‘We were almost overwhelmed’: Life in a hospital on the North’s Covid-19 front line

At its busiest, 10 or more people with coronavirus were being admitted to Altnagelvin Area Hospital in Derry every day.

"I think we were aware we could become overwhelmed, but we didn't hit that point. We weren't too far off it, I think," says respiratory consultant Dr Martin Kelly.

Some of their patients were “frighteningly” sick; “middle-aged people with otherwise good health who would land in very short of breath who’d never been short of breath in their lives before, and needing oxygen. It was intense.”

He recalls several patients who were extremely ill. “One of them in particular I thought, ‘Are you going to make it?’, but she did, and there have been others as well who did, and it’s a joy to see that.”

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According to the North's Department of Health, as of June 6th, 537 people with a positive test for coronavirus have died in mainly hospital settings in Northern Ireland since the Covid-19 outbreak began. Derry has been one of the least affected areas, with 21 deaths.

It is clear the virus is in retreat. Of the 1,120 people who were tested in the most recent 24-hour period, only 14 were positive.

At the end of last week, Altnagelvin marked its own milestone, with the last of its coronavirus patients discharged from intensive care.

Dr Kelly describes the feeling of relief and the “very real sense of achievement”, especially among intensive care staff. “We didn’t lose anybody in intensive care.”

Yet there is also “slight trepidation”; much has had to change in the hospital, and nobody knows if the virus may return. “There is a sense we’ve come out into a territory which is not the same as when we went in.”

Covid-19 centre

At Altnagelvin, many of their coronavirus patients arrived as referrals from the local Covid-19 centre, staffed by GPs on the hospital site.

The sickest were sent to intensive care, where there were 10 beds, though plans were put in place to double this if needed. “It would have been a challenge, but as it turned out we were never overwhelmed.”

They were “relatively lucky that not too many staff got sick”, Dr Kelly says, which he puts down to the availability of personal protective equipment (PPE).

“Some of that was provided by companies who started manufacturing it, and a lot of credit’s due there, but we were well protected.”

This meant his family was protected too; Dr Kelly’s wife is also a doctor at Altnagelvin and, with two teenage children, bringing the virus home was a concern.

“You have a duty, like you have with your patients, to try and maintain some semblance of calm and balance, so I think they saw that we were taking it seriously, but not allowing ourselves to be overwhelmed, and from a purely practical perspective doing things like making sure you had a shower before you came home.

“I suppose they’ve seen us go out to work over the years as doctors and realising that it’s not that we have to, but that we want to. This is our job,” he says.

Border checks

Originally from Omagh, Co Tyrone, home for Dr Kelly is Burnfoot, Co Donegal; crossing the Border every day to go to work, he has been stopped at checkpoints by both gardaí and the PSNI.

In his view, there has was “very good compliance locally” with lockdown measures, though as the weeks have gone on and the restrictions have begun to be relaxed he has seen more people out and about.

"I think there has been a lot of admiration within Northern Ireland of the actions of the southern government; that's not to say that they haven't done well up here either, but I think people have looked at Leo Varadkar and said he's done good. He has many critics, but I think he has demonstrated leadership."

In Altnagelvin, Dr Kelly and his colleagues are already preparing for life after lockdown. There is still a reluctance among people to come to hospital for fear of infection; lung cancer, which often presents late, is a particular concern, and he urges anyone with symptoms to seek medical advice.

The hospital is also exploring different ways of working, such as consultation by telephone or video conferencing. “We’re a long way from a waiting room full of patients.”

Waiting lists - already lengthy before the coronavirus crisis – are one of the challenges ahead. “People won’t be forgotten about,” says Dr Kelly. “It will be difficult – there’s no point in saying it’s grand and in two or three months it will be totally back to normal, no doubt we won’t, but we’re working on it.

“There are a lot of good people who work in the NHS, and we will do our best to claw that back.”