First, I will not go into statistics as I am no longer sure on who is telling facts. With the present lockdown for almost a month now, majority of the population worldwide have been glued to their TVs and are aware of the statistics with the pandemic.
With what's happening in Wuhan and in Italy with the pandemic from when it started, it was expected in UK, like the rest of the world, the intensive care units(ITU) will be overwhelmed. In preparation, elective cases were stopped, level 2 beds were renovated to accomodate ITU beds ie. Coronary Care Units(CCU) having cardiac monitors and respiratory machines in managing patients. To manage this in our hospital alone; ward, theatre and catheter lab staff were upskilled with ITU training with further 2 days exposure in ITU as extra hands with the aim to handle patients independently.
In ordinary times, ITU skills that can be learnt in a few months, a week was all it took to armed themselves for battle. As such was the preparatory taken for a great responsibility in an ITU environment.
Furthermore, the nurse to patient ratio of 1:1 became 1:3 for the skilled, more or less with ward nurses and health assistants working as one with the massive admissions. At some point in those times in March, the lack of ITU beds was so obvious that triage was necessary on who can be admitted in an ITU bed. Where as if there's no bed available, there was a waiting list of patients needing to go in. Such criteria for examples were: patients aged 60 and above were excluded, more so for those who have a lot of co-morbidities that lessened their chances of making it. Among others, these was applicable to EVERYONE, including medical staff.
There were not just enough ITU beds, coupled with less ventilators. To make it worst, oxygen utilisation was so great at that time that the reservoirs were almost at bursting point. Not to mention the number of staff having symptoms, getting sick, on quarantine etc. For the healthcare staff, it was a battle, day and night.
For ITU beds not being enough in the whole of London, hence the creation of ITU BEDS in Excel having a total of 4,000 beds capacity, if needed. Staffing were shared by a lot of hospitals, nursing agencies, those who have retired, even airline industries, so staffing it was not an issue. That being said, as far as I know, the full capacity wasn't utilised from completion, even now.
If that's good news for the country, and for the world to know, the news going around our hospital is that, our ITU beds are getting empty. Seconded by friends of mine who are working in West London and down south in Devon, their ITU admissions are also getting less. From having a waiting list for ITU beds in March to vacant beds this late April only meant that admissions are becoming less. And from the grapevine, the number of staff in our ITU are now way up to the number of patients present. Perhaps it's time to re-evaluate on how those renovated ITU wards return to how they were before the pandemic.
Having discharged a few patients from last week who were intubated due the viral complications of pneumonia, septicaemia and acute respiratory distress, a lot of patients have overcome. Majority had a very long hospital stay but at least they got better.
From the start, the rising number of positive cases was very overwhelming everyday. Although doubtful as not backed by data, that's all what people are getting in the news. More so now that massive testing has been happening. Soon after, I have stopped looking in the numbers from the news, even in our hospital's website as there are too many. In saying that, those statistics lacked basis as no data was included in most reports seen on TV, this from my point of view only. Some would say that maybe in reality, there should be more cases that are not being reported as a lot of patients were not tested.
Perhaps.
I don't deny the seriousness of this pandemic as we have had deaths from a friend of a friend, a friend of colleagues and actually knew some in our circle who were seriously admitted to the hospital, a few were also intubated. As I am writing this post, my ACLS instructor of long ago is presently intubated in ITU somewhere.
As a healthcare staff working in a Covid-positive ward as an ITU step-down and from other wards, our ward have the stable patients from ITU. It's a long recuperation but it's a relief to discharge them home, walking and seeing how eager and are looking-forward they are in seeing their families. Let me reitirate though that a lot of confirmed cases in our hospital are asymptomatic, wherein their admissions were from other medical issues.
If these trends go on, perhaps the world will follow and lift all these lockdowns in placed with this pandemic. We expected the worst and in some places, the number of deaths was overwhelming in such a short time. But I think that the death's projection was greater than what the reality is showing us.