22 July 2020

Johnathan Waugh: Life in Lockdown

Johnathan Waugh MCOptom reflects on his time working in a COVID-19 Assessment Centre at the beginning of the pandemic in part one of his diaries.

The start of lockdown

“Like many of us in eye care and optics I had high expectations for 2020. As well as a new baby due in June, I was planning to purchase my own independent practice. Then, by the middle of March, just as the purchase was about to proceed, talk of a lockdown started. Although I still had my work doing diabetic retinal screening in the hospital eye service, for three days a week I faced having no income, and would have to find some employment to plug that hole until my plans could resume.

“The screening team held a meeting to discuss the future. All screening services were to be suspended until further notice, and we could expect to be redeployed within a week or two to where we were needed most. No-one knew what, or how, that might look.

 “On 30 March, one day before I should have been opening the doors to my new practice, I was sent to the main COVID-19 Assessment Centre (CAC) for Glasgow. It had only been open a week, and was based in a decommissioned health centre. Its remit was to triage suspected cases and reduce the number of patients presenting to A&E. The staff were from across the NHS and included podiatrists, nurses, healthcare support workers, physiotherapists, GPs and admin staff.

A new role

“It was an unusual feeling going into a new role almost entirely unprepared. The biggest fear was becoming infected. The tension was palpable. Thankfully, I was asked to man the desk for the first few days. As my wife was pregnant, centre management were careful to keep me out of direct contact with patients until I felt comfortable with the level of risk. That first week felt like everyone was thinking on their feet, developing a new service while trying to keep abreast of updates coming from all over. Patients were presenting in increasing numbers and the clinical advice for managing them changed daily at least. There was just about enough PPE to go round, but supplies were limited. It was amazing how people came together, though, and the team spirit carried us through.

“I was asked to move into a more frontline role, helping patients put on masks and taking basic observations at the door. We were given a pulse-ox machine and an ear thermometer, and any patients with high fever or low blood oxygen levels were sent more quickly through to the clinical area to be seen urgently. We noticed that those with the worst initial appearance were not always the ones who needed the most urgent attention. Presentations varied wildly, and we had patients of all ages from months to over 90 attending. There was so much wiping down, disinfection, donning and doffing of PPE, and infection control that our heads were spinning at times. 

“By April, I was in a routine of changing out of my uniform at work, bagging it, then putting it into the washing machine and heading straight into the shower before even saying hello to my family. On 9 April I felt a bit hot and checked my temperature; 37.8 degrees, not that bad. I took some Paracetamol and things improved. The next day was the same. I took both days off just in case. My wife and I assumed that this was a different virus, as things weren’t severe.

A positive test

“The next day, over a period of a few hours, my taste and smell disappeared. Losing two senses suddenly and for a prolonged period was unsettling. There had been talk that this may well be a symptom of COVID-19. I realised that despite my best efforts, my family may have all been exposed. Had it still got through somehow? Testing was just starting for NHS staff, so I requested one straight away.

“The test centre was a drive-through facility in an outdoor marquee at a north Glasgow hospital. Although my fever had passed, I still had no taste or smell and I felt lethargic. The test was over quickly and 36 hours later I received a text – positive. The only advice was to isolate and monitor symptoms. Thankfully I recovered, and none of my family developed symptoms. We won’t know for sure if they had the virus until we have antibody testing. I took another 10 days off work, just to be safe. 

“When I returned to the COVID-19 Assessment Centre, everyone thought I had been on leave enjoying my garden! Many took a step back when I told them I had tested positive; I was the first from the Centre to do so, but I think it was reassuring for most of them that I had recovered and had no lasting symptoms. 

Back to work

“Over that fortnight, so much had changed. The clinical processes had been tightened up and the management structure was more clearly defined. Rotas were electronic and staff numbers had significantly increased in anticipation of demand. Local companies had donated laundry bags and lunches, and everyone felt quite buoyant with the support from the community. Patient numbers were reducing, which was unexpected but welcome, although the proportion of more serious symptoms was increasing. There was talk of reaching the peak soon, so no one was relaxing just yet.”

Johnathan Waugh MCOptom is an optometrist working Glasgow.

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