Greyfriars Kirk graveyard, Edinburgh

Three weeks ago, there was an outbreak of COVID-19 on my ward leading to 14 members of members of staff becoming infected and subsequently being absent from work. The ward was closed for two days, with no new patient admissions allowed into the ward. This resulted in cancelled elective surgeries and nowhere for recovered intensive care patients to go, subsequently blocking expensive intensive care beds. Patients in the ward were swabbed for COVID-19 and the ward remained closed until all patients had tested negative. Staff were tested, but only if they displayed symptoms of COVID-19. The remaining asymptomatic half of the ward staff were not tested. Multiple studies have found that over 50% of infected healthcare workers are asymptomatic carriers. The risk of asymptomatic transmission between healthcare workers is significant. I am angry and upset that we were not tested on the ward. It added significant uncertainty and anxiety into my personal life as I worried about unknowingly spreading COVID to my household.

We owe the success of the NHS to the highly interconnected and dynamic teams in which we work. The close proximity that this teamwork requires renders social distancing both impractical and perhaps even detrimental to our patients. Additional interim junior doctors have been fast-tracked into the role of a doctor several months early, to bolster the NHS workforce. In response to the COVID-19 pandemic there are now unusually high levels of staff on the wards. Space in the doctors’ offices and break rooms is at a premium with the recent addition of thousands of additional staff members into the NHS. This has increased both the number of possible carriers of infection and the size of the susceptible population. We have entered an environment where our NHS staff are now more at risk from our own colleagues than from our patients. Therefore, we must improve the standards of testing our staff for COVID-19 to protect our workforce and outcomes for our patients.

The UK government has only just begun to hit its widely touted 100,000 tests a day target. With over 1 million NHS staff around the UK, it would be impractical to suggest testing all NHS staff routinely for coronavirus. However, we should be identifying and testing individuals at high risk of infection regardless of symptoms. This includes those who are routinely around high-risk, aerosol generating procedures, such as intensive care staff. This would minimise the effect of asymptomatic transmission amongst healthcare workers, leading to fewer staff shortages, and would reduce the significant fear amongst healthcare workers in high-risk areas of unknowingly being infected with COVID-19, or infecting members of their household. Should an extended response to the COVID-19 crisis be required, a physically and mentally healthy workforce will be essential to maintaining our high standards of patient care.

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