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I’ve been a matron at University College Hospital (UCH) in London since 2011 but had actually been on secondment for six months at The Lister Hospital before COVID. I returned to work at UCH on Monday 2 March, the day we received the letter to intensive care hospitals from Italy saying ‘start preparing now’ – we haven’t stopped since. We expanded massively within a very short space of time, going first from 35 to 86 critical care beds then creating a further 22 up on one of the wards. I’m responsible for the ‘3rd floor’ as we call it, which is the critical care area and the theatre area. On our busiest days so far, we’ve seen up to eight new COVID patients, with around 62 critically ill patients.
Letting staff know that ‘it’s OK not to be OK’ and that the NHS ‘has their back’ is the best way of ensuring that they will be able to care for our nation during this crisis and beyond, writes Professor Neil Greenberg The whole health and care workforce is due a well-earned rest at the same time the mammoth tasks of reopening services that are adapted to necessary infection prevention and control measures and responding to physical and mental needs that have been suppressed during lockdown need to be tackled.
As nurses worldwide feel the pain of prolonged PPE use, we assess the advice on minimising the discomfort caused by marks and visors Nurses have reported skin damage and bruises after wearing personal protective equipment during long shifts. PPE needs to be properly fitted and ideally worn for shorter periods of time, but when this is not possible, there are other ways nurses can reduce the risk of damage. Experts offer advice on avoiding skin damage, emphasising a ‘clean, protect and restore’ approach
At the time of writing (11th April 2020) there are 1.72 million Covid?19 infections and 104,889 deaths worldwide. In the UK the first recorded death was on the 5th of March 2020 and in just 37 days 9,875 deaths in hospital have been recorded. The 10th of April saw the highest number of UK daily deaths (980) to date. These UK figures do not include those who died in care homes or in the community. Similar death rates have been experienced in China earlier this year (3,339) and are rising globally with particularly high death rates in the US (18,761 with over half of deaths in New York State), Italy (18,939), Spain (16,353) and France (13,197).
Whatever our situation as healthcare professionals—good pacing, refreshment, and support will be key to surviving the long road ahead Here in the UK we have been in lockdown for over six weeks and our personal and professional lives have changed immeasurably. We are starting to face the reality that our lives may never return to “normal.” As healthcare professionals caring for doctors, we are impressed by how our profession has adapted to the new order. However, we are also noticing many of our colleagues, ourselves included, struggling to absorb the enormous changes forced upon us over the last two months.
Doctors have expressed concern over new guidance from Public Health England that recommends reusing personal protective equipment in the face of shortages.1 The guidance, which also recommends alternatives for unavailable equipment, has been seen as an admission by the government of the PPE shortages facing healthcare staff. Rob Harwood, chair of the BMA’s Consultants Committee, said, “This guidance is a further admission of the dire situation that some doctors and healthcare workers continue to find themselves in because of government failings.
The BMJ has made a selection of key topics and patient information freely available to support clinical decision making during this covid-19 crisis. Their evidence-based topics provide step-by-step guidance on symptom evaluation, test ordering, treatment, follow-up and prevention. The accompanying patient information provides concise, user-friendly summaries to reassure patients and carers and help them to make informed, shared decisions about their treatment and management. Updated daily, the BMJ Best Practice will provide you with the latest and most practical clinical information to support your decision making.

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