Hospital ready for January Covid case rise amid Christmas bubble concerns

Dr Eleanor Mishra, a consultant respiratory physician at the Norfolk and Norwich University Hospital (NNUH), is part of a team of doctors who assess patients daily around their treatment, monitoring and actioning further treatment before their condition worsens.

Working during both waves of the pandemic, Dr Mishra said the work around new treatments and the hospital's understanding had given staff confidence rather than anxiety about a second wave. She said her main concerns looking to the new year were the impact of Christmas bubbles and the drop in referrals of possible lung cancer patients.

Since March more than 500 people have recovered from the virus and been discharged from the NNUH. The hospital has confirmed 174 deaths where patients had a positive Covid-19 test.

As of Thursday, there were 60 people being treated on the hospital's Covid ward with a positive test, and a further 30 patients recovering after having the virus.

The Norfolk and Norwich University Hospital. Picture: Nick Butcher (Image: Archant © 2018)

Dr Mishra said: "When it started it was a very anxious time.

"I think it was very difficult to know I was going to have to lead a team looking after patients with a condition that I had never treated before. I was extremely anxious about childcare and who was going to look after my children but we got through the first wave and I almost felt quite euphoric to know that I survived it and then we had a break over summer and we were able to get back to some semblance of normality."

In the lead up to summer, the doctor worked on the RECOVERY trial, which looked at possible treatments for patients with Covid-19 and led to the steroid dexamethasone being used.

Dr Mishra, who has been involved in research for 15 years, said: "In those very early days there was no specific treatment to help reduce mortality we were really giving people oxygen and trying to give their bodies time to get through it themselves. There was a lot of different drugs being touted saying they might help, some anti virals, they were all being used without evidence."

Dr Eleanor Mishra with the team at the NNUH running the RECOVERY study. (Image: nnuh)

With Christmas approaching, she said the hospital is preparing for a possible increase in admissions in the middle of January.

Dr Mishra said: "I think our concern with the bubbles people make over Christmas is that it is going to lead to a big outbreak in the middle of January. So we're very prepared for an increase in patients at that time and I think that's why it's really important though people are mixing a bit more over Christmas that they still keep up with hand hygiene and wearing a mask and social distancing even if they are seeing more people at that time.

"One of the key differences we are seeing now is we're admitting much fewer patients from nursing homes. That is a testament to the fact these vulnerable people are being protected by the new measures that have been put in place and it really shows those measures of hand washing, and wearing a mask and social distancing do work. We should all be using those to protect ourselves.

"More people are surviving. More people are getting better and going home."

While summer saw less Covid patients, Dr Mishra said it was a busy time to catch up to run clinics and consultations but raised concerns the pandemic had resulted in fewer referrals for conditions such as lung cancer.

The respiratory expert works with patients with lung cancer and pleural disease, and said one of the symptoms of lung cancer can be a persistent cough, a recognised symptom for Covid.

She said if people have a cough or breathlessness they should contact their GP, as delays to treatment risked leading to worse outcomes.

"One of the things that makes it so difficult because patients may contact their GP surgery and told to get a Covid swab first, its putting additional delays in place," she said.