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We received hundreds of questions during the webinar last week and even more by email afterwards – we just couldn’t answer them all. But we collated some of the most popular questions and our Doctor kindly took the time to answer them for you. 

If you missed the webinar, or if you would just like to watch it again, there is a link at the side or bottom of this page.

 

Q – Is anything else we, or the Government, could do to fight this virus? (Meron)

A – I think the combination of COVID-19 being novel and its ability to spread so rapidly means it’s very difficult to be ahead of the virus. The government’s plan of minimising social contact and therefore minimising the spread seems the most effective option we have at the moment according to the research and advice they have been given. The government is investing in developing a vaccine which is in progress, but it has been suggested that this could take up to 18 months to produce. So the current advice of social distancing, regular hand washing and improved hygiene control is the best tactic for everyone to try and fight the virus right now. This may change in the very near future.

Q – What happens to non-COVID A&E patients? (Merrie)

At our A&E we are acting as if all patients are COVID positive. This means that all of the staff are protected and to reduce transmission as much as possible. Many people will be asymptomatic and could a carrier therefore we have to act like they have it for their safety, other patient’s safety and our safety. As well as this, if this patient does need to be seen as an emergency then they stay and get reviewed as they would. At our A&E, we have introduced front-desk streaming. If a patient does not need to be seen as an emergency then they are directed to a more appropriate place, e.g. GP, ambulatory care, other hospitals.

Q – A&E is already a fast-paced ward, how is the atmosphere during the pandemic similar/different? (Merrie)

The atmosphere within A&E has changed slightly. Over the past few weeks we were expecting a large rise in COVID-19 patients so there was an atmosphere of anticipation. The hospital has increased staff numbers and we haven’t seen as many patients come in as we expected so it has been relatively manageable. There has also been a large drop in overall non-COVID patients coming into A&E so that has reduced the pressure within A&E and made it easier to manage the increased COVID patient numbers.

Q – Are there any books about life of a Doctor or medical school that you suggest we read? (Levi)

I would suggest:

– Adam Kay – This is going to hurt?
– Being Mortal – Atul Gawande
– Trust me, I’m a junior doctor – Max Pemberton
They’re the ones I have read and enjoyed anyway

Q – How do you deal with any worries you may have?

There is a never-ending list of ways that I deal with my worries and to be honest, it depends on what the worry is. If it is a mild work worry that I can ask one of my colleagues and confide in them, then I will do so. This may be another junior doctor, one of the nurses or a senior colleague. If the work worry is a bit more than that, I have very supportive consultants in my department and honestly feel I could approach one of them – they I feel would be helpful in giving me the appropriate advice or point me in the direction of who to turn to. If it is a worry that is related to outside work, then I can confide in and discuss it with one of my friends/family.
I think you have to think about other ways to deal with worry too. Sometimes, I watch a good TV programme and switch off, sometimes I cuddle my dog and sometimes I actually do housework to deal with my worry.

Q – Are you doing what you thought you would be when you were in college? (Hollie)

In college I was always set on applying to medical school and becoming a Doctor. However, during medical school, I did have various ideas about the specialty I wanted to progress into – I quite liked the idea of Orthopaedics. Once I started my job as a Doctor and I spent time in various other departments, I found I really enjoyed other specialties such a Respiratory and Gastroenterology. I still have a few more years where I will spend time in further departments but these will be more focussed on internal medicine, so even now I still have time to develop my interests before committing to a single specialty. I would suggest being as open-minded as possible whilst applying and throughout medical school…you will probably change your mind!

Q – Will A&E departments operate differently once the virus has passed? If so, how?

Some people hope so. I think that some people have evaluated their true need to attend A&E in this crisis and has led to quieter departments. The hope is that people do still manage their own health when it is not by definition an accident or emergency and can visit the appropriate other services. However, I do think that A&E will return to their fairly normal processes once this has started to pass but it may change how we see the department and patient experience in the long-run.
I do think that if anything were to happen like this again in the future the departments and staff would be better prepared after the experience we have all gained.

Q – What is the main problem A&E departments face during this pandemic? e.g. lack of staff, ventilators, beds, protective equipment.

My A&E department is coping relatively well with the current COVID-19 situation and there aren’t many strains on the department. Quite often the media can focus on the worst case scenarios for the news stories, so I would always bear that in mind applying one news story to all hospitals. Hopefully from the webinar you gained an insight into a different hospital and can use it as an extra resource point any you are not solely reliant on the media for your information about the COVID-19 situation.
We have been quite fortunate and not been hit hard by staffing shortages or ventilator shortages thus far. There has been anxiety about protective equipment amongst staff but I think only unless we were all away from the environment then the risk would be less. Unfortunately, being exposed to the virus especially in A&E can be a risk but we all have our patient’s needs at heart.

Q – Has your shifts dramatically increased due to corona? And do you think this is good or bad as tiredness can lead mistakes (Mia)

My shifts haven’t changed at all really. I am a Locum Doctor and typically work 4 shifts per week and I am on a similar number of shifts now as I was in the weeks/months before the COVID-19 situation. You have to think of patient safety and staff well-being especially throughout a crisis like this. Being over-worked can cause tiredness, stress and risk to patients – many hospitals I can imagine have tried their hardest to keep shifts the same according to the Working Time Directive.

Q – Do you think there will be a time when doctors are going to have to have to make a decision on who gets a ventilator and who doesn’t because of shortages and if this decision had to be made what factors would be taken into consideration? (Bethan)

Overall from the latest government briefing we are hopefully seeing that the overall levels of hospital admissions are stabilising at a manageable level. I cannot predict the future but I certainly hope that we as doctors do not have to come to this.
A lot of companies are working very hard to provide more ventilators and I have seen that other countries are helping each other out – we have had a generous donation from Germany recently.
IF the situation came to it, there would not just be one person involved. There would likely be team decisions, family discussions and there would be consideration of the patient wishes and their health and history. We are being very proactive in A&E currently and making sure that every patient has their wishes known in regards to resuscitation and ventilation. Having these discussions early can help plan and make the best management plan for patients if the worst was to happen and they would deteriorate.

 

Missed the webinar? You can watch it on-demand here:

Further Reading

The Virology of COVID-19

Author: Holly E. Third Year Medical StudentWhat is a virus? Viruses are the smallest type of microbe. They are much smaller than the cells found in our bodies. Unlike cells in our body, and bacterial cells, viruses are only able to replicate inside other organisms’...

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How will COVID-19 revolutionise healthcare?

Author: Edward S. Fourth Year Medical StudentCovid-19 has had drastic effects on the economy, healthcare, and education. It is a surreal yet defining moment in human history and will result in tragedy on a global scale. Our healthcare will need time to recover, and as...

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Top 20 Revision Tips During COVID-19

Author: Krsna M. Fourth Year Medical StudentSo, school has been shut, many assessments cancelled or on hold. Yet, some others continue online, or have been postponed to a later date. Whatever you’re revising for or will be revising for in future, if you need some...

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