Britain has been in lockdown for six days as Covid-19 continues to overwhelm the NHS.
A junior doctor in one of London’s worst-hit hospitals tells how the wards are swamped with patients – and underequipped medics are being forced to make life-or-death decisions.
MONDAY NIGHT
It’s the first of a four-night stretch. It’s the busiest night yet.
The hospital is like a war zone, but I fear we will look back in two weeks and see this as the calm before the storm.
I work in acute care. It’s my job to keep patients alive before they go to the intensive care unit.
Half the staff are absent, self-isolating because they or relatives have symptoms of the virus.
There are about 25 patients with Covid-19. Those with coughs and temperatures get sent home.
Tonight, I discharge a patient in their 40s whose chest X-ray isn’t too bad. Their oxygen levels and blood pressure are normal.
We know how people can quickly deteriorate, but we need to keep as many beds free as possible.
Most of the sick I treat are not ready for invasive ventilation but need help to breathe and are on pressurised oxygen.
Difficulty breathing is pretty common and everyone who comes in is scared. We want to reassure patients, but we can’t.
By the time we clock off, we have lost six elderly patients.
TUESDAY NIGHT
Waiting for the Tube, I see a group of young people messing about on the platform.
They are not practising social distancing. I want to shout at them. If they pass this to relatives, it will be their fault if they die.
Tonight is the worst. The hospital loses 20 patients in 24 hours. I lose two patients when CPR fails.
It’s awful, but I don’t have any time to process it.
Supply of personal protection equipment is sporadic at best.
We have to wear fitted respiratory masks when we perform CPR or intubate patients, otherwise it’s a flimsy apron and paper mask.
CPR is being delayed in some cases by 10 to 15 minutes while staff run around the hospital trying to find the right PPE – because we are all sharing.
We have to carry out chest compressions until it arrives.
The virus attacks the lungs, which puts strain on the heart.
Most patients who die do so because their hearts give up.
Before this, I probably performed CPR on someone every second night shift.
Now it’s five or six patients a night and it’s been the same since mid-February.
We don’t carry out CPR on the very frail or elderly because it’s brutal and we know they won’t survive it.
There’s also a risk to staff because pushing up and down on someone’s chest releases far more virus droplets than talking or coughing.
WEDNESDAY NIGHT
A&E is unusually quiet and those who come in with conditions other than coronavirus are, in the main, sent home.
I think when this is all over, we will reassess how we admit people. Have we been too cautious in the past?
None of us talk about the elephant in the room – the number of patients who will die because they are too frightened to come to hospital or those who won’t get proper care because we are overwhelmed.
An elderly gentleman comes in with a gastric bleed and I run about like a blue-arsed fly making sure I care for him properly.
Tonight, I watch three people die before my eyes.
A patient in his 40s dies. He had an underlying health problem, but nothing major.
I hear the same from colleagues – people dying with minor issues, not the underlying health problems the Government talks about.
I hear about a case of someone who has died whose wife has tested positive for Covid-19.
She’s now got to self-isolate for 14 days. She has to bear her grief alone.
THURSDAY NIGHT
I don’t go in to work tonight. My partner has a dry cough and a temperature. I’m pretty sure it’s coronavirus. I call it in.
My boss is understanding and gives me a choice to stay at home with my partner or go to a hotel for a week so I can carry on working.
It’s a hard call, but I can’t let my colleagues down. I pack a bag and go to a hotel near the hospital. It’s going to be hard without having someone at home to offload to.
If my partner’s symptoms get worse I’ll have to return home and self-isolate, but, for now, I will be where I’m needed.
