubs and gyms. I turn on the news, I turn it off. The cancellations, postponements and restructuring are all part of preparing for a global pandemic. My plans are now insignificant.
The COVID-19 virus is a monumental challenge we must face. Yet it is in moments of order amongst chaos, of organisation and ingenuity that we stand together. I have seen changes to the organisational structure of our A&E department. I have seen ambulances be met by staff wearing masks. I have been part of a surgical team reorganising their theatre lists, switching clinics to virtual telephone clinics and restructuring the on-call rota. Every hospital is doing the same; everyone is working to reduce footfall to hospitals, to prioritise cancer and urgent surgery and redeploying personnel to other teams in need. Evidence of teamwork is aplenty.
Concerns have been made public of inadequate availability of Personal Protective Equipment (PPE), simple surgical masks and the correct fitting of masks (and when to use them). There is mixed information regarding the testing of exposed and potentially infected healthcare workers. Confusion also arises over 7-day isolation recommendations for healthcare workers, compared to the 14-day isolation given to the public.
The fear of exposure is real – healthcare workers want to work, but also to stay safe – and a lack of consistent information fuels more concerns. We fear exposing family members and those they share accommodation with, and the dilemma of keeping those that are pregnant safe is justifiable. All trainees face a pause on training and progression: exams, courses and Specialty Training interviews are postponed and ARCPs are under review. However, we accept these changes with grace and composure; we trust in the Colleges and trainee representative groups that will support us. Working in the NHS is rarely easy, but we hear of support, thanks, special shopping hours and discount codes quicker than the virus can spread.
Social media has become an increasing source of connection and entertainment during #socialdistancing and #selfisolation. Notable examples include the memes and messages promising Wembley-sized lasagnes, videos of hand-washing dance routines and hundreds of singing jelly babies. There’s been a surge in downloads of virtual meet up Apps such as ‘Houseparty’ and ‘Zoom’ as the public are told to do their part; to self-care, stay at home and forgo their right to party. Staying in is quite literally the new going out. Sadly, there’s news of queues, empty shelves and fights over toilet rolls, but we’ve also seen kindness and community goodwill (for example, the ‘Mutual Aid UK’ community group flyers that facilitate offers of help to those that need it). Foodbanks have had a surge in demand; but initiatives such as Fareshare have been working hard to reallocate surplus foods from now-closed restaurants to those in need.
Important lessons are being shared between from doctors in countries worse affected by COVID-19 via Twitter. Treatment plans, models and assessment tools from different institutions are made public; this is quality improvement without the audit cycle. Lessons are being learnt quickly. This virus knows no borders and it doesn’t discriminate; the elderly and co-morbid are most at risk, but no one is immune. Learning from colleagues and sharing ideas are key.
Everyone will be affected economically, professionally and personally. Yet it is in this difficult time and times of change that we see the best in people. The evidence is in the selfless attitudes and mobilisation of the NHS workforce working together to deliver care, containment and treatment. We won’t see specialists, individuals or any one person more important than the other in the fight against this pandemic: in human terms there is no ‘I’ in COVID.