I arrive at work at 7.30am after driving through the empty streets of London. After coffee and breakfast, I don my personal protective equipment (PPE) and go into the “red zone” in the adult intensive care unit, where the Covid patients are.

As a perfusionist, I ordinarily manage cardio-pulmonary bypass during cardiac surgery and something called ECMO (extracorporeal membrane oxygenation) which is respiratory support for people whose heart and lungs are unable to provide an adequate amount of gas exchange to keep them alive. 

Normal is a meaningless word at the moment. All routine operations have been cancelled and last week I started on the frontline ECMO retrieval team for Covid-19 patients. 

We’ve currently got more than 30 patients, about half capacity in the adult intensive care unit, but we’re expanding that beyond normal measures. It’s a mixture of ages, but mostly elderly, and almost all with underlying health conditions such as pre-existing respiratory disease, hypertension and asthma.

We’re fortunate compared to colleagues elsewhere in the NHS because we have always had the personal protective equipment here. The main problem has been stock distribution but new stocks are now coming through. 

We expect to lose patients over the coming weeks. It’s not necessarily a daily occurrence but that may well soon change. Equally we expect to have many successes. 

I did feel nervous when I first went on into the red zone but I don’t any more. In the same way that the military are trained to go into war, we in the NHS are used to dealing with deaths and severely-ill patients.  What causes the most stress, aside from the long working hours, is the knowledge that Covid-19 and the condition of patients can impact on our own health, and the health of our families. 

The disconnect we’re ordinarily able to create between work and home is more difficult. My partner understands my job is essential and trusts the hospital is providing the right equipment.

We’re a centre for this and getting patients from the whole of the south of the UK. We’re not yet running flat out but working under extraordinary circumstances and already beyond the ICU capacity of our hospital with all non-clinical and management staff pulling together and the hospital closed to the public.  

The canteen has started doing free food for all staff and the special hours for NHS workers at supermarkets and takeaway discounts make a big difference. 

Right from very early in the planning of this pandemic, the hospital has been providing training for inter-disciplinary skills, so staff can move between roles they’re not normally involved in to relieve other staff groups. The hospital is still producing and refining procedures for Covid patient management, and working on increasing oxygen supply capacity because of the amount of ventilators we will have running. Thankfully there is no current shortage, yet.

We are fully staffed at the moment, but expect a significant amount of sickness in the coming weeks which will stretch us all to the limit. 

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