Dr. Leo Gurney
March 4, 2021
In this article, he talks about the impact of the pandemic on healthcare staff, returning to normal, vaccines, and COVID-19 denial.
What follows are Dr. Gurney’s responses to our questions, which we have lightly edited.
I am a specialist senior registrar doctor in the Birmingham Women’s hospital in the U.K. I work as a specialist in the maternity and fetal medicine departments.
My job involves looking after pregnant women and their babies (while they are still in the womb).
I provide care for women through the antenatal period, during labor, and postnatally. I also perform specialist pregnancy scans for babies that may be unwell in the womb or have a problem that they might be born with, for instance, congenital or genetic problems.How has your job changed?
In lots of ways. We now have to wear theatre scrubs at all times and face masks all day. We also have to use gloves for any patient interactions.
All patients now receive COVID-19 swabs before they can come to the hospital. If they are positive but still need to come — for instance, if a patient is in labor — then we must wear full personal protective equipment (PPE) and take necessary precautions to ensure that we and other patients are safe.
Many patient appointments that were face-to-face are now performed via telephone to avoid unnecessary visits to the hospital.
The biggest change that is most difficult for women, I think, is that they have to come to many antenatal and routine appointments on their own.
This is very stressful and challenging for women, and I think the sooner we can have birthing partners back to support pregnant women, the better.
It is very similar. There have been large numbers of women coming through the hospital with COVID-19, including a number of very unwell women. We have to transfer some of these women to intensive care at the Queen Elizabeth hospital, which is next door.
Testing is now much better organized and much more widely available. We could not swab every woman who attended the hospital during the first wave, so we had to reserve the swabs for women with symptoms.
This time, we can swab every woman admitted to the hospital, as well as their birthing partners. We see a lot of people who test positive but don’t have symptoms, so we can take more action to prevent the spread of COVID-19.
On the labor and antenatal ward, there will typically be around 5–10 patients with COVID-19 each day (at the peak). Most of these are asymptomatic, and only a few of the women will be unwell or symptomatic.
It is worth remembering, though, that we are a specialist women’s hospital. Therefore, most of the people with COVID-19 (men and non-pregnant women) will attend the Queen Elizabeth hospital next door.
This is one of the biggest single-site hospitals in Europe, and there have been times during the peaks of the waves that this hospital has been full of unwell patients with COVID-19.
During the two peaks of the wave, we saw lots of very unwell pregnant women with various COVID-19-related illnesses. Unfortunately, we have seen some pregnant women either in intensive care or die during pregnancy or soon after delivery.
I have seen bad seasons of influenza over the past 20 years as a doctor in the U.K., and there is no way to compare that with what is going on now.
The number of people who are extremely unwell or have died from COVID-19 far outweighs anything seen for at least three generations.
The most recent comparison would be the 1918 influenza pandemic that wiped out millions of people across Europe and killed more people than World War I.
During that time, many societies “closed down” to try to contain the pandemic, and many people wore face coverings in public — including in London, U.K. So, many of these things are not unique to now.
At the peak of the second wave, patients with COVID-19 made up 20–30% of all NHS [National Health Service] bed capacity. Even during bad flu seasons, the number of patients with flu might make up 1–2% of NHS capacity.
My cousin is an intensive care unit (ITU) consultant in London and has been a doctor for many years. During the peak of the second wave, his department needed to double their full ITU capacity every 24–48 hours; this meant creating an extra 10–20 ITU beds out of the blue, just in one hospital.
He has never seen anything like this, and there are similar stories from all around the U.K.
We would all like to return to normal. But there will be no sense in doing so until it is safe. Otherwise, people will die unnecessarily, and we will have to return to full lockdown and be back to square one.
This has already happened in the U.K. too many times now, and we need to learn from our mistakes. It won’t be safe to go back to normal until a large proportion of the population, particularly the most vulnerable people, have been vaccinated.
It is vital that we don’t open up until the daily cases are low — under 1,000 each day — so that the NHS track and trace system has a chance of operating successfully.
I also think [we} should be doing much more to forcibly quarantine all people arriving from abroad (as New Zealand, Australia, and Southeast Asian countries have done very successfully) as we do not know where the next variant will come from.
It has been a time of very high stress and difficult emotions. We have been faced with some extremely unwell patients and the challenges at the start of dealing with an unknown illness where you had to learn how best to manage things as you went along.
Unfortunately, at my hospital, some staff members. including a consultant and a midwife, died during the first wave, which was extremely upsetting for everyone and really affected the staff’s mental health.
Despite this, there has been a lot of solidarity and a sense of everyone pulling together both within the hospital and with other colleagues.
Members of the medical community shared information regarding managing COVID-19 and different presentations of the illness very rapidly online, which has helped immensely. It demonstrates how the internet can be a force for good.
I think everyone is also very proud of how the scientific and medical community have pulled together so quickly to produce a vaccine in record time.
I have, and I urge anyone reading this to have the vaccine when offered it. It will not harm you, and we cannot dream about returning to normal as a society until everyone who has been offered the vaccine has had it.