PPE Free

3rd August 2020

UK COVID Deaths - Daily 9 / Total 46,210

James Cook Hospital – Total COVID deaths – 255

All COVID cases within South Tees Hospitals Trust – 2

James Cook Critical Care COVID cases – 0

I’m back at work today after a two week holiday. I have to admit that it has been good to unwind and forget about work for a little while. Like most people we had to change our original holiday plans and instead hired a narrowboat and spent a week navigating the canals of Staffordshire, Worcestershire, the Black Country and Birmingham. A lot more fun than you might think. Honest. We were blessed with lovely weather and had a great time. A canal boat holiday was something Nicky and I had always wanted to try but had never quite got around to organising. I can highly recommend it.

Normally when I return to work from holiday any feelings of tranquillity and relaxation have evaporated by about 3pm on the first day. However, today was different. I arrived to work to find that we are no longer obliged to wear full PPE whilst working in the Intensive Care Units. Woo-hoo!

New guidance, issued late on Friday by the Faculty of Intensive Care Medicine, the Intensive Care Society, the Infection Prevention Society and the British Association of Critical Care Nurses recommends that full PPE no longer needs to be worn in units that contain only COVID-negative patients.

You will have read many accounts of how unpleasant it is to wear PPE for hours on end and I’m not sure I can add any more to the subject. What I will say is that it’s only when you stop wearing it that you realise what a relief it is. We can now enter the ICU wearing only scrubs and a surgical face mask once we have washed our hands. Of course, when we enter a patient’s bed area we have to wear an apron and gloves and when we perform any procedure that is classed as ‘aerosol-generating’ (such as intubating a patient) we are back in full PPE temporarily.

This now means that we can enter the ICU to check how a patient is doing or to talk to a member of staff almost as easily as before the pandemic. It also means we can leave for bathroom breaks as and when we need to. No small thing for a middle-aged man with a compulsive tea-drinking habit…

The other piece of good news is that we have finally discharged our last COVID patient to the ward a few days ago. We now have no COVID patients within critical care. Nil. Zilch. Nada. None. This is the first time this has happened in four and a half months and is a major milestone for us.

As of today there are only two COVID patients within the whole hospital and one of those is our ex-ICU patient. The numbers of non-COVID patients are steadily increasing and there is a progressive return to ‘normal’ day-to-day hospital activity. More surgery is being performed, more procedures undertaken and more patients are to be seen walking to and from appointments in the hospital corridors. Hospital visiting is still not allowed except under exceptional circumstances in order to protect vulnerable patients from exposure to COVID-19.

Being on the ICU today felt very much like old times and this wasn’t just due to the lack of PPE. Nearly all of my patients today had neurological or neurosurgical problems and were relatively stable. Cases included severe strokes, patients with brain tumours, meningitis and a brain injury following an assault. We also treated a gentleman who had suffered a heart attack and cardiac arrest whilst gardening who was resuscitated by his neighbour. Not one of these patients had any symptoms that could have been put down to the coronavirus. In fact, none of them had any appreciable respiratory failure which made for a refreshing change.

So, a much more relaxing day than I thought and a chance for that holiday feeling to perhaps last another day or two? We shall see.