I'm treating more and more young, unvaccinated people in ICU – get your jab

On the weekend of Halloween, I experienced a different kind of scary during my 40 hours across three nights in intensive care.

As an anaesthetist turned intensive care doctor for this shift, I looked around and realised that almost all of my patients were suffering from Covid-19 – and nearly every one of them was unvaccinated.

Donned in PPE, a tight-fitting respirator mask, visor, and gown, I caught sight of myself in a mirror and briefly thought how 2020 my Halloween fancy dress was.

Things have of course changed since the pandemic began. The major difference between then and now is that we have a vaccine – the major tool in bringing society back to functioning as it is now. But there’s still a large proportion of people who aren’t vaccinated, and I’m seeing the results of this every day.

I meet a lot of healthy people who think they’re bulletproof and can’t get taken down by this virus. Many are young – in their 20s, 30s and 40s – yet they’re struggling to breathe, even with lots of oxygen.

Seeing an unvaccinated patient is incredibly frustrating and sad. Frustrating because the vaccine probably would have prevented this, sad because I know what’s likely to be next for them. As an intensive care doctor, I’m called to see people struggling on the wards, who too often share the same story.

They’ve come to hospital after having been ill with Covid-19 for a week or so. They arrive with a dry cough and fever, but now they’re struggling to breathe so they need tons of oxygen. We order a chest X-Ray and like so many others before them, it doesn’t look good. Soon the medical ward isn’t enough to keep them alive – they need to come to the ICU.

‘Just take some slow, deep breaths’, I always say, trying to keep the patient calm. The monitors beep furiously to tell me their heart is racing, the oxygen levels are low, the mask covering their anxious face can’t give them oxygen fast enough. We get everything ready – spare O2 cylinders, portable monitoring, and a transfer bag with intubation drugs – should the worst happen and they stop breathing en route.

We wheel them fast through the corridors, hoping their oxygen levels keep up for the 10-minute journey to ICU. This is incredibly nerve-wracking for both me and them, until we reach ICU and are greeted by the warmth of the nursing staff.

‘You’re OK now, you’re in a safe place,’ they say. Are they talking to me or the patient? Either way, I’m reassured amidst this chaos, which has somehow become my average hospital work day.

We put the patient on an advanced oxygen mask, I insert a line into their radial artery to measure blood pressure directly. Drug pumps and infusions decorate the bed. We made it, but only just.

Over the coming days, they’ll need more and more oxygen. Then slowly they’ll become so tired that they can’t breathe for themselves. The last resort is to put them on a ventilator. Here they stay for days, weeks, or even months. And too many never wake up.

A cycle of emotions that are by now all too familiar course through me. Sadness. Frustration. Anxiety. If this is what it’s like now, what will the winter be like?

I never ask these patients why they’re not vaccinated because that horse has already bolted. Vaccines work to prevent illnesses – not cure them.

I’m guessing that most of my patients would do anything to turn back time and have the vaccine. But they can’t, and so they’re here, needing a host of other drugs to try to keep them alive. Between the doctors and nurses there’s always whispers of ‘why’? and a widespread feeling that all of this was and is preventable.

Ask anyone on the frontlines of this pandemic and they’ll tell you how exhausting and anxiety-inducing their job has become. Comedy has always been my escape and stand up is where I go to switch off. When my creative outlet of live comedy disappeared in last year’s lockdowns, I used writing as an outlet away from hospital land.

Catch Your Breath: The Secret Life of a Sleepless Anaesthetist was the book that emerged, documenting my experience of becoming an anaesthetist. As you might imagine, there’s a lot of humour but also darkness, as it charts my experience learning the ropes as a junior doctor through to becoming an anaesthetist, to finding myself working in ICU in the height of the pandemic.

The increasing amount of Covid-19 cases in hospitals and ICU wards across the country is as much of a worry as it was last year. And it’s one of the biggest reasons we need as many people to take up the vaccine as possible.

The bottom line is – I’m an anaesthetist. If I get dragged into ICU full-time again, who will anaesthetise patients for their operations? Of course it’ll lead to more treatment cancellations and more exhausted staff.

Outside of the hospital, the relaxed attitude towards Covid-19 could trick you into believing that the pandemic is over. Prime Minister Boris Johnson sets a prime example when he sits down – sans mask – beside 95-year-old David Attenborough, while we currently see around 40,000 cases ravish the country every day. In reality, the NHS is teetering on its edge as we head into winter.

So, what do we need? Well, we could start with more NHS staff with better pay, better working conditions and retention. Hospitals that aren’t falling apart and have sufficient capacity to deal with fluctuations in these pandemic times. Leaders that don’t dither and send mixed messages. And we need more people to get jabbed. Please.

Recent government statistics show current hospitalisation rates are more than twice as high in unvaccinated people across all age groups, compared to those who are double vaxxed, and the risk of dying from Covid-19 is much higher too.

It’s soon going to be two years since Covid-19 first hit the UK. One calendar year from now, where will we be? No one can know for sure.

All I can hope is that by the time next year’s Halloween rolls around, the scariest thing on my night shift will be someone dressed as a skeleton, or the sweets brought in for a mid-shift sugar boost. Treats, not tricks. 

Do I think this will all be over by then? No. Although I hope I’m wrong.

Dr Ed Patrick’s debut memoir, Catch your Breath: The Secret Life of a Sleepless Anaethetist – which follows his journey from bewildered medical student in Aberdeen to unflinching anaesthetist on the NHS frontline – is available here.

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