“The physician’s challenge is the curing of disease, educating people in the laws of health, and preventing the spread of plagues and pestilences.” — William Osler FRCP
There has never been a more challenging time for our already struggling health and social care services, or the UK economy, than the impact from the COVID-19 pandemic. It is inspiring to see heroes on the NHS frontline walking into work to potentially facing increased risks to shield the public, whilst many others are pushed away from their workplaces. There have been many unsung heroes emerging already—people across the NHS staff, social care, local authorities, and government departments. Indeed, the kindness of countless friends, families, strangers, businesses looking out for the sick and vulnerable in the public has made many of us realise all that we have taken for granted prior to a pandemic.
With such a battle looming against this coronavirus, healthcare professionals need to know that the UK governments have their back and ensure that all the protections they need to do their jobs safely are in place. As an example, there have been concerns that NHS and social care staff don’t have access to the personal protective equipment (PPE) that they need. We are getting reports from across the country that staff either don’t have appropriate PPE, or that it is being rationed. While we welcome the work to try and resolve the local supply chain issues, we are concerned that NHS and social care staff are currently risking their health to support patients in their care. The government and local healthcare organisations must do everything in its power to ensure that staff have the appropriate equipment they need when taking such risks to serve the public.
The National Health Service has been operating beyond maximum capacity for many years. [1] This has been recognised in the 2020 Budget—which now seems a long time ago. There are progressive issues with bed numbers, and intensive care unit capacity which was previously optimal, but with little scope for increase. There has been a drive for increased ventilator production, and the acquisition of private hospital beds to help tackle the crisis. Even with these in place, physicians and other healthcare workers, unlike ventilators or wards, cannot be manufactured nor sustained for a long period of time. It is vital that the UK government, hospitals, and clinical services, recognise that their healthcare professional employees are not simply soldiers in a battle against covid-19, but that these are human individuals with families, with longer term aspirations, skill sets, and future societal impacts.
In the UK, and globally, the safety of physicians and other healthcare professionals is paramount. Sustainable resourcing and implementation of PPE is just the first step. Appropriate implementation of testing of covid-19 to ensure that those NHS and other keyworker staff who have had this virus can safely come back to the workplace for themselves and others is another key issue. Putting the wellbeing of the healthcare workforce and implementing all that can be done to reduce their risks needs to be at the heart of the pandemic response. At the frontline, kindnesses that have been long taken for granted are also required: space to rest and recover, food and hydration, and the physical and psychological support of family and friends as well as the camaraderie of colleagues. Just as there is no good health without good mental health, there is no sound healthcare system without sound healthcare professionals.
We all know the importance of the public health messages, most prominently washing our hands, but the government mustn’t wash their hands on this issue of physician, public, and patient safety. Moreover, other public health measures such as social distancing, and avoiding large gatherings are now being mandated by the government in accordance with the rapidly evolving Public Health England guidance. The isolation of symptomatic cases, many of whom have been working on the frontline themselves, must be implemented to reduce risks for the public and shield the vulnerable. Our challenges ahead are not just the longer-term control of the coronavirus pandemic (and scientific development of vaccines), but educating the public in the principles of public health for the benefit of themselves and others. We all need to recognise that love at the time of Corona*, and kindness for healthcare professionals are the United Kingdom’s, and world’s most valuable resources.
* Love in the Time of Cholera by Colombian Nobel prize-winning author Gabriel García Márquez. The novel was first published in Spanish in 1985.
Neeraj B Bhala, consultant physician and gastroenterologist, Queen Elizabeth Hospital Birmingham
Ajay M Verma, Chair of Royal College of Physicians New Consultants Committee
Matthew Roycroft, co-chair of RCP Trainees Committee
Donal O’Donoghue, registrar of Royal College of Physicians of London
Andrew F Goddard, President of Royal College of Physicians of London
Competing interests: None declared
References:
- Underfunded, underdoctored, overstretched: The NHS in 2016. Report published by the Royal College of Physicians London.