The COVID-19 response: did we get it right?

by Nick Flatt

The backlog of elective surgery is only now being tackled, which will also cause anxiety and distress among patients and staff

Location: UK
Published: Friday 14 August 2020
nick flatt 27761

Anaesthetists are fond of adages: ‘The empty bag is always bad’ (breathing circuits); ‘the last organ to fail is the bladder’ (urology lists); and so on.

Perhaps our most famous saying describes the specialty as a whole: ‘99 per cent boredom, 1 per cent panic.’

Looking back at late March this year, for many of us that ratio was reversed when COVID-19 came to town. Elective lists disappeared, along with our job plans. The ICU spilled out of its usual confines, occupying empty theatres, recovery and vacated (sometimes created) wards. Queues formed at mask-fitting stations – always assuming PPE (personal protective equipment) supplies were available – then once fitted, FFP3 respirators turned out to be comfortable for the first few minutes only, followed by hours of genuine facial distress.

Our beloved anaesthetic rooms were abandoned, and bread-and-butter procedures cursed by the description ‘aerosol-generating’.

Frankly, a few anaesthetic colleagues appeared to quite enjoy it. There have always been those unhappy with our relative anonymity, where many patients don’t know that we’re doctors and only our occasional failures get noticed. Here was a chance to shine, we were needed and valued in a national crisis, the public applauded! However, for many it has been the most stressful time of their professional lives, and the psychological fallout has yet to work its way through the system.

The effects of COVID-19 have been awful but looking back at all that fear and extreme anxiety, not only among us but also the public, one can’t help speculating whether our reaction to the pandemic may cause more long-term damage than the actual virus.

As I write, the initial wave is over. Plenty more positive cases are being identified, but that isn’t translating into nationally increased hospital admissions or deaths. ICU has retreated to its original location and elective lists have largely recommenced, although with a markedly reduced throughput. That ‘sword of Damocles’ feeling has also eased, and many FFP3 masks now hang unused in changing-room lockers.

However, waiting lists were at a historical high before the lockdown, have since ballooned and will continue to grow without significantly more resources. Let’s hope the Government appreciates that without us there can be no solution, and that the autumn budget doesn’t use another adage – ‘we’re all in this together’ – to punish those who have risked their lives and livelihoods this year.

Nick Flatt is the specialty lead for anaesthesia on the BMA consultants committee