“What size do you want, Pat? You need to feel comfortable with it.” One of the nurses at the Intensive Care Unit (ICU) asked me while looking for protective clothing. The word “comfortable” kept ringing on my ears. “Did he really say ‘comfortable’?”
I was about to tell the nurse that I had never entered the COVID-19 ICU - I have often brought patients, together with nurses and doctors, to the examination room, just outside it… But never actually been inside that ICU itself. It seemed that the nurse was reading my mind. Before I could open my mouth, the smiling nurse said: "Yes, you have to go in now. And I mean this very moment. Put your protective gear and go pick up the patient who is in the ultrasound room".
The last time I wore PPE (Personal Protective Equipment) was for a news report I did on the malaria transmitting Anopheles mosquitoes. I did it at an important English medical laboratory, doing groundbreaking research on malaria prevention. On that occasion I had some protective clothing on, but never the “mighty PPE regalia”, my nickname for the life-saving protection gear, I was now forced to wear.
Mask, visor, glasses (I have my own ones) and overalls, which I like calling, "portable sauna". Wearing this stuff makes you ridiculously hot inside. Comfortable?
The shifts for nurses and other health professionals’ staff in the United Kingdom last for 12 hours. For those working directly with patients infected by COVID-19 (CO: Corona, VI: virus, D: Disease, 19: the year the virus was identified), the usage of PPE is mandatory throughout these working hours. No ifs, no buts.
Since my conversation with the nurse, I have been surrounded by the COVID-19 virus, all day, and all night. All the time. I have experienced watching the disease’s diverse stages and how it impacts patients. And this I will never forget, for as long as I live.
How and why I started working in one of the “outstanding” hospitals in London? Well, this is another story which I hope to tell you soon. Now I want to share with you some of my observations about one of the biggest medical emergencies in humankind’s contemporary history.
"Look, you must wear two pairs of gloves", said the nurse who helped me "assemble" the gear. I looked at him, still without wearing the mask, and said: "But my hands are already sweaty with just this pair, imagine if I wear another one ?!". The nurse did not even bother to answer me, he just handed me another pair of gloves! "Okay, but do I really need the cap on my hair?" And there I was, covering my hair with a cap.
My job - assisting in the transportation of patients within the hospital – required that, as a safety rule, I wore the same protective clothing that the entire medical team was wearing. COVID-19 is an extremely aggressive virus. We can say that it is a virulent virus that virilizes easily… And medical staff worldwide have paid an exceedingly high price. Infections are everywhere. Particularly in hospitals. Because of my job, I got to listen to stories from nurses, doctors, and above all, patients who do not have anybody else talk to. Listening to them was an important part of my responsibilities. But these stories take a heavy toll on my own physical and mental health.
The ultrasound room was now different from the room I knew before. It had now become a cornucopia of cables, oxygen tanks, computers, and other machines. But it was not just that room that changed – the entire architecture of the hospital was transformed. The number of beds available to patients almost tripled. It seemed that the hospital grew. But that was just an impression. The hospital was the same size as before. What had increased dramatically was the number of patients. And this was due exclusively to COVID-19.
"Wait outside, don't stay here because you coming from a restricted area, stay there and wait for the team to leave, this ultrasound will take at least an hour," said one of the technicians.
The medical team, made up only by women, was engaged in the struggle to save the life of a young man. I knew that some were my colleagues, people I knew. But it was almost impossible to recognize them under all the PPE. The only way to identify them was their names written with pens on their uniforms. My way to greet them was, "Hello super-powerful girls!" And one of them sitting on the floor replies: "Today not so powerful today Pat, not so powerful...". Their exhaustion was noticeable in the muffled voices barely audible coming from somewhere between their masks and their visors. The voice of heroes. Or rather, heroines!
Sweating is the name of the game. Not only our sweat but also the patients’. Every time a patient breathes, every inspiration leads to sweating due to the extreme difficulty in bringing in the air into their lungs. It’s a bizarre body perspiration “festival”, coming from the bodies and souls of patients, nurses, technicians, doctors and all the other professionals who assist them. Unrelenting. Unstoppable. Unforgiving.
"It is so terribly hard to work with these clothes, with all the equipment for 12 hours a day. But there is no alternative, we have to follow all the procedures, because that is our protection. It is vital for us to be able to work safely and, thankfully, we have the necessary equipment. Most places do not have it. We are lucky, really."
The UK government has been working around the clock to provide hospitals with the necessary equipment to deal with the pandemic. More than 1 billion PPE items have been delivered across the country, according to the health authorities.
In England alone, hospitals and nursing homes received approximately 900 million items including masks, aprons and gloves.
There are currently 1.6 million professionals working under the country’s National Health Service (NHS), trying to meet the demand of patients with or without COVID-19. Heart attacks, cancers and other diseases do not stop because there is a new virus in town. On the contrary. And dealing with this “perfect storm” is, indeed, a huge challenge for the entire system.
The logistics for equipment purchases, production and distribution is mind-boggling. Hospitals request different items of PPE according to their own needs – including number of patients, staff and whether they happen to be in a COVID-19 hotspot. The results are, naturally, uneven. But everyone is doing their best. I asked a colleague who works as a nurse whether she had all the PPE needed and her reply was that until that moment there was nothing missing, neither equipment for her and her colleagues nor for the patients, but she was unsure about other medical facilities.
But the truth of the matter is that, yes, many hospitals around the UK are still lacking protective gear. Last week more than 400 thousand gowns coming from Turkey, purchased to protect NHS staff from coronavirus have been impounded because they were poor quality. There is a black market in PPEs going on around the world. It is basic capitalism: a question of supply and demand.
Bodies bent due to exhaustion, legs curved in arches, heads swaying and a constant thirst – this is what the end of a day’s work looks like at my hospital. “A drink of water? Not now, I will finish my shift in 40 minutes. I can wait a little longer”, answers one of the nurses next to me. Another complements: "We can quench thirst later, COVID-19 does not wait, this patient cannot wait. Water can…”.
I am simply overwhelmed by the strength of these professionals. "Heroes? I don’t know about that. We have done our job in the best possible way, but it is a cruel, murderous disease. Our greatest wish is for a cure to come soon. Until then, people must stay at home”, said one of the nurses.
The 1-hour "break", waiting for the patient in the ultrasound is now over, the exam has been completed, and it is now time to bring the patient back to the ICU. He is completely intubated and, I think to myself, he cannot imagine the number of people, equipment, medication and care that he has received. The effort we are all making has one simple goal: to keep him alive.
"I will go home, shower and sleep, tomorrow I will be here again, another day, another battle, this war is not over yet and there is no way to negotiate peace, at least, with COVID-19", says the nurse.
I go into the ICU and the feeling is, I am living in a science fiction movie, but this isn’t fiction! It feels more like a documentary, cine-verité style, where the main protagonists are NHS health professionals. I feel privileged and honored to be part of the team.
In the room more patients and more nurses, I have never seen so many members of staff in one place taking care of each patient with a surreal determination.
A non-stop flow of patients and nurses, an organized chaos, a ballet of movement and stillness punctuated by the electronic soundtrack of machines that beep. It is all surreal and yet it makes perfect sense to me. We remain determined and we will continue the struggle until we defeat this virus.
In my heart, an enormous pride to see that, at least somewhere in the middle of this pandemic, there are human heroes that wear capes and masks, gloves and visors. And sweat pours out of them all. Sometimes tears flow as well but you have to keep them private.
The patient is back in his room, it’s now time to remove the PPE that protected me for over an hour. Without hurry, even while I am sweating buckets, step by step, I follow very carefully the procedures, removing my clothes, gloves, the visor, praying that I didn’t get infected so that I can come back tomorrow to help my colleagues and the men, women and children who have the misfortune of falling ill to this horrendous and treacherous disease. I say good night to my colleagues, and the fresh air outside lift my spirit very high…
For the latest data from the UK Ministry of Health website well over 30,000 people have died so far in the UK because of COVID-19.
The war is not over: #StayHome.