A senior doctor has warned of his concern for the welfare of staff on medical wards who are dealing with increasing numbers of Covid-19 patients (07 January).
Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said up to 90 per cent of the 30,074 Covid patients now in UK hospitals were being cared for in acute medical units and on respiratory and elderly care wards.
In addition to providing the level of care normally seen on intensive care units, such as continuous positive airway pressure (CPAP) ventilation, these staff are also among those assessing patients on arrival at hospitals and caring for non-Covid emergency patients.
“While it is perfectly understandable there is currently a lot of focus on the work of our colleagues in intensive care units who are treating very sick ventilated patients, medical teams in acute and respiratory units are also working under intense pressure caring for far more Covid patients than will ever reach ICUs,” he said.
“This is really important to recognise and amplify as they are also the staff who, along with those in emergency departments and older people units, will be assessing Covid admissions and are under pressure to move patients from emergency departments to wards as quickly as possible.
“At that point it is crucial not to mix those with Covid, possibly with Covid and probably not with Covid prior to their test results being received, making it a high stakes assessment – and this is also while these staff continue to manage non-Covid patients, of which the numbers are growing now we are in the winter months.
“This is all very unnerving for us in acute medicine as our staff were often called upon during the first wave to bolster hard-pressed respiratory and intensive care units, the pressures have never dropped and they are now higher than at any stage in the pandemic so far – they are exhausted.”
Dr Scriven said he also “remained anxious” about the vulnerability of staff in acute medical units given the rising number of Covid patients and the current recommendations for personal protective equipment (PPE).
“In theory, acute medical unit staff could be at higher risk than any other as recommended PPE for assessment is a plastic apron, mask, eye protection and gloves, not the full PPE used in ICU.
“While full PPE will be provided should a patient on an AMU require an aerosol generating procedure, given the sheer numbers of patients our staff are seeing for assessments, possibly admission and continuing care waiting for a bed on other wards, they are at greater risk and that should be considered.”
Dr Scriven said he hoped highlighting the intensity of work being carried out away from ICUs would help convey to the public just how precarious the situation is throughout hospitals heading deeper into winter.