Coronavirus: Doctors and nurses will need PTSD treatment after Covid-19 virus peaks in hospitals, warn health leaders

Expert in intensive care medicine says staff are already facing unprecedented toll on mental and physical health

Doctors and nurses will need treatment for post-traumatic stress disorder after working in harrowing conditions on wards during the coronavirus crisis, health leaders warn.

The strain on their mental and physical health is already unprecedented and the virus has not yet reached its expected peak, they say.

NHS staffing is at levels that were previously unthinkable as workers – forced to spend hours in hot conditions while wearing full protective gear – try to keep up with demand amid a lack of equipment.

The increasing numbers of infections mean staff could be forced to work this way for many more weeks. Almost 2,250 patients have been admitted to more than 200 intensive care units across the country up to 3 April, with the NHS preparing for an expected peak in cases in the next seven to 10 days.

It comes as the head of intensive care at London’s Royal Free Hospital described in a memo how most units had already shifted from the usual one nurse to one patient ratio to one to six and were running out of key machines and equipment.

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, told The Independent: “I am really concerned about the toll this is taking and will continue to take on staff.

“We are used to dealing with emergencies, but we have never been exposed to this sort of demand. We know staff are already struggling physically and mentally and that this will only continue.

“The government’s approach to flatten the peak will help to spread it out but what that means for staff is that we are in this for the long haul. We will get through this because that is what we do. But there will be some patients and staff who will suffer forms of PTSD and some staff with mild symptoms may not be aware and continue working and make themselves worse. We need to consider staff wellbeing in the future.”

Dr Pittard, a consultant at Leeds Teaching Hospitals NHS Trust, said critical care units had been forced to change in order to cope with coronavirus.

She said: “It is an unprecedented situation. In critical care, we are being forced to change how we work. Six months ago we wouldn’t have been able to cope, there is no doubt about that. We are pushing the boundaries of what critical care is in order to cope with demand.”

She said this included weakening staffing ratios, which she said was “very uncomfortable” for staff, adding: “There is no doubt there will be situations where safety will be compromised. We have to do the best that we can.”

In a memo shared online, Dr Dan Martin, head of intensive care at the Royal Free Hospital, said: “Most centres now getting towards 1:6 nursing ratio with high level of support workers on ICU.” He added: “Training has largely fallen by the wayside as it is too large a task. People are being trained on the job.

“We need one support worker per patient. Other centres are using everyone they have. From med students to dental hygienists.”

Dr Martin revealed King’s College Hospital in south London was “running out of” blood filtration machines and another unit had “run out of pumps” for administering drugs.

He added: “We need to adapt fast to what we learn about this disease and learn from our colleagues at other centres. We are all in this together and joined up thinking is required.

“We desperately need to look at our own data to understand whether we are getting this right or not. Good luck, stay safe and be kind to one another.”

The latest data on intensive care patients with coronavirus reveals 2,249 patients were admitted to 210 intensive care units by 3 April. Of those, 346 have died and 344 have been sent home. The majority, 1,559 patients, were still in intensive care.

Around three-quarters of the 2,249 patients were male, with an average age of around 60.

Saffron Cordery, deputy chief executive of NHS Providers, said: “The NHS is facing the biggest challenge of its lifetime and staff are working extremely hard round the clock to ensure that patients seriously ill with Covid-19 get the care they need.

“Trusts are doing all they can to support staff health and wellbeing and there are well-established support systems in place.

“However, there is no denying that this extraordinary effort by staff will be extremely tiring, stressful and demanding. Staff will be dealing with physically and emotionally challenging situations every hour of every day.

“NHS colleagues, whether they are a clinician, nurse, porter, cleaner, or senior leader, are pulling out all the stops, sometimes at the expense of their own wellbeing, to look after others. The NHS has never been more under strain but also the evidence of the spirit of the NHS has never been more evident or valued.”