I knew the coronavirus was coming; I think we all did, but we didn’t know it would be like this. My sister lives in Hong Kong, so I had heard from her early on about this novel virus, transmitted from the wet markets in China that caused a cough and fevers, and that some people were unable to fight it off. I knew they were in lockdown months ago, that they were avoiding public transport, offices were shut, schools were closed and everyone was wearing masks.
So when cases arrived in the UK you’d think I would have been prepared; I wasn’t. I somehow thought that here in the UK it wouldn’t affect us as badly, that we wouldn’t need to instigate the same stringent rules as in Asia, that somehow we would be able to manage it with ease and that the cases would be few.
When the announcement came on 23 March that we were entering lockdown, the reality of the situation jolted me. My mind raced, considering the implications for myself, my family and my work. The thoughts of how I would manage to homeschool my children, whether I had enough food at home, of not being able to see my parents or being able to play netball on a Tuesday night flitted through my mind.
I thought about work; thankfully I would still be able to, but what would it look like? Surely we wouldn’t be doing our usual non-stop face-to-face clinics and visits that take us through our day? Would we manage our patients remotely and would it be safe? As the days went by I eased – well, crashed unsteadily – into our new routine. Within a week I had to self-isolate for two weeks as a household contact of someone with signs of corona.
I frantically tried to establish how I could work remotely from home but it quickly became clear that the IT systems were not ready to enable this. I received contradictory advice about whether I could return to work or not, and with no hope of testing it became clear to me that as an organisation we were not quite ready for this, and there was a long way to go to iron out the creases. I looked on at the rapid speed with which new guidelines were released from the Government and NHSE and the way that LMCs, PCNs and practices were scrambling to keep up. I was both impressed and terrified in equal measure.
After my two weeks of isolation I returned to work, amidst the ongoing worries about PPE shortages, and wondered what it meant for us all, how likely we were to contract corona and worse still, how likely we were to pass it on to our family. Colleagues were so fearful of this that some were choosing to live separately from their children and other vulnerable relatives to protect them. I started to hear of locum colleagues having their shifts cancelled at the last minute and losing large parts of their income.
I watched closely as the new scheme was implemented to bring back retired doctors, but to what? And how quickly would they be able to start? There was a strong feeling from doctors that everyone wanted ‘to help’, but not necessarily knowing how. The barriers to accessing work due to bureaucracy became clear.
Like most of us I have tried to keep positive, finding different ways of coping; for me it has been running, for others it may have been baking banana bread, painting, reading or walking. The sadness comes in waves, not least when we lose another relative, friend or colleague due to the virus, with so many like me from a BAME group.
The challenges at work are varied and always evolving, trying to manage patients with unusual symptoms and trying to identify those on the phone who may have corona, or often – more worryingly – those who may be having heart attacks, strokes or other life-threatening illnesses. We wonder how many people are unwell at home and not contacting us. This feeling of walking a tightrope and desperately trying to avoid making the wrong decisions is not new, but is constant in a way that is different to our usual daily practice.
Then, coming home and trying to learn how to teach maths, phonics, to play and paint and create. To make sure that we are reaching out to our relatives living alone and trying to reassure our friends and family who are worried about the outbreak. All whilst wondering, deep down, ‘will we all be ok?’
Don’t get me wrong – there have definitely been some aspects of lockdown that have been good: slowing down, spending more time as a nuclear family, having time to consider our priorities and to set ourselves new challenges. At work the sense of camaraderie and selflessness is like nothing I’ve ever experienced before. We now have weekly ‘claps’ from the public thanking us, special discounts from retailers and priority queuing for supermarkets, all of which help.
But the questions still burn inside:
- Why are we having to use donated visors made from a school D&T department?
- Why does a 99-year-old war veteran need to raise money to fund the NHS?
- Why has it taken so long to get testing for healthcare professionals and their families?
- Why is there a PPE shortage in a country that prides itself on having one of the best healthcare systems in the world?
- Why is our death toll so high?
These questions won’t go away and we must continue to seek answers once the crisis settles down.
Life post-corona will no doubt be different. Personally, I think each of us will come out of this with a slightly different perspective. Professionally, the pandemic has forced the medical world to work in an entirely new and different way, and some things will no doubt stick, for the better. We all wonder if it will change how patients use the health service; we will have to wait and see.
Sadly, before we get there we will see more of our colleagues, friends and family lost, some through corona, others through different illnesses. We will have to learn to grieve in private, without proper funerals and the option of consoling each other.
But I do know that all of my training, from the textbook learning and lectures at medical school, to the grueling and terrifying night shifts as a surgical SHO trying to keep the sick patients alive until morning handover, to the consultation styles teaching and practice of breaking bad news during VTS and the duty doctor GP days sifting through those who needed to be seen to those who could wait, were all preparing me for this... They taught me how to be inquisitive, methodical, empathetic, calm and resilient, and this pandemic, both at work and home, is requiring me to use all of these skills like never before.
I know that we will all get through this, each in our own way. In the meantime I can only wish good health and wellbeing for all of you out there working during this unbelievable time.
Sarah Westerbeek is a member of the sessional GPs committee executive team