Doctor’s diary: We know a coronavirus tsunami is coming

Tuesday, March 31st, 2020 00:00 |
John Wright.

 John Wright

We know from what’s been happening in Italy how Covid-19 is likely to affect us in Bradford (Institute for Health Research).

Multi-generational households are common in Italy and also here - particularly among Pakistanis, who make up under a third of the population and are genetically predisposed to heart disease and diabetes, the very underlying health conditions that can make Covid-19 particularly deadly. 

There are poor areas in Bradford, and some white people have high levels of lung disease from smoking. We know there is a tsunami coming.

At present there are 16 intensive care beds in the hospital and that’s usually enough, but it’s been projected that we could be treating 500 people at the peak of the epidemic, so we need to ramp up very quickly.

A disused ward has been fitted with ventilators and other wards are being reconfigured.

Dr Debbie Horner, in charge of Covid-19 intensive care planning, says accepting the scale of what’s happening has been like going through the stages of bereavement. 

We have also been taking steps to obtain more personal protective equipment.

Our stocks of surgical masks are good, but supplies of more effective PPE masks and eye-protection visors were running low.

So a consultant, Dr Tom Lawton, went to Screwfix to buy industrial masks - and then found a way of attaching medical filters to them, using a 3D printer he keeps in his garage. Another went to a builders’ merchants and bought 2,000 pairs of goggles.

Consultant anaesthetist Dr Michael McCooe, meanwhile, started looking into ways of sterilising masks, so they could be re-used, and called Whittaker’s gin distillery in the Yorkshire Dales.

Mr Whittaker himself answered the phone, and said that his 96 per cent proof gin could be diluted for the purpose.

“He was very happy to donate to us,” Dr McCooe told me. 

Seasonal viruses

But in the last week or so, both Horner and McCooe have gone into isolation. Debbie called me on 20 March, just before we were going to run our Covid-19 case rehearsals, to say that she had some mild symptoms and was going to go home, just to be on the safe side.

We haven’t yet started testing staff for the virus, but given how important she was, we felt that we needed to make an exception - and so we arranged for a surreptitious visit to Accident and Emergency on Saturday to swab for Covid-19 and other more likely seasonal viruses.

Then, on Monday, our microbiologist rang to drop the bombshell: the swab had come back positive.

A day later the clinical director of urgent care, Dr Sam Khan, started to feel unwell. And then Dr McCooe was forced to self-isolate because his partner, another anaesthetist at the hospital, was ill.

It seems likely that we were infecting one another as we planned our response to coronavirus.

If we lose many more of our senior clinical leaders at this early stage of the campaign it would be a disaster.

We have a rapidly increasing number of cases, but it still feels like the calm before the storm. And the eye of the storm will be in our Intensive Care Unit.  —BBC

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