THE clinical director of Lymington New Forest Hospital has called on the government to provide “more clarity” on easing the lockdown – warning that mixed messages risk causing a second coronavirus peak.
In an exclusive interview with the A&T, Dr Rachel Anderson declared the first peak had passed locally and stressed that anyone feeling ill should feel safe to attend the Ampress hospital as normal.
But we are not rid of Covid-19 yet, she warned, adding it could be up to 18 months before people can enjoy a “return to some semblance of normality” and there were preparations for a second and even third peak.
Dr Anderson said: “It’s until we get a vaccine that works, and that is likely to be 18 months. There are bits of emerging evidence from Wuhan, South Korea and Germany. As they release the lockdown the rate of infection creeps up again, and it feels as though that is what is likely to happen to us.
“My biggest fear is that if we get a second peak we do not, as a population and as a government, learn lessons from what happened during the first peak.
“If we have a system getting a bit hot, we need to go into lockdown within 24 hours, and we may need to switch it off and then on very fast.”
However, she felt the government’s ‘stay alert’ message was “not as clear” as the ‘stay home’ one, adding spreading confusion would not help the situation improve.
“There is no particular reason why if we all went back to doing what we did in February and back to life that it would not go back to the same [lockdown]. We haven’t got a new treatment or care, so it would just happen again,” she said.
“How we behave now – that will determine what happens next. I think the new advice is more complex and not so easy to follow – it does not feel as clear as I would like.”
Dr Anderson added: “Moving forward, health and wealth are interlinked and if we all go through this but there is mass unemployment then, in the long run, the health consequences will be as bad as the effects of the pandemic. However, the new advice feels a bit mixed.
“People need clarity. They need to know what they can and cannot do and how best they can protect their relatives and friends.”
The crucial method of keeping the rate of infection down was testing, tracing and tracking, she emphasised. The focus needed to be on getting that up and running to help studies being carried out, such as an ongoing one on the Isle of Wight.
Dr Anderson said: “At Lymington we are seeing less Covid-19-positive patients within the hospital system than we were four weeks ago – by quite some margin. Nursing homes also seem to be improving. There was a later peak at those, but that number seems to be settling.
“It’s really hard to say when we had the peak, but it definitely has passed. We are probably getting on for three weeks past the New Forest peak in terms of having Covid-positive patients.
“That was a testament to public behaviour in lockdown. But now it’s where we go from here. We have not seen the back of it. We need to maintain a degree of patience.”
There has been a drop-off in patients suffering from ailments other than Covid-19 seeking medical help, she said. “We are seeing patients who have stayed at home who would have been much better had they come in a few days to a week beforehand.
“The message is: if you need to come to Lymington hospital you can safely come because we are reducing footfall, using social distancing, we have PPE, we are washing our hands and keeping the wards thoroughly clean and moving things through.
“We have not got lots of patients with Covid-19 in the hospital, which is what people think. We are open and can keep you safe – but also, it will not be the same as it was.
To combat the pandemic the hospital, which is run by Southern Health NHS Foundation Trust, joined forces with University Hospital Southampton (UHS), local GPs, care services and nursing homes, and its sharing of services had worked “outrageously” well, she said.
The joined-up approach had enabled staff to switch roles between hospitals to allow them to respond to in-house or community demand relating to Covid-19, she explained.
Those acutely unwell were transferred to UHS, where there is more room, while patients who had declined or had no need of ventilators were treated at the Ampress site.
“No matter how frail they were when they came to us, almost all of the patients we’ve treated have been able to go home or back to a care environment,” Dr Anderson said.
“I don’t want to underplay it but within the region we have obviously been less affected than London, Birmingham and the big cities. We prepared for the worst and so far have not reached capacity.
“In terms of PPE we have never run out or come close to running out, but there is always an anxiety over the right amounts to use.”
She praised medics, saying they had quickly adapted to a “new normal” of using PPE during patient interactions, including visits to people in their homes, and new ways of working, including consultations over the phone.
The changes could have long-term implications, Dr Anderson added, and up to 30% of follow-up appointments could be done over the phone rather than face-to-face. However, other areas, such as the endoscopy department and services provided to diabetes patients, could be detrimentally affected.
Moving forward, the hospitals will have to consider how best to deliver those services should a second or third peak occur, so patients do not lose out, she said.
“Now for the first time we have got a chance to realise what this means for healthcare for the next year to two years; the system is now at ‘restore and renew’ and has worked, and we now can look really hard at how we deliver safe healthcare while social distancing,” said Dr Anderson.
She added that the staff wanted to pay tribute to those who have supported them, including their own friends and family.
Dr Anderson said: “We have to give a huge amount of thanks to our support staff. The help they give is massive and so very important to us.”