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:
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.