Friday 8th May 2020
Figures for 7th May
UK COVID Deaths 539 / Total 30,615
James Cook Hospital – Total COVID deaths – 204
All COVID cases within South Tees Hospitals Trust - 71
James Cook Critical Care COVID cases – 12 / 9 ventilated
James Cook Critical Care non-COVID cases – 25 / 12 ventilated
Not the VE day I originally had planned and not just because I’m at work today instead of having the day off as originally planned. There was an attempt to honour the occasion at work but the monitors and ventilators alarming interrupted the start of the two minute silence and the urgent re-intubation and near respiratory arrest of one of the patients put paid to the rest.
The wards appear to be seeing a few more COVID patients than they were last week. We are seeing a couple of such patients admitted each day but our numbers are remaining fairly static. Our numbers of deaths and recovered discharges are balancing the numbers of new admissions.
We are still seeing more non-COVID patients than before and we are seeing an increasing number of trauma cases as more people appear to be leaving their homes. Having said that, the most surprising case today was a lady who was doing the right thing and staying put. She was enjoying a lunchtime glass of vodka and a cigarette to celebrate VE day when somehow she managed to spill her drink over her head and set fire to it at the same time. Luckily her impression of a human Christmas Pudding didn’t last very long and her burns were not as bad as they sound. Any severe burns patient would normally be transferred up to the Regional Burns Centre in Newcastle but our plastic surgical team were happy for her to remain at James Cook for treatment.
Because of the increase in non-COVID patients we have had to turn the Surgical Assessment Unit (SAU) from a COVID HDU back into a non-COVID HDU. This means that we have now collated all the COVID patients into our two original ICU’s. We are starting to realise that flexibility is the key for the future and we may need to flip units between being COVID and non-COVID as necessary. Using hydrogen peroxide fogging machines we can clean a unit within a few hours and have it ready to receive patients if necessary. The only problem is that we have to empty it first.
In the afternoon we receive an urgent transfer from the ward. It is a gentleman in his 50’s who was admitted to hospital 2 days ago with COVID pneumonitis. He is normally healthy apart from hypertension and underwent a CT scan of his chest this morning which showed significant COVID inflammatory change. He deteriorated quickly over the next few hours and my colleague Tim was understandably worried about him. Rather than try CPAP on the ward, Tim arranged for him to be transferred up to ICU in case he needs intubating and ventilating.
When the patient arrives he is clearly anxious at the turn of events that have taken place over the last hour. He is now very breathless, despite high-flow oxygen and the move to the ICU has clearly unnerved him. He is putting on a brave face and pretending otherwise but he can see and feel how serious the situation is. We set up a CPAP circuit for him and strap the mask to his face. I explain what is happening and try to reassure him that there is a good chance that the CPAP will work and that his breathing may be much better soon. I’m not sure he believes me.
Fortunately about ten minutes later things are looking vastly improved. He has responded to the CPAP very well and his breathing is slower and less laboured. I tell him that he will need to keep the tight-fitting mask on for a few hours but then we will be able to give him a rest. I also tell him that CPAP is his best chance of recovering and that we will try very hard not to put him on the ventilator until it becomes clear that he can no longer breathe by himself. He looks rather disheartened when I tell him that he may have to wear the CPAP mask for over five days if his illness follows the same pattern as most of our patients. I try to get across how important it is that he learns to tolerate the mask and that no matter how bad things get, to persevere and follow our advice. There is no disagreement from him.
I forget about the VE Day celebrations for the rest of the day until I’m leaving work. It’s a lovely mild spring evening and for the first time this year, it’s still fairly light as I cycle home. Someone has thoughtfully decided to set off their extensive firework collection in their back garden as I leave the hospital; it proves to be quite an impressive backdrop to the end of the day.
VE Day 1945 - A street party in Stonyhurst Avenue, Acklam, Middlesbrough. My mother is the little Dutch girl on the bottom row, 3rd from the left. My uncle is the Scotsman with the over-sized sporran on the top row, far right.
Red, White and Blue - Patriotic PPE