Yesterday, an Essex trust called in the army after declaring a major incident, and patients are routinely being treated in ambulances outside hospitals, due to lack of space inside.

On Thursday, the Government said a further 964 people had died within 28 days of testing positive for Covid-19, bringing the UK total to 73,512. as hospital admissions go well past the April peak.

In an exclusive interview with the Sun, two frontline doctors reveal their tears over the latest Covid crisis and say the NHS – and its staff – are at breaking point.

Dr Pushpo Babul Hossain, a junior doctor working in South London, says:

“I don’t think any health care system in the world is equipped to deal with a pandemic of this scale.

We’re working all the hours we can and it’s absolutely draining.

Sometimes, you don’t feel like you’re saving lives anymore. You’re on autopilot, you’re just firefighting, holding the fort until the next shift comes to rescue you.

When we see the anti-vaxxers spreading nonsense and people refusing to wear masks, or obey the rules, it breaks our heart. How are we ever going to deal with the consequences of their actions? We really can’t.”

She says:

“Being a doctor should be a very rewarding profession but at the moment, we don’t have the time to feel anything.

We are having to deal with an unimaginable number of patients and doing so many extra hours, we’re in a non-stop, ‘eat, sleep, work, repeat’ cycle which is exhausting.

As a medical doctor on the Covid wards, I see patients who have been referred by A&E with suspected coronavirus infection.

Because we are so full, we’re only taking patients that desperately need oxygen.

Everyone else is told to go home, self-isolate, and monitor themselves for signs of breathlessness, chest tightness and chest pain.

As well as the Covid patients, here are some of those who were sick in the first wave but didn’t come in because of the pandemic and have now developed more serious complications of other diseases. It’s a recipe for disaster.

During the first wave, I had to fight to get a patient up to ITU and, just before my night shift ended, we finally got a bed.

I was relieved he was going into ITU and convinced we’d saved him.

The next morning, the bereavement office told me the gentleman had passed away, and I couldn’t believe it. He looked so good and was only in his 70s, so I really didn’t think we would lose him.

I had tried so hard for him and I remember I cried for a good 15 minutes. It still haunts me today.

But this time is worse. In the first wave, I was dealing with one case like that per day. Now it’s two to three cases per day and it’s getting worse.

Never before have so many patients required oxygen at the same time and many NHS hospitals are old buildings which have not been built to deliver oxygen on such a large scale.

We do have the oxygen to supply to patients but what we don’t have is the capacity to provide it to all of them at the same time.

We are constantly reviewing all our patients to see who can come off oxygen, so we can reduce output.

If too much is being pulled out at once, there’s a risk that certain systems can collapse and cause a complete outage, meaning the hospital would have to be emptied out and people’s lives would be in danger.

The weekend before Christmas was the most stressful of my seven-year career because of the huge number of patients requiring urgent attention. We were just drowning – with two to three emergency calls coming at once.

I felt so scared and helpless.

My pager was bleeping non-stop and I was running around the hospital, dealing with two cardiac arrests and bed after bed of people suffering from lack of oxygen.

I did a vital protein level test on a heart patient suffering chest pains and it was five hours before I had time to read the results – which showed the level was 100 times what it should have been and required urgent treatment.

My heart sank. I remember thinking that this gentleman was my dad’s age and that could have been him lying there and receiving no treatment for five hours.

That weekend, I did three night shifts, back to back, without any breaks.

In a 13 hour shift, we’re allowed a 30 minute rest so we can sit down, eat something or just have a cup of coffee. I couldn’t do that.

On one shift, I didn’t sit down and drink water until 5am when my registrar marched me to the mess.

The NHS is on its knees. There are so many sick patients, doubled with the fact that so many of our staff are off sick having caught the virus themselves, despite wearing all the correct PPE.

The new variant is more transmissible and a lot of my colleagues are coming down with Covid, so I don’t think the guidelines on protective equipment are adequate.

On one set of nights, two of my team of four came down with Covid.

The NHS has always been understaffed and staff levels are now lower than ever.

Everybody from clinical directors to medical students are putting in extra hours and we’re trying our best. But at the end of the day, we’re so tired.

I got married in October, in Bangladesh, and spent ten days with my husband, Taufiq, before coming back to the UK without him.

I’ve not seen him since and none of us know when we will next see our families because all our leave has been cancelled.

I work almost every day and a lot of doctors like me are volunteering to fill in the gaps that are left by our sick colleagues.

It’s no longer possible for doctors, health care workers and nurses to deal with this pandemic alone.

We all have to work together. The public has to understand that they need to play their part, we all need to play our part, to be able to fight this.

I understand that it is difficult, and frustrating and it’s taking a mental toll on people, because they’re being asked to stay at home. But this is the time when we need to think about the entire nation as a whole and protect the old and vulnerable.

Maybe you’re young and a Covid infection or a hospital stay of 10 days doesn’t affect you that much. But your 90-year-old gran can’t afford that.

And would you be able to forgive yourself if you lost your gran just because you were having a night out drinking at the pub? I don’t think so.

As much as the public think they need the NHS – the NHS now needs the public.”

Dr Pushpo Babul Hossain, DAUK

Read the rest of the article here.

The number of doctors reporting burnout increased to 37% this year from 22% when we last asked in 2018.

“This latest survey absolutely aligns with what the Doctors’ Association UK is hearing from members,” commented Dr Natalie Ashburner, wellbeing lead for the Doctors’ Association UK (DAUK).

“NHS staff were already suffering from high rates of burnout and mental illness in the context of a decade of chronic underfunding of services, lack of staff, and erosion of pay and working conditions.”

Danger Pay

More than half of doctors thought overtime or danger pay would be appropriate. Instead, most doctors in England got a 2.8% pay rise said to be in recognition of frontline work, but described as “a metaphorical slap in the face” by the British Medical Association.

As well as burnout, nearly 1 in 5 doctors said they were clinically depressed.

“COVID-19 has drastically exacerbated these pre-existing issues and the result is that dedicated, highly skilled staff have been pushed to the point at which they are unable to cope any longer,” Dr Ashburner said.

Second Wave

Thirty-six percent worked longer hours during  the pandemic’s first wave.

“The same staff who worked on the front lines during the first wave of the pandemic, many of whom have been traumatised by the experience, are now tackling the second wave.

“We cannot place insurmountable pressure on staff who are suffering from psychological distress, at high risk of mental illness and just expect them to cope.”

Clap for Carers

Nearly 7 in 10 doctors said ‘Clap for Carers’ did not boost morale in the long term.

“Whilst the ‘Clap for Carers’ was appreciated, it did little more than paper over the cracks when the true causes of low morale in the NHS run much deeper,” Dr Ashburner said. 

Most doctors experiencing burnout/depression were not planning to seek help and 30% were not aware of workplace help programmes.

Dr Ashburner commented: “Prioritising the wellbeing of NHS staff must be at the forefront of the action plan to tackle the second wave of this pandemic.

“Adequate and effective equipment, sufficient numbers of well rested and supported staff and appropriate remuneration for their work are essential.”

Among burned out doctors, 47% were considering early retirement. “The NHS is haemorrhaging staff; without addressing this and without also achieving parity of esteem for mental health services, we risk not having a workforce left to care for us,” Dr Ashburner told us.

Full article here: https://www.medscape.com/viewarticle/940129

The NHS was struggling to cope before Covid struck, so the scale of the crisis quickly widened the cracks. It has highlighted the communication silos that slow progress between community care services and hospitals, and exposed the red tape and inefficiencies that exacerbate staff shortages and waiting lists. Clinicians are exhausted, patients are being let down, and the situation is set to worsen, as GPs scale back care to ramp up the vaccination programme.

The expectation is that GPs will start to deliver vaccinations as early as December. It will be a monumental logistical and human effort, consuming hundreds of hours of clinical time. We’re incredibly lucky to have so many skilled individuals poised to deliver this essential function. But stretched GPs will be forced to funnel yet more resources into the Covid response, worsening backlogs and reducing already limited community care provision.  

More public money (in excess of £150 million) will be spent reacting to the crisis and bolstering our defences. This is essential expenditure, but we also need funds to simultaneously start building a brighter and better functioning future for the NHS. Covid might become more manageable once enough of us are vaccinated, but there’s a long way to go before the NHS will be released from the virus’ grip.

Our healthcare workers themselves are another crucial piece of this complex puzzle. Without them, we have no NHS. Without them, we have no hope of recovery. But in the throes of the most debilitating health crisis in the NHS’ history, the prognosis is looking increasingly grim for the individuals at its heart.

Preliminary research has shown increased instances of depression, anxiety and insomnia in frontline workers, who have been up against the pandemic since March. A recent Doctors’ Association survey found that more than 1,000 doctors have seriously considered quitting this year, with 45 per cent of those asked citing the crisis’ impact on their mental health. Gruelling 12-hour shifts, exhaustion and burnout are also leading growing numbers of nurses to quit within three years of joining the profession.

Full article here: https://www.independent.co.uk/voices/nhs-covid-funding-vaccine-patient-care-b1721861.html

Covid-19 is having “a chilling effect”, says Samantha Feinstein, a staff attorney at the Government Accountability Project, a Washington-based organisation that supports whistleblowers. “In the US, we’ve seen a huge increase in the use of gag orders and we’re also seeing it in other countries . . . people are afraid to blow the whistle, because they’re afraid they’ll lose their job.”

One way to make workplaces safer is to provide secure channels for reporting wrongdoing. In the UK, organisations including the whistleblowing charity Protect, WhistleblowersUK, and the Doctors’ Association UK are campaigning for change. Reform is also the goal of a private members’ bill sponsored by the MP Philippa Whitford and of a House of Lords’ bill sponsored by Baroness Kramer.

Full article available here: https://www.ft.com/content/284f67a5-c221-443d-b525-258a3fc7ee66

“On 31 March the media reported on a dossier from the Doctors’ Association UK detailing numerous instances of medical and nursing staff being warned, disciplined, threatened, monitored, and gagged for speaking out on social or mainstream media. Their concerns included a lack of personal protective equipment and testing for covid-19—putting them, their families, and their patients at risk. The staff also highlighted what they saw as inconsistent and unconvincing guidance from their employers and national authorities.

There’s a long history of NHS executives and managers being leant on to prevent them speaking out publicly about other issues, such as serious overcrowding and bed pressures in winter. Speaking to the Guardian’s Denis Campbell about the Doctors’ Association report, an NHS England spokesperson emphasised the importance of consistent, clear, centralised official communication during a major national incident but said that individual staff members remained free to speak out in a personal capacity”.

“Threatening, disciplining, demoralising, or suspending the very staff we need most to get us through the next few months is a spectacular own goal and reputationally disastrous. It must stop”.