In a year like no other, my work as a GP has seen a constant whirlwind of activity and emotions. I have seen first-hand the lasting effects of Covid-19.
I was hospitalised in April with Covid pneumonia, incidentally the same week as Boris Johnson was. I had been meticulously washing and donning and doffing personal protection equipment and stripping down and showering on reaching home. But my husband had been working on a hospital ward where most of the staff had contracted Covid. It was inevitable that we would catch it. For him it seemed like the worst case of flu he had ever hand. I felt bulldozed. My doctors said I had mild pneumonia, but coughing until I could not breathe and feeling like I would drown in the secretions of my own lungs, then it seemed anything but mild. Three weeks on, I thankfully made a good recovery, although I still could not run for long periods and felt fragile emotionally. For us Covid was real not some distant entity from a far off province of China. We had lived and breathed it and come out scathed but alive.
But its impact has been devastating on some people – young patients suffering organ failure or catastrophic strokes following Covid infection. Our white board in the back office has a list of those who have died. In the first wave, this became painfully full with many sudden deaths in previously well individuals. This was not just a virus. It had the capacity to maim and kill or go undetected in super spreaders.
Our local hospital like many across the country has full wards this winter. Some have been closed as large numbers of staff contract Covid or self-isolate. This is despite use of personal protective equipment, strict hygiene measures and patient testing on arrival for elective and emergency admissions. There is also regular testing for staff. We are also seeing people with Long Covid symptoms over months - one in five patients – such as fatigue, shortness of breath and chest and joint pains.
There is also indirect impact of Covid as people arrive late with their medical problems. There is reduced access to external services such as secondary care with delay in appointments and tests. Deteriorating mental health in many patients has also been a significant concern as we see more people with emotional distress from prolonged stress and isolation.
As we look towards Christmas, everyone is in need of a restful break and a chance to reflect. There is Covid fatigue amongst NHS staff too after months of unrelenting workload and heightened stress. Christmas is about family but after all the sacrifices of this year, ultimately we have to keep ourselves and others safe. There is limited capacity within the NHS now and the concern is that social mingling across tiers over Christmas will result in higher infection rates and overrun hospitals a few weeks later.
It's important to consider how our social mingling could pose health risks. Covid is highly infectious in close group settings and can infect the same household very quickly – such as spending a few hours with them or staying overnight. This can be reduced by physical distancing, face masks and by limiting outside contact prior to visiting elderly parents or vulnerable relatives. Some people also test regularly such as in certain occupational settings. My husband has been testing following working on the Covid ward. We would potentially pose a risk to my parents who are shielding, so we will not be travelling to them in Manchester. This is their wish and mine.
But for many people the right decision for their emotional wellbeing is that they do meet loved ones, as safely as possible. Mental health burden has sadly been so significant during the pandemic that the need to isolate must be balanced against harm that this can cause.
I have also thought about people’s capacity for resilience and kindness - pulling together emotionally whilst staying apart physically. There are many stories. Our lovely NHS volunteers are delivering parcels and medicines to housebound, a running group takes monitoring equipment to sick patients and the wonderful rainbows that we see everywhere have become a symbol of NHS.
The prospect of Covid vaccination gives hope too that we are nearing the end of this painful chapter. We were due to start vaccinations this week but this has been delayed. It was disappointing, but we donned our Christmas jumpers over scrubs, that are frayed and faded from countless washes. The mood was still festive. At home, my son made a Christmas card with a big ship and an even bigger Christmas tree – it would be one of 600 handmade cards for each seaman and woman spending their Christmas on HMS Prince of Wales. This will be a Christmas like no other and for that it will be memorable.
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