6 months on from the first patient
Six months ago, on the 29 January 2020, Britain was on the cusp of a global pandemic as the first COVID-19 patient tested positive in York.
Fears grew about the impact of the arrival of the virus here.
The biggest test on the NHS for 72 years began.
NHS staff in every field prepared to respond.
A state of emergency was declared by the Government
Plans to contain the virus and protect the NHS at every stage were everyone’s priority.
The simple logistics surrounding safely moving, treating and protecting patients, NHS staff and the general public became intricately complex.
Specialist HART (hazardous area response teams) made up of ambulance paramedics around the UK geared up to respond and transport patients to infectious disease units.
This is the journey of four NEAS members of staff who are part of HART, who collected and transported the first COVID-19 patients to the infectious disease unit at the Royal Victoria Infirmary (RVI) in Newcastle.
NEAS received a request from NHS England for a HART response to collect and take the first UK patients from a hospital in Hull to the RVI. Two adults were infected and they did not speak English. Their son who was with them spoke English and so he was able to translate between patients and crew.
Established for 10 years in the North East, the team deployed four specialists to take the journey.
Already nine hours in to a 12-hour shift, at 3:54am, the job was assigned to HART team leader Mick Hulme, who quickly advised control to reallocate his colleagues Ken Heads, Jeff Hutchinson and Andy Staley.
Mick explains, “Can you imagine how many people were taking an interest in the country's first positive COVID-19 patient?
"I was very aware that this was the first transfer and that it would be scrutinised, but it was also a challenge we have been trained for.
“I’m coming up to serving 30 years in the ambulance service and consider it a privilege to do the role I’m currently in.
“I was understandably apprehensive as to the risks because we knew so very little about this disease - you do ask the question ‘what if?’ when you’re doing this job and I was responsible for the team and my main concern was getting through traffic at rush hour without a hitch.
“I mustered the crew and briefed them on what was required - we would travel to and from Hull under blue light conditions. We left within five minutes of receiving the call.”
Mick adds, “I had every confidence in my team on the night, our unit was ready for this type of event and all new how to use the required PPE.
“My plan was for Andy to be attendant with the patient in the back of the ambulance. In the event of the patient deteriorating, Jeff, who was driving would assist with Andy in patient care. Ken and I could step into the position of driver with both vehicles if required.
“Communications mechanisms between us were in place. I planned to get fuel near to the pick-up point so we could return to Newcastle without having to stop.
“I was in touch with the consultant at the hospital in Hull and kept him up to date of our progress.”
Arrived at scene: 6:10
Mick continues, “On arrival at the hospital I liaised with Yorkshire Ambulance Service clinical care manager and the hospital consultant where we developed a plan of how we would extract the patients to the ambulance with minimum impact on the hospital and its staff, as day shift workers were arriving on site.
“Our head of resilience, Simon Swallow contacted me at the hospital in Hull and arranged for our decontamination team; Ben Dixon, Joanne Hulme and Lee Tait to meet us at the RVI in Newcastle on our arrival.
“We prepared the patients. The two parents spoke no English, so we communicated via their son who acted as an interpreter.
“A Yorkshire Ambulance Service crew who were transferring one of the patients were assigned to the convoy. Together we planned for every eventuality in the event on an emergency, such as if we were involved in an RTC or breakdown.”
Andrew explains, “Before the transfer we had to put on our PPE. At the time, little was known about the virus, what it was and how contagious it was and because of that, top level PPE was used.
“We then escorted the patients to the ambulance. This was complex because it involved walking into different segregated areas within the hospital in Hull, protected by one-way systems with air locks to prevent cross contamination. It was important not to take the patients into the wrong area, to avoid further infections."
The NEAS HART team transferred the patients to the waiting vehicles and departed the hospital in Hull lead by the Yorkshire Ambulance Service crew, who transported the third relative that was not infected at the time but posed a high risk, taking them the quickest route to the motorway and then lead the convoy to the North East.
Left scene: 07:03
Onboard, Andrew explains, “On the ambulance no observations were required because the patients were stable. My main challenge was communicating with patients who spoke no English.
"As you can imagine, they were anxious knowing they had a serious illness. I tried hard to communicate with them as clearly as possible, with the utmost compassion and empathy but this was really difficult in PPE.”
Mick continued, “The journey was uneventful apart from a short stop to readjust the patient’s position. As easy as this sounds, doing this on a motorway required a little more planning to carry the readjustment out safely.
“We carried out welfare checks every 15 minutes on route to make sure staff and the patients were ok.
“The team never questioned a thing but carried out their roles on the day to perfection, particularly considering that in total they completed a 17-hour shift.
“As we approached the region, I updated the RVI on the condition of the patient and of our estimated time of arrival.
“We progressed through the heavy traffic across our world-famous Tyne Bridge and into the RVI.”
Arrived at Royal Victoria Infirmary: 09:26
On arrival, RVI staff were ready for the patient as well as a decontamination team from another NEAS HART crew.
The patient was handed over to the hospital staff and the decontamination of the crew and vehicles was carried out at the RVI before the crew returned to Monkton station.
Andrew adds, “Once handed over, we had to begin the process of taking off our PPE, which was done outside of the building in a cordoned off area following a step by step guide, read out aloud by another member of the team.
"I remember thinking that the process was quite slow and the amount of PPE that is used per patient contact is substantial - but all necessary to minimise the risk of further infections.”
The crew returned to station for a shower and a cup of tea ahead of another night shift later that night.
They finished their shift around noon that day.
Andrew concludes, “Looking back at the whole incident, it was a snap shot of what pre-hospital care was about to become.
"The challenges and difficulties around putting your PPE on and taking it off including how this effects patient care, how labour intensive the process is and the amount of down time required to clean vehicles; has now become the norm.
“It's changed the way we work forever. Obviously, staff have an increased fear of contracting infection at work, but they continue to deliver high quality patient care despite this.
"I really want to emphasise what a pivotal role my colleagues out on the road have played through the pandemic and all of the challenges and risks we face as frontline staff. I think our NEAS response to the whole COVID-19 pandemic has been amazing.”
More on HART
HART trains to work as a team - each operative knows exactly what their role is on any given incident. They are trained to provide life-saving medical care in hostile environments such as industrial accidents, natural disasters and global pandemics,
Following the first COVID-19 transfer, the NEAS HART team carried out numerous more transfers. They also delivered hundreds of swabs in a drive through clinic for staff and their families and trialled testing 500 NEAS staff over a three-day period.