A Day in ICU London’s ‘Parallel Universe’

LONDON – A crowd of masked nurses and doctors in blue paper gowns are moving from one coronavirus patient to the next providing life-saving care. Some patients had to stretch for days or weeks. Others calculate their length of stay in months.

If two years of the pandemic are over, health care workers lament, you hardly know it here.

Lucy Jenkins, who leads the critical care nurse team at Homerton University Hospital in East London, said: “We live in this parallel universe, comparing what healthcare workers are on the front lines. experience with what the public sees.

Political leaders have moved to herald mild symptoms of the Omicron variant and declare pandemic over. The UK government lifted nearly all restrictions on coronavirus in mid-January as infection and hospitalization rates plummeted compared with early last year and as vaccines reduced the number of people who became seriously ill.

But for doctors and nurses, a return to the normal rhythm of work is still a long way off. While Homerton’s intensive care units are few and far between, like they were at the beginning of last yearlike many in the UK, they still face a constant stream of coronavirus patients.

So many people have been infected with the coronavirus this winter – a record of about 186,000 new daily cases in the first week of January – that even if few of them become seriously ill, hospitals are still struggling. under great pressure.

In intensive care units like Homerton’s, which treat the most severe illnesses, nearly everyone in care is unvaccinated.

Since the start of the pandemic, the hospital has treated more than 2,000 patients with coronavirus. Nearly 500 people died from Covid, according to hospital data. Now, the pandemic has created a lasting change in the way the intensive care unit and many other facilities in the country operate. We visited Homerton on January 21st.

A group of doctors and nurses made their way around the stairwell of the intensive care unit, dedicated to treating coronavirus patients. They hovered over the charts and compared notes on five patients. Each person needs ongoing care.

Four of them were hooked up to ventilators, and the machine’s rhythmic beeps sounded steadily in the background.

The area was set up at the height of the pandemic to treat the most critically ill Covid patients. The space was originally a reception area for surgery and was never intended to be used for this intensive care service. But as of spring 2020, it has never closed.

It’s like trying to set up a specialist unit in the living room, says Dr. Susan Jain, anesthesiologist and specialist in intensive care and primary physician. This area is not fit for purpose.

Things have slowed down, she said, but staff are still on the move.

“We have yet to see a point where we believe the number of critically ill Covid cases is declining,” she said. “So there’s a kind of unpredictability hanging in the air, in terms of how much and how long the pressure continues, but it’s there for the foreseeable future.”

Mary Connolly, a senior nurse who has worked here for 32 years, moves easily from bed to bed, explaining the important details of caring for each patient. She explained that nearly all of what they were being treated for was unvaccinated. A few deny that the virus even exists.

“Now that’s a new thing, people are refusing to experiment,” she said, shaking her head. A man with a tracheotomy groaned as she and another nurse slid him onto the bed to prepare him for an X-ray.

“Don’t pull it out,” she said softly as he grabbed the plastic tube protruding from his neck.

One of the patients being cared for at the unit is 47-year-old Dean Grey. He was there for 5 days and was the only patient not on a ventilator. Tubes ran from the tube in his tattooed hand. An oxygen mask is fixed on his nose and mouth.

I sat by his bed as he told me how he had come to London to see his family for Christmas. He and his mother became ill with coronavirus at the same time. She was admitted to the hospital first. He was brought in the day she died.

“I never got to meet her,” he said.

Mr Gray decided not to vaccinate and said his reluctance stemmed from distrust of the government and worry that the true scale of the pandemic had been exaggerated.

“You’ve got Boris Johnson going to parties, and that really puts me against that,” he said, pointing to the recent government scandal amid alleged that the prime minister lied about attending parties during the lockdown. “If all these problems hadn’t arisen, I would probably have been vaccinated. But if the milk looks sour, I won’t drink it.”

Visitors are not allowed to go to areas where coronavirus patients are being treated, but an exception was made in the case of Mohammed Tahir. He has been hospitalized for the past six months after contracting the coronavirus in August.

For a while, he got better and was moved out of intensive care, but he returned in December. His bed stood alone in a separate bay. Unlike everyone else in the ward today, he was vaccinated before getting sick.

When his son, Omar Tahir, visited for an hour, Mohammed’s expression immediately softened. He was worried without his family around, Omar explained. So Omar quit his job and moved home to be closer to the hospital and be with his mother, he said.

“A job can be replaced, but you cannot replace him,” he said.

Omar massaged his father’s frail legs with lotion, his hand moving carefully over the sharp corner of the shinbone. Mohammed motioned him to ride safely on his motorbike, his hand gesturing as if he were gripping the handlebars, and he flashed a smile.

Mohammed looked deeply into his son’s eyes and smile, rarely breaking eye contact. When it was time to say goodbye, Omar wiped his tears.

When evening came, Ms. Jenkins, who was leading the nurses here, discovered that they would be taking in three more patients. It is always a logistical strain.

Adding to the difficulty is the fact that coronavirus patients are treated in a separate unit of the unit and that the nurse-to-patient ratio in intensive care is higher than in other parts of the hospital.

The surge in patients coupled with staff shortages – caused mainly by the pandemic, Brexit and burnout – have meant the hospital has to rely on many ICU temporary nurses. So even if the number of patients decreases, the pressure remains.

“I think people are exhausted, they are exhausted,” Dr. Jain said. “The incentive to work in any of these environments is very minimal, which is a big deal.”

However, things have improved from this time last year when my colleague, Andrew Testa, visited the unit. It is the peak of the second wave of coronavirus infections hitting the UK, and The unit is overflowing with patients. All the beds were full, with a total of 22 Covid patients.

Currently, there are typically between half a dozen and a dozen coronavirus patients on any given day, the hospital said.

But many health care workers are still grappling with months of monitoring illness and death on a scale they’ve never experienced, with some suffering from post-traumatic stress disorder.

“It’s the sheer volume,” Dr Jain said, adding that it was the same in hospitals across the country. “It was mass death and it also felt like it was avoidable.”

Outside, banners lined the street opposite the main entrance with the message for staff: “Thank you to all the hard workers at Homerton Hospital. We love you,” one read.

The edges of the banner are now tattered and blackened from the exhaust of passing cars since they were first hung in 2020, when the pandemic began.

In many ways, the employees inside feel a far cry from the early days. In a way, little has changed, but what has changed is profound.

“You know, in Wave 1, we were the heroes,” said Ms. Jenkins, nursing team leader. “In Wave 2, we were the enemy. And that is difficult. ”

https://www.nytimes.com/2022/02/02/world/europe/covid-london-icus.html A Day in ICU London’s ‘Parallel Universe’

Fry Electronics Team

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