It’s half past midnight on my last night shift in 2020, a year of work I’m never going to forget. We are sitting outside the emergency room in our ambulance with a patient with covid symptoms, waiting for an isolation booth, and have been around for almost three hours. I keep apologizing: the patient smiles politely, tells us that it is not our fault, and makes a joke about how a mustache looks like her nasal oxygen tube.
A doctor talked to her outside and a nurse drew her blood, both from the back of the ambulance. There are other crews coming and entering the queue.
At one point, within 10 minutes, four ambulances with blue lights appear; their patients have priority because they need urgent treatment. But even these patients are first examined in ambulances because space is so scarce in the hospital. Our radio dispatcher tells us time and again of the backlog of calls waiting in our city. There are patients with time-critical conditions – strokes, heart attacks, serious breathing problems – and the delay in response can be devastating in such situations. There is nothing we can do before we can discharge our current patient, however. We’re stuck waiting here – angry, exhausted, unable to support. I’ve seen from the inside how the healthcare system is under unsustainable strain as the number of diseases has skyrocketed and covid-related deaths have risen – a pressure that can only get worse, at least in the short term. The rise of patients who now need to be hospitalized is what is worrying. It is difficult to imagine how the demand can be fulfilled in the coming weeks, with the number of cases still growing and the time gap between transmission and peak symptoms.
We are sent into coronary environments, like canaries in a mine. We put our PPE on and test patients to assess where on the covid spectrum they are.
Some of us leave home with self-care tips, while others are transported to the hospital to get extra oxygen.
We give the hospital a head up in the most serious cases and they search for a space where they can do high-level procedures such as CPAP (continuous positive airway pressure) or help for the ventilator. We take off our PPE and clean, clean, clean, clean when we are finished with each patient. We have recently been with many patients who have almost definitely developed the virus at home.
Incredibly, we also go to individuals outside their households who contract it, reported Covid-positive patients who need to be advised to wear a mask, and individuals with weeks of symptoms who have not yet been checked and apparently have not heard of self-isolation.
This is the most demoralizing part of the whole process after the year we’ve had, even after all we know about the virus. The question I’m asked most frequently is how the current crisis compares with last spring. The easy answer is: it’s worse. We seem to have lost the chance to get ahead of the transmission and interfere decisively, while we have a clearer understanding of how the virus spreads. Three weeks ago, when things unexpectedly seemed to spiral out of control, there was a major change in opinion – so why was the answer so delayed?
Sick leave is high, and even at elevated rates, there is little desire to work extra shifts.
I recall feeling energized by a strong sense of intent during the first wave – the inherent momentum that comes when you’re needed. I just feel drained this time, after a year that has been physically and mentally exhausting. Among my colleagues, there is now a real fear of what is coming next, and the psychological consequences are starting to show. The lack of cohesion, in some quarters, if not all, is most disappointing to me.
I’m not calling for applause. Don’t worry.
I would settle for a return to the feeling of apprehension that defined the first lockdown process, and the helpful constraint it had on the actions of people.
On those odd days, I never intended to look back nostalgically, but how relieved I will be to return to the empty streets now. Absolutely the