The best of times and the worst of times: COVID-19, a year on

As the world has learned to adjust to the changes brought about by COVID-19, Dr Dan Magnus reflects on his thoughts from last year and expresses his feelings about the recovery from the pandemic and what it means for the wellbeing of all of us.
Dr Dan Magnus

I was febrile, breathless and exhausted. The intensive care doctor said “We’re moving you to the COVID High Dependency Unit, Dan.” He said the CT scan of my lungs was bad, my oxygen requirement was getting higher and it looked like I was going to need more respiratory support. Just two weeks before as the pandemic was gaining momentum, in late March 2020, I had written a blog on staff wellbeing. I wrote “it is worth remembering that the double jeopardy of the current situation for healthcare staff involves fragility and fear both at work as well at home in our family lives.” How little I had appreciated just how personal that would become for me.

There is an understandable push for NHS recovery and for us to get back to ‘business as usual’. But we also urgently need to pause, reflect and start to heal

Thanks to the amazing care and support I received from my NHS colleagues I was eventually discharged and have recovered well physically. But it has been a hard year for us all in so many different ways and the psychological toll that the pandemic has taken on healthcare staff in particular cannot be underestimated. As COVID-19 prevalence continues to fall nationally and restrictions ease, there is an understandable push for NHS recovery and for us to get back to ‘business as usual’. But we also urgently need to pause, reflect and start to heal.

In paediatrics our clinical experience of COVID has been challenging in different ways. In the peaks of the pandemic many saw bewildering drops in paediatric emergency attendances and other viral illnesses almost disappear. At the same time many have seen worrying rises in mental health presentations in children and young people. But healthcare staff working in paediatrics have experienced the burden of COVID at work none the less.

Many were drafted to support adult clinical areas or to see adults in their own places of work. Some helped to prone adults on intensive care units, whilst others volunteered to vaccinate. We are hearing increasing accounts of the painful guilt felt by staff forced to shield or by staff in relatively quiet paediatric departments while they sensed their colleagues under pressure in other parts of the hospital or the country. All the while, still providing care for children and families.

Every single one of us has been through something not just as individuals, but in our ‘work families’ too. We need to not only acknowledge this but be pro-active in taking the time to process our experiences in our own way

Things have also been hard at home too: the worry about taking COVID home to ones we love; the challenge of home schooling; the anxiety about employment or earnings for non NHS family members; the emotional strain of not seeing family and friends; the hurt at watching public stories of denial or refusal to comply with restriction measures; emotional fatigue and exhaustion, to name just a few. Each day coming back to work, donning PPE and carrying on. Every single one of us has been through something not just as individuals, but in our ‘work families’ too. We need to not only acknowledge this but be pro-active in taking the time to process our experiences in our own way. I have found the following three steps helpful in looking after my own mental health and we have recently run a series of activities in our department along these lines too:

1. Create space and time to Pause. Allow yourself to be still and to breathe. This can be anything from a minute stood at the blood gas machine, through to an afternoon in the peace of nature.

2. Reflect on your experiences. Processing what you have seen is important. Talk to somebody about how you feel or what you have done, go to a Schwartz Round, write down or draw something.

3. Begin to Heal. Take the time you have taken to pause and reflect and turn that into something positive looking forwards as we reach out to brighter days ahead and our own individual and collective recovery.

Despite everything, we have seen some of the very best in ourselves and our colleagues as well as ingenuity, innovation and the capacity and creativity to work together and to overcome some of the most challenging circumstances humankind has experienced in generations. There have also been amazing examples of NHS staff supporting each other and working hard to look after wellbeing.

The pandemic is not over yet. There is more work to be done and prioritising our psychological wellbeing and how we support each other is going to remain vital

The pandemic is not over yet. There is more work to be done and prioritising our psychological wellbeing and how we support each other is going to remain vital. We have learned so much about ourselves and each other. A year ago I wrote that “the unending riches of the human spirit and the things that make us great have not changed” and they still have not. We need to look forward now and we can do so with optimism and hope in our hearts.