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 The latest COVID-19 wave has hit the hospital northwest of London
with even more force than the first: younger patients fill its wards
and fewer of the sickest people respond to treatment.
Doctors and nurses are grappling with the strain of exhaustion and
loss.
Joy Halliday, consultant in intensive care and acute medicine, is in
charge of a high-dependency unit for COVID-19. It is a step down
from an intensive care unit (ICU), and severely ill patients there
are receiving CPAP oxygen.
Stephen Marshall, 68, is one of them. After testing negative for
COVID-19 following a recent operation on his back, he initially
thought he had a cold.
"I should never have left it, it's just made it worse," he said,
speaking through a mask pumping oxygen into his lungs.
"I'm on oxygen all the time now," he said. "I seem to be holding my
own at the moment, so touching wood," he added, lifting his hand to
his head.
Halliday said that with visits curtailed, the doctors and nurses
were supporting patients emotionally as well as medically.
"I can only just imagine how difficult that is for family at the end
of the telephone to be told that their loved one is getting worse
... or they're agitated or their oxygen levels are dropping," she
said.
"It's difficult for us to see and it's even more difficult for
them."
The youngest person in her eight-bed unit is 51-year-old supermarket
worker Victorita Andries. She was put on oxygen immediately when she
was admitted five days ago.
"The machine for me has been good," said Andries, adding that she
felt positive about the future. The oxygen levels in her mask are
gradually being reduced as her condition improves.
The youngest person being ventilated in the hospital is just 28.
The official death toll from COVID-19 in the United Kingdom is
93,290, the highest in Europe and the fifth worst in the world after
the United States, Brazil, India and Mexico. 39,068 COVID-19
patients are being treated in hospitals. Deaths rose by a record
1,820 people on Wednesday.
INTENSIVE CARE
In the ICU, where all seven patients had COVID-19, the quiet is
interrupted by machines bleeping and oxygen pumping.
Wassim Shamsuddin, clinical director for anaesthesia and intensive
care, said the patients were receiving mechanical ventilation, which
requires sedation.
"This time around what we're finding is that patients aren't faring
as well if they need to be invasively ventilated," he told Reuters.
"Our mortality probably in the first wave for patients coming onto
intensive care was around 40%. This time around we find that the
mortality is about 80%."
He explained that unlike in the first wave, all COVID-19 patients in
the hospital now automatically receive remdesivir and dexamethasone
after they were found to be effective.
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 That means that those who end
up in ICU during the second wave of the pandemic
are more likely to be the sickest patients,
because they have not responded to those
treatments. Shamsuddin added
that he did not know whether a highly transmissible new variant of
the disease found in the UK also contributed to higher death rates.
He said intensive care staff, who have been boosted by medics and
nurses from other wards during the pandemic to maintain one-on-one
care, were not used to such high levels of death.
"At the moment we're just all keeping our heads down and just
getting on with it," he said.
"Intensive care hospitals are meant to be a place where we treat
patients and make them better. The difficulty here is that even
though we try our best and we throw everything at the patients, it
just doesn't seem to be working."
'DEATH EVERY DAY'
Joe Harrison, chief executive of Milton Keynes University Hospital
NHS Foundation Trust, said the hospital had seen more than twice the
number of patients in the second wave than the first, and currently
had 186 patients with COVID-19.
"We believe that over the next week or so, we're going to continue
to see real pressures in our critical care unit," he said. "And then
hopefully we will turn the corner and things will start to improve."
He found it "absolutely inspirational" to see how the medical staff
had dealt with the pressures that COVID-19 had brought since it
first surfaced in the country early last year.
Back in the high-dependency unit, Halliday and other staff managed
to forge close bonds with the patients, despite having to wear full
protective gear and interact from behind masks and visors.
Patient Geoffrey Winter, aged 70, called the care he had received
"fantastic".
"Two of the nurses were cleaning my feet this morning; I felt like
Jesus," he joked.
But Halliday echoed the view that it was tougher this time around.
"It's draining. It's draining physically. It's draining mentally,"
she said.
"It's difficult to keep going on a day-to-day basis for staff, just
to see death in death out, every day."
(Reporting by Paul Sandle; Editing Guy Faulconbridge and Mike
Collett-White)
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