In a series of posts giving a frank account of experiences on the NHS frontline, Sally Williams hears from Dr Jonathan Bennett, Honorary Professor of Respiratory Sciences, University of Leicester, Respiratory Consultant at Glenfield Hospital and Chair of the British Thoracic Society. Here’s what he said in the week beginning 6 April 2020.
I think I’ve got COVID-19. I started feeling unwell last week, with waves of bad muscle pains that stopped me sleeping. It feels like repeatedly I’ve been hit by a cricket bat all over my body. I’ve never had this degree of muscle pain. It reminds me of years ago when I went white water rafting in Patagonia. The raft capsized and I was swept down the rapids. I’d never felt so battered, as my body hit the rocks. I feared for my life. That’s how I’d compare the last few days.
Of course, I can’t be sure until the test results come back. My symptoms are not like the patients who have been coming on to the respiratory unit, who tend to have breathlessness and ongoing fever. I’ve got a bit of a cough and a headache, but I haven’t had any fever.
I feel better than I did a few days ago; all the same, I’ve worried about my condition getting worse and developing pneumonia. I’ve spent the weekend being very aware of my age and gender. I’m a similar age to Boris Johnson and male, which puts me at higher risk – more men than women are becoming seriously unwell with COVID-19.
Due to the lockdown most of the transmission happening right now will be within households. The way the disease works, if people are going to get worse, it tends to happen after six to 12 days. With the lockdown now into the third week, we are seeing whole households coming into the respiratory unit – husbands and wives, and fathers and sons, together critically ill. Sadly, we have had instances where more than one member of the same family has died. It’s terrible: for patients, for relatives and for staff.
We’ve had debates about whether family members can come into a room to be with a dying loved one. Unfortunately, members of the same household already may be infected and could pass the virus to staff. We can’t take that risk. I’m now off work and my wife, also a clinician, must therefore also be off work. As it is, healthcare staff are being deployed from all over the hospital to fill gaps.
Various organisations have produced guidelines for healthcare workers on how to contact relatives and provide information in a compassionate way. These guidelines are being adapted and adopted across the country. The Royal College of Physicians and the Association for Palliative Medicine has recently issued a guide to end of life care when a person is dying from COVID19 (https://elearning.rcgp.org.uk/mod/page/view.php?id=10537).
Some of the patients I’ve been speaking to say that in addition to feeling poorly, they’re just so bored. They may be in a side room or a bay, breathing hard, feeling unwell, with little contact from the outside world, just waiting to feel better.
Inequalities and COVID-19
When we started this blog, I said we were waiting for the wave to hit. It is hitting us now and there is no way of determining the full size of the wave or how long it is going to last. We’re hopeful that it won’t be too long, but we’re not going to hold our breath because we’ll run out of air, quite literally!
What has also become clear is that it varies region to region, and city to city. London and the West Midlands have been having a particularly difficult time. Once we’re out the other side, I’m sure the data will tell a story about coronavirus and social inequalities. There’s been a lot in the news about people going to a park to sit in the sun. But if you live in a cramped flat in a tower block, sitting in a park may be the most socially distant you’re able to be, compared with crossing people in a stairwell or taking a lift to get out to the shops.
Adverse outcomes from COVID-19 seem to be associated with people with diabetes, heart disease, obesity and chronic lung disease. Some of these conditions have a higher prevalence in deprived areas.
One of the unintended consequences of the pandemic is that people are delaying seeking urgent and emergency care because they fear contracting the disease. Whilst our intensive care is full of patients with coronavirus and the hospital is expanding into theatre and recovery areas, the numbers of people attending A&E with asthma attacks and heart attacks has fallen. There’s some evidence that people are presenting late with heart attacks because they are scared of coming to hospital. There will be a price to this.
I hope to get my test result soon. I’ll be grateful to have had the virus and to still be here, conscious that as a male in my fifties it could have been a different outcome.
As told to Sally Williams
Image by skeeze from Pixabay