Skilling-up for the eye of the #MSCOVID19 storm

S

I want to apologise to my students and colleagues for not delivering on certain teaching and academic tasks; I will get there. I have had to spend the last 48+ hours starting the process of reskilling and learning new skills for when I am redeployed onto the front-line of the NHS. Our hospital is being reconfigured as if we are preparing for war. There are red or hot floors that are for managing the COVID-19 positive patients and green floors for the COVID-19 negative patients. There are new systems being put in place to triage and manage patients depending on their predicted outcome. Several wards are being converted into ITUs or ventilator units. The Royal London Hospital is being transformed.

If you are a neurologist the following slides from Dr Ali Jawad, from the Royal College of Physicians (RCP), is a good starting point to learn about COVID-19.

In the last 48 hours, I have ploughed through a new Chinese textbook on how to diagnose and manage COVID-19 and I am reading as much as I can in relation to what needs to be done on the frontline. I am also having to reskill myself in relation to my general medical skills. I spent yesterday shadowing a college on the general medical wards at the Royal London Hospital. The experience was uplifting; I have always loved general medicine and my experience made me recall my days as a medical student and as a medical registrar. I am particularly grateful to Professor Tom Bothwell (see my obituary ‘Emulating your mentor‘) who taught and influenced me most in my early years as a medical trainee.

We are anticipating that neurologists will be redeployed to work in A&E (accident and emergency), the general medical ward or even in the new makeshift ITUs (intensive care units) that are being established in London. One thing I still don’t feel competent to do, which I used to be able to do when I was a general medical registrar 30+ years ago, are awake intubations and to manage patients on a ventilator. I recall it not being that complicated. I worked for four months on an eight-bed respiratory ICU and was responsible for managing the unit when on-call. I am sure I could relearn these skills if and when the need arises.

I am doing this post to make you aware of the seriousness of the storm or tsunami that is about to hit us and what is expected of all HCPs working in the NHS. This is underlined by the fact the NHS is constructing temporary morgues across the country and converting conference venues into mass hospitals.

The following is an excerpt of an email I was sent yesterday:

…. We have been asked to support the resourcing process for the new Nightingale Hospital based at the Excel in East London due to open this weekend. The resources we are seeking to identify are varied but include expertise in the following areas:

Staff:

Clinical care especially ICU and rehabilitation post-ICU
Educators for Teaching and training of clinical staff

I appreciate these are broad categories but the plan will be to train up around 1000 or more clinicians to run a unit for ventilated patients with around a week to move from where we are now to a functioning unit…..

These are just a few of the reasons why pwMS in the UK need to understand that the management of MS and many other chronic diseases are being put on the backburner. In these extraordinary times, you will also need to upskill yourselves in the self-management of MS; you may have to take responsibility for some of your own care.

I am so impressed with the professionalism and the ‘can-do’ attitude of my NHS colleagues. Prior to this crisis morale in the NHS seemed to be very low, but yesterday’s experience showed me what a remarkable organisation the NHS really is. The call to arms has given the NHS a new sense of purpose. The willingness of the people who work in the NHS to make a difference makes me very proud. I predict that we are going to get through this crisis better than we expect and hopefully this will convince our politicians and politicians the world over that healthcare has to socialised.

I will try to continue running my #MSCOVID19 microsite to give you advice at a distance. The idea behind the site is simple; to provide you with information on COVID-19 and MS and to collate all the answers to the questions you have in one place, which makes it easier for others to find. You are also welcome to ask me non-COVID-19 questions? As I am not meant to be giving personal opinions online I will anonymise the question and provide generic advice that can then be used by the wider MS community.

Please take care of yourselves and we will hopefully see each other in a few months time.

CoI: multiple

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

38 comments

Leave a Reply to Jolene Cancel reply

  • ProfG, thank you so much for everything you’ve been doing! Your efforts are of tremendous importance.
    All the best and please keep us posted.

    I am also optimistic the health systems will get improve once we’re on the other side of this pandemic.

  • thank you professor for all your efforts lately to take us into the information about covid-19 and MS, the considerations regarding the DMTs, it has given me a lot of support. It is now up to me to be careful and wise. I wish you all the strength you need against this storm! Take care.

  • Do we have statistics on MS patients under treatment (or just immunodeficient patients like HIV patients) , are they really more at risk than the general population?

  • Good luck Prof G. Don’t underestimate the national psyche. Dunkirk, the Blitz, gallows humour are what we are about. The 400k people who signed up to be NHS volunteers says something about the people of this country. That’s why so many want to come here. My neighbours are already talking about a street party when the storm has passed. I like the idea of neuros widening their experience. The chance to save lives is what doctoring is about. I hope the neuros who get this experience will strive to do better for their patients – perhaps for MS tackling the real disease not the collateral damage. Best wishes.

    • Perhaps those who’ve bought all the bog rolls might listen to your appeals to the Dunkirk/Blitz spirit and return them to the supermarkets.
      Still, welcome back “Mark”” 😉

      • Good to hear that one of the extended Team (not UK based), has already pulled through.
        Hope we all make it. I suspect ProfK will be soon sent from the front line, once we makes people worried he’s infected 🙂

  • I would like to take this opportunity to thank you for all the information you have posted, you have given me a large torch to make my way through a dark tunnel. Good luck for you and you all NHS fellow workers.

  • ProfG, Thank you for a positive and uplifting post. Its good to read something that is encouraging and seeing the glass as half full.

    I am sure a lot of positives will come into practice as a result of this global crisis

    • Tell that to the Students…..they were expecting a lecture:-)

      I suspect that our bosses will realise that we can use videos for all our teaching…We will all become open Universities. Maybe the COVID thing was a plot by our university to generate “online degree courses”

  • Thank you to all the doctors,nurses, cleaners security staff everysingle employees of the NHS. Thank you. 🙏🏻 Stay all safe.😷😷🐶

  • Thank you so much for everything you and the team do, the speed and detail of the information over the past few weeks has been amazing.
    Good luck over the next few months, stay safe and take care!

  • Thank you so much for doing so much to give guidance to people with MS and also for everything you and other NHS employees are giving of yourselves right now.

  • Maybe my wife and I have watched too much TV. But we say good hunting rather than good luck. It sounds too passive for a steely eyed professional.

    Good hunting!

  • Gavin, you and all your colleagues (both here in the UK and across the world) and everyone in the NHS are quite literally our heroes. You constantly work against a tide but as you said, this time you’re preparing for a tsunami. On the days (and I’m sure there will be many) when you’re exhausted, mentally drained and feel like things can’t get any tougher, just remember that your patients are forever grateful to you (and your family – let’s not forget that you have people at home worrying about you) for everything you do, not just for the MS community but the wider healthcare environment. Words don’t seem enough. Good luck for the coming challenge and please take care. (From me and the whole family)

  • Prof G – you remind us of how dedicated, adaptive and resilient NHS staff can be, and how you all put patients’ needs foremost, especially in a crisis. Thank you for your detailed, timely, reassuring, honest appraisal of how things are and how things will probably be in the UK very soon.

  • The medical staff all over the world are quite literally doing the hardest job ever. Words can’t express how much gratitude we have for you all. We wish you all the best in your upcoming challenge and thank you, your colleagues and your family from the bottom of our hearts for what you are doing.

  • What an inspiring post! We all hope for the best you and all the staff there. Perhaps this sobering experience, when over, might lead to a less unsustainable world for all generations in the future. I can’t help but feel everything has changed.

  • As everyone else has said, thank you for everything Prof G
    The war analogy is apt, as the situation is truly grim and you will be at the frontline

    (this reminded me of the people, film stars and others, who went to fight during the world wars! )

    By now we are all aware of how serious the situation is. Reading about the NHS preparations has filled me with even more dread

    India is on the third day of a 3-week shutdown that is causing unbelievable suffering to millions. Let’s hope it is worth it , and a Covid-19 tsunami is averted. The health system here is way too inadequate even without a pandemic

  • I stood at my front door this evening with my family applauding you and all your NHS colleagues. It sounded like every household joined in. Our thoughts are with you all, keep safe, thank you.

  • Sending huge amounts of grateful love to you all. The entire country thanks you. Keep safe and well, love Shana xx

  • Good luck, take care and stay safe Gavin. Thank you for all you have done, for all you are doing, and for all you will do in the future. Bron.

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