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Panorama 2020 E14
Transcript
00:00The sound of Coventry and Warwickshire is BBC CWR.
00:06There's been a sharp rise in the number of deaths
00:09from Covid-19 across the Midlands.
00:11The government says the Midlands is now a particular area of concern.
00:15The question remains, can the region weather the storm?
00:22The last few weeks have seen record numbers of deaths
00:26and the biggest challenge for the NHS in its 70-year history.
00:38Panorama's been invited into University Hospital Coventry
00:42to see how the NHS is responding.
00:51Coronavirus infections appear to be levelling out.
00:55Is there light at the end of the tunnel?
00:58We will probably, hopefully,
01:00never see anything like this again in our entire careers.
01:04It's fine. OK.
01:20This is Dr Tom Billiard, an intensive care consultant.
01:26Oh, I see.
01:27He's agreed to wear a body-mounted camera
01:30during one of his shifts.
01:32OK, let's go.
01:38Oh, yes.
01:40The intensive care unit usually has around 30 beds.
01:44Because of coronavirus, there are now almost 70.
01:51Because Covid-19 is a new disease,
01:54it creates a steep learning curve
01:56for those on the front line trying to treat it.
01:59Right, we're going to prone this chap.
02:01The team are here. Yeah.
02:03So, are you ready-ish?
02:06Proning involves turning patients onto their fronts.
02:10It helps them breathe when the infection is deep in their lungs.
02:15Ready, steady, move.
02:17We're suddenly seeing more and more patients
02:20that are benefiting from that.
02:23Turning patients prone, placed down, is a good thing to do.
02:26It makes them better.
02:28But it takes a lot of manpower to do it.
02:31You need at least five people to turn a patient prone.
02:34It's physical.
02:36Ready, steady, turn.
02:40It's because his shoulders haven't rotated all the way.
02:44One, two, three, lift.
02:46Looking good, yeah, looking good, looking good.
02:49Right, one more, one more, one more.
02:51We can do this.
02:54Well, this is indeed the eye of the storm
02:57for this hospital and others up and down the country.
03:00This is intensive care,
03:02and many patients here are very sick indeed.
03:05They're on ventilators.
03:07They're under pressure here
03:09because more and more patients are arriving every day.
03:12Around one in ten people who test positive for Covid-19
03:17become severely unwell and are admitted to intensive care.
03:21Recent research suggests only half those patients might survive.
03:29We've had a death on here today already.
03:32That's been very difficult
03:34because obviously the family haven't been able to come in
03:37and see the patient, so I've had to do all that over the phone,
03:40which is just strange.
03:42It's not what we normally do,
03:44so it's quite difficult, quite unpleasant to do that.
03:47And difficult for the nursing staff as well.
03:49Yeah, absolutely, yeah.
03:55For hospital staff, social distancing is not always possible.
04:01The Coventry Hospital is one of the busiest in the Midlands
04:04with 1,000 beds.
04:06So they were due to be delivered yesterday.
04:08At the daily strategy meeting,
04:10senior medical staff and management
04:12are updated on their Covid patients and the fatalities to date.
04:17If I can hand over to Dan and Gavin
04:20just to give us a current situation report in terms of where we are.
04:24Today we've had 349 positive patients,
04:27of which 136 of them remain in the hospital.
04:30We've had 73 deceased patients.
04:32That was at eight o'clock this morning.
04:34Medical chief Professor Kiran Patel
04:37needs to know how much space they have.
04:40How many side rooms do we have available at the moment
04:43for potential positive patients?
04:45At one o'clock, there were two empty and nine potential.
04:49Chief Executive Andy Hardy believes the planning is paying off.
04:54We are feeling pressured.
04:56The pressure has been around for two or three weeks now.
04:58What we have done, because we know this is coming,
05:00we've been creating capacity for the expected surge,
05:03and we're getting close to that now in a number of ways.
05:06The most important way, of course, is increasing critical care capacity.
05:09We've prepared as well as we can.
05:11I do not want that to be famous last words,
05:13but I'm very confident in the preparation we have done.
05:21The most experienced medics are being drafted in to support intensive care,
05:26while some of the most junior are volunteering to help.
05:32Some are fresh out of medical school.
05:36I think on the one hand, I want to really welcome them and inspire them
05:40to say this is the start of your journey in medicine.
05:43On the other hand, I want to be honest and say
05:45you're heading into the unknown a little bit, but we will look after you.
05:49So it's a mixture of emotions, isn't it?
05:52I want to first of all say thank you.
05:54You've all volunteered to help the NHS at a time of real need,
05:59and I'm quite touched by that.
06:02You're going to see some really difficult things.
06:05You're going to see some horrible things in some areas,
06:09and you're going to see some fantastic teamwork in other areas.
06:13Keira Doyle passed her final exams last month,
06:16but graduation is on hold because of the virus.
06:20To start here at the hospital, I moved up away from my family home
06:23to move up here on my own,
06:25and hearing about the risk that we were going into
06:28and we'd be exposed to things we'd never seen before,
06:30I was really worried, and I wasn't 100% sure
06:34on what protection would be provided for us.
06:36But I think going into something like this,
06:38especially on the horizon of starting a new job as well
06:41while this is all going on, was quite daunting.
06:44Before coronavirus, there were two wards for respiratory diseases.
06:49Now there are eight, treating 230 patients
06:53who have or are suspected of having COVID-19.
06:57And then we've had to accommodate them in other wards.
07:00So you've had to expand, basically, because of the number of patients?
07:03Absolutely. All medical, surgical wards we've had to expand into.
07:06Have you ever seen anything like this in your career?
07:08Absolutely not. Absolutely not.
07:10There's nothing like this we've ever come across.
07:15Dr Poonan Puthran's patients are returning from intensive care
07:19or have symptoms too severe to manage at home.
07:24Many are elderly, like Peter,
07:26who's been living in sheltered accommodation.
07:30Hello, Peter.
07:32And we're hoping that once you're up and about, as you normally would,
07:37we should be able to get you home.
07:41Peter's getting better,
07:43but the condition of others on the ward remains in the balance.
07:48Just like her colleagues in intensive care,
07:51Dr Puthran is learning how to treat this new disease.
07:55There's a lot of studies coming from China.
07:58There's a lot of studies coming from Italy.
08:01Tell us how severe the disease is going to be,
08:05but it's not been sort of well-defined.
08:08No definite treatment strategies as yet.
08:11There's a lot of people who are becoming extremely unwell,
08:14but we can't differentiate who that is going to be.
08:19Student Dr Kira is now on the Covid wards,
08:23providing much-needed backup for the hard-pressed medical staff.
08:28We're doing more supportive roles,
08:30so things like bloods, writing up things for the patients.
08:33On my first day, I again came in, saw the patients.
08:37It was all quite new to me,
08:39and the next day when I came in,
08:41a few of the patients had passed away overnight,
08:44which isn't something that I've really had to deal with before.
08:48Even experienced staff are having to adjust to the intense pressure.
08:53What's the most difficult thing that you and your nurses
08:56are coping with here on this Covid ward?
08:59I just think it's the sheer level of how unwell our patients are.
09:04It's just not what we're used to.
09:06The patients are so sick, and it's really testing our nursing skills
09:09and our time management
09:11and our ability to actually get to them all quick enough.
09:14And what about the pressures on the nurses,
09:16the hours that are being worked, the shifts,
09:18going home to their families, with the risks, of course.
09:21We're all worried when we come to work, but we follow public health guidance,
09:24so we wear the PPE that they ask us to wear.
09:27And I do feel quite safe, but I think prolonged exposure
09:31and doing many days and doing extra days and doing it over time,
09:35you know, there's extra exposure that maybe we didn't need to have.
09:40The availability of PPE, personal protective equipment,
09:44has caused a political storm ever since this disease took hold.
09:50First thing is we had a kite delivery of safety masks.
09:54We've got 8,500 of them delivered this morning.
09:58There are still concerns across the UK about supplies of PPE.
10:04In this hospital, they say they have enough for now.
10:08The roving teams are really happy with their own goggles
10:10and they're happy with the decontamination.
10:12One of the groups decided to see whether it could go through the washy steriliser
10:15and it did very successfully.
10:18But they have to manage supplies carefully.
10:22Stocks are lower. We're having to look at things in a different way.
10:25So we get daily deliveries and we have a COVID store that we're keeping an eye on,
10:29so we're letting it come out.
10:31We're having to manage how it goes out.
10:34Anxiety over PPE has been heightened
10:37because many healthcare workers across the UK have contracted coronavirus.
10:43Mark? Hello. How are you feeling?
10:47One of them is here on the ward, paramedic Mark Anders.
10:52He spent a week at home trying to fight off the virus
10:55before his colleagues rushed him to hospital.
10:59When I was in A&E, I think because my temperature was so high,
11:04lots of things in my head going on,
11:06and then they kept coming in and saying we can't get your temperature down,
11:10your blood pressure's too low.
11:12And then the next minute they said,
11:14I think you're going to have to go to ITU,
11:16and I think that must have been something that...
11:21So just fighting it from there on.
11:24In the end, Mark didn't need intensive care.
11:28He can't be sure how he caught COVID,
11:31but knows he was exposed to the virus while doing his job.
11:36I suppose it shows the risks.
11:38Yeah. You try and do everything by the book, and it just...
11:42It's not easy.
11:44It's not easy.
11:46It's not easy.
11:48It's not easy.
11:50You try and do everything by the book, and it just...
11:54You know, something catches you out and you get it.
11:59I don't think you realise how...
12:04..it's everywhere.
12:06Everything you touch, everything you breathe, everything.
12:11You've just never had to deal with anything like this before.
12:15Mark's wife is alone at home.
12:18Kathy also had symptoms, but is feeling better now.
12:23For Mark, it's his job, it's his life.
12:25He absolutely loves being a paramedic, and I know that.
12:29And, you know, but I'm frightened for him.
12:32You know, I'm frightened for myself, for my family.
12:35You know, it's been the most awful, awful experience
12:39that I think we've ever experienced.
12:41You know, it's just been horrendous.
12:49While the NHS is focused on beating coronavirus,
12:53there are many people with other conditions.
12:58This morning, Professor Patel is operating on a patient
13:01with a heart condition.
13:06So, we have to make sure that the patient is healthy.
13:10So, we have to make sure patients like this
13:13do have their pacemaker batteries replaced,
13:16regardless of what's going on.
13:19Across the NHS, non-urgent operations and clinics
13:23have been scaled back, postponed or cancelled.
13:27That's true for Coventry too.
13:31So, from 32 theatres,
13:33they've now gone to between five and seven a day operational,
13:37and that's because they want to create capacity
13:39to treat the patients who are suffering from the coronavirus.
13:44Across the hospital, the risk of COVID infection
13:47means everything takes longer.
13:51This sort of procedure normally would have probably taken
13:5415 to 20 minutes, door in, door out.
13:58It's probably going to take us up to about an hour in total today
14:01because of the preparation that we've had to make.
14:03And this is precautionary because of COVID?
14:05Yes.
14:07Where operations are being carried out,
14:10there's extra pressure on staff.
14:13It's not sustainable long-term.
14:15We're hoping that as soon as this crisis is over,
14:17we can go back to regular working
14:19and getting through the normal volumes of work that we should.
14:22But that could be quite a while.
14:24It could be.
14:28The latest mortality figures reveal that in England and Wales
14:32in the first week of April, there was a record number of deaths,
14:366,000 more than expected.
14:39Only around half of those deaths were attributed to COVID.
14:45More people are likely to die from non-COVID-related illness
14:48over the next few months than COVID.
14:51Kiran Patel worries that many people may die
14:54from other treatable diseases.
14:57We must continue to provide good healthcare
14:59for things like heart attacks, strokes,
15:01any bleeding disorders, etc, etc.
15:04So we still retain the ability to function with business as usual,
15:08day by day.
15:12In the intensive care unit,
15:14very sick patients have to be monitored constantly.
15:17It's staff-intensive,
15:19and normally there's one nurse dedicated to every bed.
15:22Now, as in many hospitals, it's one to four beds.
15:27There's a wire not attached properly.
15:30Nationally, COVID patients in intensive care
15:33have an average age of 60, and around two-thirds are men.
15:38He wasn't really breathing enough by himself to manage.
15:41If there's problems, we might need to sedate him a bit more.
15:45For Dr Billiard, there's no clear pattern to this disease.
15:49There are some patients that seem to get better early
15:52and then almost have a relapse and deteriorate again
15:57in a very unpredictable way.
15:59So that can be quite demoralising, actually.
16:01When you've seen people get better
16:03and then suddenly they get worse for no apparent reason,
16:06that's quite difficult to deal with.
16:10This is where it's so difficult for the staff to work.
16:13I mean, I've only been in here a short time in this equipment,
16:17and I'm finding it really hard, really hot,
16:19and they're here for hours on end.
16:22How long can you actually work in this full gear, realistically?
16:26We've advised all our staff to be maximum of two hours,
16:30and you have to go and get some ideation.
16:33They can just go and sit down, relax, just release some tension
16:38and have a drink or a chocolate,
16:40and then go back and start all over again.
16:44So what's our next step with this chap?
16:47It's difficult.
16:49Like all the others, we're sort of still learning what they do.
16:54But if they're clearly deteriorating, despite everything we're doing,
16:59then they're not going to get better.
17:02In intensive care, it's important to make sure
17:05that they're getting the care they need.
17:09In intensive care, it's important that relatives remain involved and informed.
17:14But now, because it's dangerous for them to visit,
17:17families are updated by phone.
17:20What you don't want is if she gets worse,
17:22you don't want it to come as a big surprise to the family.
17:25So I should give the husband a call.
17:33Hello, my name's Dr Billiard.
17:35Hello, my name's Dr Billiard.
17:37I'm one of the intensive care consultants from Coventry Hospital.
17:40Yes, so she's not doing dreadfully, and this is not a bad news call.
17:47I just wanted to make sure you're up to date.
17:50She's still pretty sick and, you know, she's still in danger,
17:56but she's holding her own.
17:59We're used to communicating bad news,
18:01we're used to communicating at the end of life,
18:04but so much of that is nonverbal,
18:06picking up on body language cues and things,
18:08and you can't do any of that on the telephone.
18:10So it makes those conversations really difficult.
18:13The worst day was when we had three deaths in our unit.
18:18It was way too much to bear with all of us.
18:22Staff were emotionally breaking down,
18:25and we just didn't know what to do
18:28because we never had that much death in a day.
18:31Working in intensive care, you see death a lot,
18:34but we're seeing more deaths than we normally would,
18:37and that can get you down.
18:40So I have to make a conscious effort
18:43not to take that burden home with me
18:46because it's not fair on my family.
18:49But one thing we can assure everybody,
18:51nobody's allowed to die alone.
18:53We always sit there and hold their hands until everything happens
18:57and with utmost dignity and respect to them.
19:02On the wards, they're working hard
19:05to make sure that patients don't feel isolated.
19:08Emails sent from loved ones are delivered by nurses,
19:13and they're keeping patients' spirits up.
19:21Thank you very much. Thank you.
19:23The chaplain, Simon Betteridge, is often on the COVID wards.
19:32I had one poignant moment last week where there's a family
19:35and they wrote a message to take to their gran,
19:38expressing what the family felt about them
19:40and how valued she was to their family.
19:42And I took that message to her on the night just before she died,
19:46which was a great comfort for the family
19:48to know that they'd been able to express that to their gran.
19:54Good evening and welcome to the chapel of University Hospital Coventry.
20:00In the hospital's multi-faith chapel, they're having an Easter service,
20:04but there's no congregation.
20:06Instead, it's being live-streamed to the wards.
20:09How do you think things are going to go from here?
20:12I think it might get sadder. I think it will get more stressful.
20:17But I think what we're seeing is people coming together
20:20and finding creative ways of supporting each other, which is really good.
20:30Here in Coventry, like the rest of the country,
20:33NHS staff have been crying out for increased coronavirus testing.
20:38The government promised 100,000 tests a day by the end of April.
20:44Current capacity is less than half that.
20:49Lacey Moore is being tested today.
20:52She's a receptionist at the hospital outpatients clinic.
20:55Have you got any problems?
20:57Yeah.
20:58Continuous cough?
20:59No.
21:00And fever?
21:01Yeah.
21:04The hospital's ramping up testing for its own staff.
21:07It's recently expanded capacity with a new laboratory.
21:15Lacey's been off work, isolating at home,
21:18not knowing whether she's positive for the virus,
21:21like thousands of NHS staff across the country.
21:25So you're free to leave now, OK?
21:27Just wait for a call from virology.
21:30So, Lacey, how important is it for you as a health worker to get this test?
21:35It's great because if it is negative,
21:38possibly I could go back to work if I'm feeling OK.
21:41Because we're short-staffed at the moment,
21:43because we have three members of staff off,
21:45so it's a lot of short-staffed at the moment, so we're struggling.
21:50We're now starting to test a lot more staff.
21:52I think over the last week,
21:53we've gone up the ability for patients and staff to go for 150 tests a day,
21:58where, of course, patients came first.
22:00Now we're up to 400, and that's getting ever bigger.
22:02We've had new equipment delivered, so we're going to move towards 24-7 testing.
22:06Surely the testing was too little too late.
22:08Well, of course, it could have been better if it was earlier.
22:11We are still seeing high levels of staff absences because of sickness,
22:14because of Covid issues and non-Covid issues, and the isolation.
22:18Paramedic Mark Anders has now been in hospital for eight days.
22:23Hello.
22:25Hello, babe. You all right?
22:27How are you doing?
22:30Yeah, and what did the doctor say?
22:34Oh, that's brilliant. That's absolutely brilliant.
22:41Glad to be going home.
22:44Glad to be going home, so I'm just reading my discharge note.
22:48At one point, I didn't think I was going to get home, so...
22:52Fortunately, it turned all round.
22:55Hopefully, I'm one of the lucky ones.
22:57I think we just have to write off 2020 as a bad year.
23:08Like the vast majority of people who catch coronavirus,
23:12Mark has recovered.
23:29What's it like to have him back?
23:31Just amazing. Just amazing.
23:33It's just the best thing ever.
23:35It's just absolutely amazing now.
23:43The hospital relies on hundreds of support workers,
23:47cleaners, porters and catering staff, to help look after patients.
23:53The chief exec is keeping up morale
23:56by handing out Easter eggs donated by the public.
24:01We're just taking them around,
24:03particularly to those wards and areas that are in the absolute front line,
24:06and just little things like this make a big difference,
24:09make people feel a bit appreciated.
24:12So, we've had the Easter weekend.
24:14That was the weekend when we were anticipating a surge.
24:17That surge does not appear to have come, it hasn't come here in Coventry,
24:20and indeed, across the country, we see those figures and we mirror that.
24:23So, yes, we are seeing a plateauing at the moment.
24:25But, of course, we don't know whether there's a surge still to come.
24:28Are we going to get a secondary surge as the lockdown is relaxed,
24:31as we see measures to bring society back to some kind of normality?
24:35But that normality is likely to be a long way off.
24:39The Covid wards are still busy.
24:45Kira's career as a doctor has started in a way she would never have expected.
24:51I was really worried about what this would be like,
24:54and that we'd be thrown in at the deep end,
24:56and it was a bit of a baptism of fire.
24:58It was a bit of a shock.
25:01We will probably, hopefully,
25:03never see anything like this again in our entire careers.
25:09While I was in the hospital,
25:11there was news that someone in this close-knit community
25:14had succumbed to the virus.
25:17Leigh Dayrit, a nurse at St Cross Hospital Rugby,
25:20part of this NHS trust.
25:23She had asthma and died at home.
25:27Adrian was her friend and colleague.
25:30I could proudly say that she was the epitome
25:33of what a great nurse should be.
25:36Being selfless, being dedicated,
25:39her loyalty is commendable.
25:42You know, she had worked in this trust for 16 years.
25:45She was definitely an unsung hero.
25:48So she was working despite the nervousness,
25:51despite the anxiety,
25:54So she was working despite the known risks of this?
25:57Unfortunately, with her background of having an asthma,
26:02that puts her to the vulnerability.
26:07And, unfortunately, she deteriorated,
26:11and it was a massive shock
26:16to all of us that have known her,
26:19because you wouldn't think of somebody that you love
26:24would be affected by this pandemic that we're currently in.
26:32Leigh Dayrit is one of almost 50 NHS workers
26:36who've died with coronavirus.
26:40It's obviously a massive blow to the hospital,
26:42to her teams and to her family.
26:44As we move towards this Thursday and clap for carers,
26:46we specifically hear, we're going to be thinking about Leigh,
26:49what she did, she's a really popular member of staff.
26:58At the hospital, they're gathering for what's become a weekly ritual,
27:02here and across the UK.
27:05The Thursday night clap-out for NHS workers and carers.
27:10We work in OTU and theatres,
27:12and there's lots of people in there that wish they could come out and see this now.
27:15So I'm going to come and take a video and show everyone inside
27:18and show them the support that's out here, really.
27:20What does it mean to you if you work here?
27:23It's just very emotional.
27:25It's very nice to see the appreciation.
27:29On the streets of Coventry, they've also come out to show their support.
27:35We came out to clap because we wanted just to be a community
27:38and show the people who live next door, who's a nurse and things,
27:42how much they mean to us for what they're doing.
27:44You just can't fault them, they're absolutely fantastic.
27:46Putting their lives at risk for us, absolutely brilliant.
27:57It's quite touching, isn't it?
27:58And I think it just epitomises the public support that the NHS has.
28:02I think it's brilliant, a great show of affection.
28:05Since the crisis began, more than 600 COVID patients have been treated here
28:11and more than 160 have died.
28:15So far, this hospital, like the rest of the NHS, has coped.
28:19But the challenge is far from over.
28:34For more information, visit www.nhs.gov.au