The mood on the wards could not be darker. We work as fast as we can, but wearily, warily, with teeth gritted and stomachs knotted. Here is a snapshot of the things I’ve heard this week: “I’ve stopped sleeping”, “I’ve got that sick, sick feeling again”, “I’m scared” and – on endless repeat – “I can’t do this again”. One doctor friend, close to tears, told me: “We stopped being heroes a long time ago, now we’re just cannon fodder.”
Some people are saying they won’t go back there again – to the Covid wards and the Covid ICUs. They say a third redeployment would break them. Who can blame them? There is only so much a person can take. Personally, the prospect of going through it all a third time has me typing this at 3am, too brittle and wired to sleep. I may be a palliative care doctor, but I saw enough death and dying in wave one to last a lifetime.
Still. It certainly rallied the troops this week when we were sent a letter from Boris Johnson, hand-addressed to “the whole of the NHS”, that assured us (literally) of his eternal gratitude. I say “sent” – he actually tweeted it. But he did make a prime ministerial promise, and you know how reliable those are: “I can assure you that this government will do whatever it takes to give you the support you need.”
The very next day, alas, he was up on that Downing Street podium, joking about “jab-a-thons” and giving Covid “both barrels” and “a left and a right”, yet singularly failing to introduce any new measures to control Omicron’s wildfire spread, or even to recommend cancelling Christmas parties. As Johnson continued to insist formal restrictions on gatherings were unnecessary, Chris Whitty injected a much-needed dose of Omicron reality: “This is a really serious threat… Don’t mix with people you don’t have to.”
London is the epicentre of the new outbreak and there, in the last week alone, the number of people hospitalised with Covid has surged by 26 per cent. This is the start of it, the dying to come. From my patient-facing perspective, it is wild – simply unfathomable – that we can be walking into another Covid horror show relying solely on booster jabs, when there are so many other prudent measures we could be taking to minimise the loss of life. Generally, I bristle at military metaphors in healthcare. But this really does feel akin to going over the top – NHS staff being ordered to walk slowly, deliberately, towards the guns and barbed wire by an Etonian overlord with a toddler’s haircut.
It is hard to convey quite how dire conditions are in hospitals, even with current Covid bed occupancy levels – before Omicron pushes them upwards. Many of us on black alert – meaning, essentially, full. New patients can only be admitted when others are discharged. Trusts have been forced to repurpose discharge lounges, offices, theatre recovery areas and even broom cupboards to squeeze in more beds (thus stretching staff even more thinly). Yet still the ambulances sit stacked up outside, unable to deliver their patients.
In this grim context, we need a temporary escalation of Covid restrictions – a two-week circuit breaker, for example, plus immediate government support for the hospitality industry – in order to protect everyone in need of healthcare. As Covid admissions rise, the NHS’s capacity to deliver high quality care to every patient – whether they have cancer, heart disease, a stroke or Covid – will only further diminish. All patients will suffer.
Something that really did improve NHS morale this week was Whitty’s withering response, during a Commons Health and Social Care Committee hearing, to a zombie argument that refuses to die. What would Whitty say, asked Tory MP Dean Russell, to those who claim we are: “prioritising Covid over other things… Covid over cancer, Covid over other serious issues.” The chief medical officer’s uncharacteristically undiplomatic reply is worth repeating in full: “This is sometimes said by people who have no understanding of health at all… and when they say it, it is usually because they want to make a political point. The reality is, if you ask any doctor working in any part of the system, they will say this: What is threatening our ability to do cancer, what is threatening our ability to do all of these things, is the fact that so much of the NHS effort, so many of the beds, are having to be put over to Covid and we’re having to work in a less efficient way because Covid is there.”
That, right there, is the crux of the matter. No-one, believe me, wants to be treating Covid. Nor does a doctor like me nonchalantly embrace the idea of state encroachment on individual liberty. But a temporary escalation in Covid restrictions is required to prevent, or at least to minimise, the unspeakable indignity and suffering that occur when a health service is completely overwhelmed.
This is not – and never was – about something so crass as “protecting the NHS” (a slogan so divisive you could be forgiven for wondering whether the government actually intended to stoke anti-NHS hostility). This is about protecting each other. The people you love, and the ones you’ve never met. All of us, in it together.
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