T.the raw numbers around Covid-19 are just unbelievable when you consider that this was a disease that almost no one heard of in December 2019. At the time of writing, this year around 240,000 people in the UK admitted to hospital with Covid-19, and more than 70,000 people have listed Covid-19 as cause of death on their death certificate.
I began to worry 2020 about the reports that emerged from Wuhan: they seemed to mean asymptomatic transmission of respiratory pathology that was severe enough to put victims in intensive care units. I am a clinical academic with specialized training in respiratory and intensive care medicine; I also lead a research program aimed at the inflammation of the lungs causing respiratory diseases – for me, and for others, what was being reported was a serious problem.
In response to the emergence of Sars-CoV-2, a World Health Organization clinical character study was implemented on January 17, 2020, in time for the first wave of Covid-19 patients admitted to hospitals in England and Wales. This observational study of patients was first established in 2013 to ensure that the necessary infrastructure was available to learn about the rapid spread of new respiratory diseases when needed. The first Covid-19 patient was reported in the UK on 31 January 2020.
In early February, it was clear that there was a major problem, and the ICU where I work began preparing for what was to come. We held our first multidisciplinary meeting to discuss how we would address emerging risk, with colleagues from public health, virology, microbiology and others all involved. join us on 12 February. To date 10 cases of Sars-CoV-2 have been reported in the UK.
Things progressed quickly, and March was a wild month for the UK’s response to the emerging pandemic. There were concerns that the situation could be so dire that the UK could run out of vital equipment such as mechanical airplanes, and as a result the government launched the Ventilator Challenge, to seek, agree and procure the equipment. made from a wide range of sources. Much has been written about this process, but I am sure that it was necessary – I would not have agreed to help if I had not.
Also in March the Recovery test was launched. It is a testament to the responsiveness of the UK pandemic research system that the trial was planned before 17 March, obtained ethical and regulatory approval, and was ready to recruit patients. . Since then, more than 20,000 people have taken part to help us understand what treatments work for hospital patients with Covid-19 – a remarkable achievement.
By April we were at the height of wave one of the pandemic, and ICUs in many areas were under severe pressure. As of April 12, 3,301 people with Covid-19 were in need of mechanical ventilation in the UK. Fortunately, by August this number had dropped to less than 70. However, by the end of October, he had again climbed above 1,000, where he has stayed, and at this time it doesn’t look like it’s going down. It is clear that Covid-19 is far from made with us yet.
In the autumn, data showed that what many thought was almost impossible to achieve was achieved – a number of effective vaccines against Sars-CoV-2 have been developed in less than 12 months . In December 2020, the UK’s major vaccination program began with 50 NHS hospitals.
Such a difficult and difficult time makes you rethink the events and your role in them. Something I particularly learned this year: by 2020, I had never written a newspaper article, appeared on TV, or even talked to a journalist about my work. I am ashamed to admit, I had not understood the importance of science communication with a wider audience. The sound output and misinformation during the pandemic changed my mind, and persuaded me to start trying to explain these issues more clearly. Getting caught is not always easy, but we need to clearly state why specialist (and not bed) health care workers are important, and why we need both medications and vaccines for Covid-19 be available to everyone, among many other things.
This year has also reinforced my view that long-term commitment and planning are needed to build the sustainability of global, national and local healthcare. For the NHS, this means we need to make sure we have the right specialist staff, equipment and other infrastructure to deal with our potential storms – with the coronavirus and beyond away. No one can honestly say that the UK has sailed through 2020 without making tough choices and compromises that we would not have preferred – the effects of the pandemic have been widespread on healthcare provision for people with non-Covid conditions has been, and continues to be. , important. At times this year, clinicians, patients, families, policymakers and politicians have all been opposed to choosing the smallest option in difficult situations. No one has been immune from this.
Most of the “winners” this year came from preparation and collaboration. One example of this is the remarkable contribution made by the National Institute for Health Research (NIHR) to the UK’s dispersed response. It has allowed us to quickly learn about Covid-19 by supporting recruitment to observational studies such as Isaric-4C (WHO Covid-19 study described above), React (Covid- 19 home test study 19), and GenoMICC (global) campaign to understand heterogeneity), and has enabled thousands of people to participate in clinical trials of therapies and vaccines. This work has helped transform clinical practice worldwide by delivering significant research.
As we head into 2021, I am once again worried about what the new year might have. However, I am convinced that readiness, flexibility and a commitment to co – operation are all that is required to overcome the storms that may lie ahead in the months and years ahead.
• Dr Charlotte Summers is a lecturer in intensive care medicine at Cambridge University