Andrew Goddard: Covid-19 and the workforce—ready and waiting

The NHS is preparing for the second wave and, to understand how well prepared we are, the Royal College of Physicians (RCP) surveyed its members last week. Depending on your outlook (and possibly your political persuasion) the results can be viewed as a glass half empty or half full. 

As far as our survey is concerned, most of our members are at work with only 6.5% off—1 in 15 compared to 1 in 5 during the peak of the first wave. This good news was overshadowed by the fact that of that 6.5% who were off for any reason, for over 40% the reason was that they were self-isolating while awaiting a test for someone in their household.

The fact that it’s taking any member of health and social care staff over a day to be tested for covid-19 is concerning. That the proportion unable to get a test in 24 hours had increased from 12% in July to 20% now—even more so. Even if you can get a test in 24 hours it takes a fair bit of effort. Only 13% described getting a test “without difficulty.”

The delay to getting results, though, is what is causing the biggest problem. Only 26% of physicians are getting their result within 24 hours and almost half are having to wait over 48 hours. These delays have a big impact, with colleagues having to cover each other and clinical activities being cancelled. Doctors are sitting at home (often with snotty kids next to them) frustrated that they can’t be at the coal face.

Some in the media and society still doubt the arrival of the second wave, but the survey shows that 53% of doctors are seeing an increase in admissions in their hospitals. It’s variable across different parts of the country, but is definitely happening.

Preparations for this wave are patchy too: less than half have been involved in a conversation in their organisation about planning for the next hit. But that’s a third more than in July, and only 10% felt their organisation wasn’t at all prepared.

Personal protective equipment remains a concern for many. Over half felt their organisation would have the necessary personal protective equipment (PPE) to deal with the second wave, but 35% were unsure. Some admit they just don’t know but, given the all the problems in the first wave, clear messaging from employers is needed about local provision of PPE—the impact on morale of fears of shortages is not to be underestimated. 

It is worrying that a quarter of our members still haven’t had any sort of personal risk assessment, but maybe a large proportion felt they didn’t need one. On the plus side, respondents from a Black, Asian or minority ethnic background were more likely to have had an assessment, suggesting messages about relative risk have been heard and acted on.

Finally, the survey suggests that 21% of physicians have antibodies to covid-19, although 1 in 8 of those having a positive PCR failed to develop a detectable antibody response. The optimists will say that this will reduce transmission and protect staff, the pessimists will say that almost 80% of the workforce remains at risk.

Overall though, as we enter the second wave of infection the picture we have is of a workforce standing ready to deal with whatever the next few months throws at them. However full your glass is, do raise it to that.

Andrew Goddard, president of the Royal College of Physicians.

Competing interests: None declared.