Healthcare in a COVID-19 world – Dr Jonathan Bennett, Respiratory Consultant in Leicester, on what’s happening in his city

As part of a series examining the challenges and opportunities for healthcare, Sally Williams hears from Dr Jonathan Bennett, Honorary Professor of Respiratory Sciences, University of Leicester, Respiratory Consultant at Glenfield Hospital, Leicester, and Chair of the British Thoracic Society. This is what he said on 2 July 2020.

Leicester has been all over the news, after the Government imposed the first local lockdown in the UK following a surge in coronavirus cases in the area. The 7-day infection rate in Leicester has risen to 135 cases per 100,000 people, which the Health and Social Care Secretary, Matt Hancock, reported was three times higher than the next highest city.

My hospital, one of three in Leicester, had already seen an increase in admissions. We weren’t primed beforehand that there had been a spike in community testing. It would have been helpful to know that testing units had seen a surge in positive cases, so that we could have prepared our service for the potential consequences.

COVID upturn

It was two and a half weeks ago that we experienced an upturn in the number of people with COVID-19 symptoms coming into the hospital. This included one large extended family, who all tested positive for the virus. We were surprised by this, as respiratory colleagues in other regions were reporting further reductions in admissions of people with COVID-19. We were further surprised to hear Matt Hancock announce that there was a local community outbreak in Leicester, which our hospital respiratory team wasn’t aware of. The NHS track and trace service is obviously efficient at what it does, but how it integrates with local systems and services is unclear to many.

Our admissions of people with COVID-19 have now plateaued, but we still have too many people in hospital with the consequences of the virus and too many who are very unwell with it.

Dexamethasone trial

It’s very exciting that the steroid dexamethasone has been identified as the first drug to improve survival rates in certain coronavirus patients. My hospital has been one of the biggest recruiters to the trial and we were really hopeful that it would be proven to work. As doctors, we’ve been trying all sorts of things to help patients, but we’ve felt powerless at times. It’s distressing to see patients struggling and to be unable to treat them. So, it’s fantastic that the NHS has trialled this treatment systematically to see if it works. My colleagues and I are really positive about it.

Sadly, it doesn’t mean everyone with COVID-19 will survive. As lockdown restrictions lift across the country, and with news of a new treatment, it’s tempting to revert to previous behaviours in a belief that it’s not as bad as we thought. For most people, coronavirus isn’t a serious illness, and now there is a cohort of people who should fare better due to dexamethasone. But we shouldn’t lose sight of the sad fact that a minority will still experience catastrophic illness from this virus.

Our hospital also has access to Remdesivir – an anti-viral therapy – which is being trialled in the US. And we will continue to try different treatments, so there are reasons to be hopeful.

Keeping momentum

One upside of the pandemic is that funding for NHS service developments has been more attainable than before. However, if a service development can’t be linked to COVID, then a new layer of scrutiny is being demanded.

Over the last couple of weeks tighter controls have been put in place and securing funding for business cases that aren’t COVID-related has become much harder. I’m talking about business cases for funds to bring services up to national standard for levels of staffing or care, things like home ventilation or cancer services.

Frustratingly, business cases that were previously agreed have been mothballed and we are having to start the process again. I accept that the country is in a difficult financial situation, but this is hard to stomach. Respiratory services have been at the forefront of the coronavirus pandemic and yet now we’re having to justify applications for funding that had already been agreed. It feels a long way from the time when everyone clapped for NHS heroes. We want to do our very best for patients, and we need the resources to do this.  

A welcome thank you

On a happier note, I have been enormously cheered by having been nominated for a ‘Wolves wish’. I’m a lifelong fan of Wolverhampton Wanderers Football Club – ‘Wolves’. One of the research fellows at the hospital, Sarah Diver, wrote to the football club and they sent me a fantastic letter of thanks on behalf of the staff and patients at Glenfield Hospital, along with a signed shirt and other goodies. Thanks Sarah!

As told to Sally Williams

Image credit: Andrew Martin from Pixabay

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