Frontline clinicians have given a harrowing account of the impact the second wave of Covid-19 is having on patients and on staff.
They said that the patients coming into intensive care at the Morriston Hospital in Swansea are sicker than during the first wave – and most of those on intensive ventilation will not survive.
Most of those patients are of working age and do not have any significant medical conditions, they said.
Intensive care consultant John Gorst said: “Sometimes we’ve seen many patients die in the same 12-hour shift.
“In some 12-hour periods we have lost up to five coronavirus patients.
“Usually we expect to see, on average, one patient a day dying in the intensive care unit. To have five die on one day is unprecedented.
“That’s been a real struggle for their families and for the staff dealing with it. It has been a real challenge for everyone involved.
“We deal with it by having such a strong team. We are able to pull together and get through difficult times for us so we can focus on helping those families who have had such a traumatic time, but also helping the patients who remain with us as well.”
Dr Gorst said the second wave had been a lot more challenging than the first with the biggest difference being that patients were sicker now.
“We do have better treatments for coronavirus now. They aim to keep people out of intensive care,” he said.
“If it wasn’t for the treatment given on the wards, intensive care would have been completely overwhelmed.
“However, when patients have failed on these treatments, sadly the safety net of the intensive care unit, the safety net of getting them on an invasive ventilator, largely doesn’t work.
“Most patients at the moment who come to intensive care to go on an intensive ventilator, sadly will not survive.
“These patients are mostly of working age. They don’t have any significant medical conditions.
“This is alien to us as an intensive care unit. We expect far more patients to survive. Now they are not.
“That’s because we are seeing a different group of patients who are just not responding to the treatment, unfortunately.”
One of the hardest aspects of these losses is that relatives cannot be with patients.
“Families are not able to see loved ones and we are having to have horrible conversations by phone with them,” said Dr Gorst.
“That has been our biggest challenge in this wave, families understanding how severely unwell they are and when they are, sadly, dying it’s really difficult for families to understand.
“The most difficult situation for everyone involved in intensive care is when a patient is dying despite everyone’s best efforts and that patient would potentially be by themselves.
“Obviously, as doctors, nurses and the whole team, we wouldn’t want that and I’ve sat with nursing colleagues with patients in their final moments to make sure they are not alone.
“That is something I can reassure families is that your loved one is never alone on the intensive care unit.”
Senior matron Carol Doggett, head of nursing for medicine, echoed that sentiment.
“The biggest thing for us is the absence of family, particularly at end of life, when a nurse steps in and becomes their next of kin, almost, the person that sits there and holds their hand,” she said.
Mrs Doggett said the extreme pressure experienced in intensive care had been felt throughout the hospital.
“Patients are coming in through the emergency department. They are sicker. The number of sicker patients has definitely increased,” said added.
“That results in them having an extended period in hospital.”