“Where are our usual patients”?

By Sobia Akhtar, junior doctor emergency medicine

15th May 2020

Since the COVID-19 pandemic hit the UK earlier this year, the emergency department has become very different to the one I have been so used to working in over the last 4 years.  The A&E I know and love is constantly busy-with patients, relatives, and a multitude of staff all in a rainbow of uniforms.

Don’t get me wrong- it is a high-pressure, stressful environment, and doing your job can be so difficult for many reasons but I wouldn’t do anything else. There’s nothing quite like it. Waking up in the morning (or night depending on the shift!), being excited about what possible cases I’m going to encounter on shift. Wondering which nurses and doctors are going to be on shift with me and whether we’re going to get takeout on the night shift.

It really is true when they say your work colleagues are like your second family.

Whilst the number of COVID-19 cases is rising, with some areas of the UK more affected than others, our emergency departments have been quieter than usual as of recent times. Now quiet is one word I never in a million years would have associated with an A&E, especially not in the middle of a pandemic. A common phrase being echoed throughout emergency departments is ‘calm before the storm’. There is a sense of eeriness, uneasiness lingering in the air. Whilst it is refreshing to be able to have time to think in between patients and reflect on the cases we are seeing; it is also worrying.

Where are our usual patients-those with falls, infections, and symptoms of strokes and heart attacks? Where are all the unwell children? Although COVID-19 is prevalent, people haven’t suddenly stopped suffering from other illnesses but we are not seeing as much of them and that is the worrying thing.

The question is why are we not seeing them? There are a variety of reasons, which I have personally heard and some, which baffle me to be quite honest. A few are:

-People are afraid of catching COVID-19 if they come into the hospital

-People are afraid if they are admitted to hospital they won’t get looked after properly and will be left alone to die

-People think that hospitals are now only open for COVID-19 patients

Whilst I was seeing one patient he said to me ‘what are we going to do when A&E closes?’ I asked him what he meant to which he responded ‘everything else is closing because of COVID-19 so obviously you guys are going to close too, aren’t you? You need to protect yourselves’. My reply:

‘No. We are here 24/7 and we are here to protect all of you.’

That is one thing to stress. Hospitals are open, emergency departments are open as usual 24/7 providing excellent care as always.

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