Although hospitals in the South West have been coping well with the pandemic, staff are anxious about what happens when restrictions ease. And, in her second report, senior NHS manager Kate Lock says they are starting to contemplate how to live with Covid – permanently.
So we are past the peak. We are holding our breath in the medium sized hospital in the West Country where I work. We know that the South West has been spared the very worst of Coronavirus so far. Of all the regions in England, we have had the smallest number of infections and the lowest number of deaths. Our hospitals have been coping well. If you are unlucky enough to have a heart attack or a stroke in the West Country, chances are that the hospital you go to will be well able to treat you.
But what I don't see is inside the care homes in my patch. I feel for all the care workers, even if they have PPE (personal protective equipment), the soullessness of caring for frail elderly people without being able to touch and comfort them. And even with the best care, many more people will unfortunately succumb to the virus before it has blown out its worst.
Whilst we think we might be over the peak, we know that as restriction on movement eases, Covid might re-emerge. So, in the hospital we are now contemplating life with Covid - permanently. Who needs to get tested before they come to the hospital? Which operations will get restarted first? How much PPE do we wear for which procedure? When will visiting resume? We have lots of questions and few answers. The good news is that the public are beginning to come back to see us - numbers are rising slowly. Previously, we were concerned that people who needed care were staying home. But, of course, we now have to care for them and for the people with Covid, even if there are not huge numbers. We know that there are two big "Nightingale" hospitals going to open soon, but we don't know which patients they are going to look after - so far only small numbers of Covid patients have presented needing the very severe ventilation care the Nightingale hospitals were designed to cope with.
So whilst as families, and individuals, we are really looking forward to the lockdown being eased, we are also in slight trepidation for what might come next. We really hope the amazing good-will which has poured out from the public will continue when the crisis of March and April, becomes a long term problem into the winter.
Gifts of joy still arrive at the hospital. A band of motorbikers, clad in black with blue scarves arrived en masse one day, loaded with food for the workers. Free food is dropped off for staff daily from a local private school, presumably whose kitchens aren't feeding hungry teenagers at the moment. Staff are coping - adjusting to all the new PPE kit. People are getting used to spotting a smile over the top of a mask.
Testing for Covid-19 is the next big thing. A few words of warning on this one! Testing is really effective in the early stages (day 3-5) of the illness, when your nose and mouth is full of the virus. Before that, you can get tested, but false negatives (you test negative, but actually have it), can happen. After day 5, it's unlikely to pick up the virus - you have fought it off, hopefully! And, of course, it can't tell if you have had the virus, only if you have got it now. So testing as a way of tracking the illness has its limitations, but better than nothing. We are all hoping that having the virus makes you immune, like chickenpox. But we are fearful it will be more like 'flu - we know that having 'flu this year, does not make you immune for life. So we have to wait and see.
We are doing lots of testing of staff and patients. Test results come back fast and can really help; staff get back to work and patients can get operated on. And, most crucially, we can separate out those who have Covid from those who don't, and protect the patients and the staff. But we all know Covid is here to stay. So social distancing, masks, eye protection, gowns and gloves, will be a constant part of our lives, in hospitals and care homes, for a long time to come, maybe permanently.
Kate Lock is a trustee of the Crediton Heart Project
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