If there is anything that we can retain from this pandemic, it’s our hidden heroes without capes: the NHS, caretakers, teachers, transport drivers, cleaners, bin collectors and an extended multiplicity of essential jobs that make the world orbit. With the imposition of England’s second lockdown, I ask one of these heroes, Manuel Pamiloza, Nurse Manager in St George’s, one of London’s leading teaching hospitals, his opinion on the impact of the lockdowns on his ward and its efficacy. He will share his opinions before and towards the end of lockdown, observing lockdown’s success. Certainly, this interview is not a holistic opinion that the entire institution of the NHS holds.
8th November 2020
Have you noticed any discrepancies between the first and second lockdown in terms of patient intake? How has this affected your ward?
“Oh yes, a big difference. I think in the beginning it was a shock to everyone because there was no preparation. Everything was decided last minute. We started Friday night, nobody knew it was coming. We started with 20 patients and the next morning, the whole ward was overwhelmed with Covid patients. [Regarding] the second lockdown, we [now are] definitely more prepared. We have a winter plan in place and are prepared to tackle the influx of patients.”
In your opinion, was the government too slow in implementing the lockdown considering the current state of your hospital? If yes, could you articulate the necessity of lockdown?
“I think in the first lockdown perhaps the implementation was too slow because of the surge of the patients from nursing homes, other wards, various communities and other hospitals. They could have acted more quickly. This time, I think the government acted accordingly, albeit not sharply, especially with the augmenting cases. We’ve seen from the previous lockdown that lockdowns are effective in flattening the curve, which makes a difference in our work.”
When asked explicitly if the lockdown was needed, he declared:
“Yes, definitely.”
Has the difficulty of managing the virus over the past 8 months impinged upon the morale of yourself & your colleagues? Is this in any way linked to the support (or lack thereof) you have received from the government?
“It was really heartbreaking to see all the deaths that we were dealing with on a daily basis. The staff [found it] incredibly difficult, which was emphasised through the fluctuating amounts of colleagues I was working with given the dampened morale. Times were certainly gruelling. Gradually, things did improve. Initially, we were unprepared with [tackling] the pandemic but we pulled through. Our team spirit amplified naturally as the weeks came by. We realised that we were here, there was no turning back and that we had to do it as a team. If the staff didn’t look after each other, we would have certainly had a different outcome.”
When asked how the increased morale was catalysed:
“[I think] mainly the support within the team [ameliorated spirits]. We were constantly smiling and joking during our breaks to augment our morale. Additionally, the public helped to lift our spirits in terms of the clapping [for the NHS] and fundraising. Government support definitely made me feel disconcerted, especially during the first lockdown in terms of the changing guidelines, alongside the lack of PPE we were given. I am not sure that we had the best of support albeit [the lockdown] being effective in decreasing patient influx. ”
Do you agree with common media discourse stating the detriments of lockdown on the well-being of young people, a cohort at a smaller risk of contracting the virus? If so, according to yourself, should lockdown only apply to regions and people of a higher risk?
“That’s a tricky one. It’s hard to sectionalise or regionalise the restrictions. I do worry about our youth, especially those isolated in university. It is apparent that we shouldn't blame our young people, particularly since this has had a large impact on their mental health and creates a feeling of being metaphorically isolated from the rest of society. What remains is that we should all take personal responsibility for our actions. With schools still open, the youth should keep up social distancing and mask wearing.”
He went on to say:
“I do believe that ideally, local lockdowns are better, as these are specifically tailored to the circumstances of a certain area, rather than considering the whole nation’s state as monolithic. But we are in this now, so let’s follow the rules and help my field of work.”
When asked about the demographics of Covid patients in his ward:
“In the first lockdown, we did have more old people coming from nursing homes and rehabilitation facilities. The patients had a commonality of underlying health problems. Now, the rate in my hospital is very low, and my ward specifically does not have Covid patients at the moment, old or young. But this does not negate that the virus is still present in our hospital, as well as on a national level.”
Could you comment on the work of yourself & the ward in the midst of this pandemic? What would be your message to the public regarding lockdown given the NHS’ action to tackle this virus?
“Vitally, the work that we do as front liners is really significant. You can’t underestimate the hard work ethic, hospitality and passion we put into everyday when we put our scrubs on, especially the work of nurses and doctors of colour who are often even more overlooked. Instead of capes, we have masks which aid us in tackling the virus. To the public - please social distance, wear your masks, and take all the necessary precautions. This is a difficult time for everyone, but we will reach the end of the tunnel with your joint effort with us, the NHS.”
Finally, I understand you had an interview with This Morning at the height of the pandemic. How do these moments give purpose and reward to your work?
“[He laughs] Oh, that was fun! Certainly, appreciation from the public, especially from a powerful show such as This Morning revives my purpose for nursing as it reasserts to me time and time again that I am saving lives. Certainly, I don’t need such validation, but it definitely puts a smile on my face. Our work is done out of humility, grace, passion and resilience, qualities which I constantly see in my ward. From this pandemic, I hope the public truly appreciates our work and helps us in saving lives.”
At that I hope we will.
28th November 2020
What are your general impressions subsequent to the end of lockdown, specifically in terms of your patient capacity at the start & end of lockdown? To what extent can you see lockdown as a success?
“The hospital was very prepared because of the learnings from the previous lockdown. Now, we have a clearer algorithm for the winter plan. It was a success - our capacity was not overwhelmed. The lockdown has helped reduced the spread. However, as a country we must maintain the safety precautions.”
How effective do you feel the tier restrictions will be?
“It will only be effective if people follow it because of course, the government can impose these restrictions, but it is up to us to adhere to the rules for the sake of public health.”
Are you content with the efficacy of the vaccines? Are you aware of when these will be made available to the public, hopefully imminently?
“The efficacy of the vaccines, for instance the Oxford-AstraZeneca vaccine (70% or 90%), have been satisfactory. It’s definitely promising, especially seeing the plans for a mass immunisation campaign. Hopefully, we will get them soon after the approval of regulators in the subsequent weeks.”
Do you think the alleviation of restrictions during Christmas is justifiable? Can we truly have a guilt-free Christmas & forget about the presence of Covid when the past month has attempted to tackle this?
“Yeah, that’s a challenging question. Of course, we have to bear in mind the mental health implications upon families, especially those alone isolating. As a result, I think that it is essential that we keep sensible. Yes, the government has permitted a five-day period of seeing our families again, but we must take personal responsibility to use this opportunity vigilantly and carefully to ensure that we haven’t made the past month futile.”
Are the increasing restrictions tenable when the end of Covid is uncertain? Do we have to adopt a mentality where we simply ‘live with the virus’?
“[He laughs.] Yeah, that’s a tough one as well! For me, I think Covid will not disappear in the near future. I feel like the mentality of ‘living with the virus’ is an amiss perception, especially after such a year of distress, and we can’t use this idea as an excuse to [infringe upon] restrictions just because of the uncertainty of Covid. [To tackle this,] I feel it is important for now to adhere to the restrictions where we live and carry out all the vital precautions in order to, one day, pave the way for a Covid-free life, especially with the hope of the vaccines. We can’t hope without doing.”
Finally, how consequential is vigilance & resilience in these times, especially with constant restrictions that can impact mental well-being?
“I think humanity across history has endured trials. This is one of those in modern times. There is always hope in darkness. [He laughs due to cheesiness, albeit pertinent in these times.] I am very certain that we will triumph as a human race. Keep hope, patience and self-responsibility.”
Again, at that I hope we will.
