I am a Doctor with Suspected COVID-19. We are all being let down in this pandemic emergency.

COVID-19 Particle. Credit: Wikimedia Commons

Edit: I am now on Day 25 since I first started having symptoms, and it’s been a really rocky ride. Some people reading this will know from experience of this clever and unpredictable virus . Writing, even when feeling awful, has helped distract me, and I wrote an update with my feelings here. Thank you for reading and take care


I’m on Day 7: High fevers, muscle aches have slowly given way to a worsening cough and chest pains. My observations are stable, so all I can do is stay at home and hope that things improve. Speaking to colleagues in London who have the same symptoms, I know that I may be in for a rocky ride. If this is COVID-19, then I wasn’t one of the luckier asymptomatic carriers.

The problem is, I can’t tell without a test. Because of the government policy of Delay, I have not not fit the criteria for testing even as a frontline NHS worker. I don’t know if I definitely have COVID-19 or not, which impacts my colleague, patients, and when I can return to work. I hope that I can just ride through this illness with lots of fluid, rest and regular paracetamol. But surely we can only tell how fast the virus is spreading, and how to respond, if we can test the public (let alone NHS frontline staff)? I am in strict isolation now, and will avoid any interaction for a week, but others may have frail or elderly family members who depend on them.

Reports from Wuhan showed that Ophthalmologists and ENT Doctors were disproportionately affected, both in terms of transmission rates and severity of their illness. The heroic whistleblower Li Wenliang was indeed an Ophthalmologist, who died tragically young at 34. Because of how close we are to the nose, eyes and mouth, and the length of time we need to spend to examine patients, we are at high risk.

Dr Li Wenliang. The whistleblower who died aged just 34. He was an Ophthalmologist and contracted the disease treating an asymptomatic routine patient. Credit: Wikimedia Commons

I knew that my profession would put me at risk in times of national public health emergency, and that it would be my professional and moral duty to serve the public and help those who are unwell regardless. I accepted this as soon as I applied to study Medicine.

Nevertheless, we lacked active leadership a few weeks ago in order to protect our patients and staff, and prevent the Wuhan experience of young doctors dying from happening in the United Kingdom. There should have been a plan to cancel routine appointments and bring into place active measures to reduce the chance of exposure, and degree of viral load (the dose of virus particles). There is conflicting information about the use of PPE (personal protective equipment) to reduce the risk of this disease, but we are dealing with unique times which call for crucial judgement calls. In places such as Hong Kong, a proactive approach from early on may well have stemmed the tide.

 
Guidance on facial hair compliance for facemark fitting. Credit: CDC

A sealed face mask, with eye protection, gloves, and most importantly care when removing and changing my equipment, may have stopped me from getting the virus. I appreciate that it is a challenge not to respond reactively, rather than proactively, in a stretched healthcare system. Nevertheless, the attitude seemed to be one of wilful ignorance and denial. An acute care clinical lead in London said:

“I was in denial about the seriousness of this virus a couple of weeks ago”

And it seems this laissez-faire approach to the pandemic is borne from the highest level, with Boris Johnson saying just over two weeks ago:

“I am shaking hands. I was at a hospital the other night where I think there were coronavirus patients and I was shaking hands with everybody, you will be pleased to know, and I continue to shake hands.”

 
Prime Minister Boris Johnson over a fortnight ago. Credit: Yahoo News

This arrogance may now prove costly, as I fear the measures in this country are too little and too late to stop the march of this awful virus. The disparity until now between the government’s approach and that of the WHO, which called for widespread testing, contact tracing, social distancing and quarantine is wide. The initial strategy of doing very little and encouraging “herd immunity” will cost many lives. Richard Horton, the Editor of the Lancet called it “playing roulette with the public.”. The actions of Chancellor Rishi Sunak to support people and business during this time should be praised, but without a leadership with a solid strategy to enlist private health organisations, expand intensive care units and protect our healthcare workforce, it will be irrelevant. The difference is absolutely stark between the approaches to protect healthcare workers in East Asia and those here, who are unable to obtain basic surgical masks.

More than anything, I feel angry with a media and political class who have systematically devalued the NHS. Few people enter healthcare professions for respect and esteem over the wish to care and treat for their fellow human, yet it feels that doctors nurses and other frontline healthcare professionals are treated worse and appreciated manifestly less than so many other countries.

 
Decades of insiduous headlines from our tabloid press have reduced trust in the NHS. Credit: Tabloid Watch

The lack of trust in our healthcare systems generated by decades of malevolent tabloid coverage now pervades social media, where a woman who was hospitalised with coronavirus received abuse simply for highlighting her condition.

I really do hope that I am another blip, and we don’t see the worst-case scenario of a paralysed workforce unwell and unable to treat the surge of patients with COVID-19.

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