Doctors and nurses in areas of northern England with some of the highest Covid infection rates have described being “physically and emotionally” exhausted, as the NHS braces itself for the second wave of the pandemic.
Most of the north has been put into the tier 2 “high risk” category, with Merseyside in the highest – tier 3 – bracket. While politicians debate whether a nationwide circuit breaker would be a more effective instrument to curb spread of the virus, frontline staff – still scarred from the first wave – are under no illusions as to what lies in store.
Carmel O’Boyle, a nurse in Liverpool, who is also chair of the Royal College of Nursing’s Greater Liverpool and Knowsley branch, said members of the public had used A&E and primary care sparingly during the first national lockdown but mixed messages and a lack of trust in the government had led to people throwing caution to the wind and attendances were rising accordingly.
“The nurses across my branch are frightened and exhausted – physically and emotionally,” she said. “They’ve been dealing with this for months and now there are more people in hospitals than there were in March. Although we know a little bit more about how to treat people and the kind of path of the disease process, it’s still frightening. It’s just so demanding and so draining to be nursing people in this manner without any family involvement and with the complications that there are.”
NHS staff expressed concerns about the ability of hospitals to juggle the needs of Covid patients and those without the virus. To cope with the first wave, tens of thousands of planned operations were cancelled. However, with waiting lists hitting record levels over the summer, trusts are under pressure to clear the backlog while simultaneously dealing with the new influx of coronavirus cases.
A consultant in Manchester, who did not want to be named, said her hospital coped with the first wave but “the difference this time is that we’re trying to continue all of the elective activity and that’s going to be challenging.
“I do think that we will manage the Covid cases. I just now worry about whether we will be able to continue to keep the normal care for people who need their operations [and] need care for cancer.
“We were all concerned that the winter would bring with it other pressures but we were quietly hopeful we had some immunity, but it’s just not been the case and it’s quite obvious now that this is a bona fide second wave.”
On a more personal level, she said she was also worried about how she would balance the demands of work and being a mother, when her school-aged daughter “inevitably” had to self-isolate because of her mother’s profession.
Simon Thornton, a heart failure specialist nurse at Royal Liverpool hospital, echoed her concerns about winter and said morale was lower than it was during the first wave.
“I’ve got to decide if I bring them [outpatients] into hospital and expose them to risk, or leave them hanging in the wind where they might get unwell,” said Thornton
“If we get really stretched and the Nightingale hospitals pull staff out, what will happen to my patients? Before coronavirus happened, winter was always horrendous anyway … I don’t see how it isn’t going to be even worse [this year].”
Prof Dinesh Saralaya, a consultant respiratory physician in Bradford, said the winter presented “a huge challenge”, exacerbated by the difficulty of differentiating between Covid and flu, but staff were up to it.
“The number of patients in hospital with coronavirus has tripled in the last three weeks but we’ve been treating it flat out in Bradford – we’ve never had a Covid-free ward,” he said. “But we as a clinical team can recognise it better and have better treatments.
“The first time it was a novel illness, so emotions were running high, and medical professionals were dying so we were being treated as heroes, but the novelty wears off,” Saralaya said. “We’ve treated it for seven months now, so in a sense we’re resigned to it. We’re continuing as we would normally do, this is what we signed up for as doctors and nurses.”