Post by Nadica (She/Her) on Nov 30, 2024 4:06:13 GMT
I’m a doctor with spinal damage from Covid – this is why I’m suing the NHS - Published Nov 28, 2024
By Sadhbh O'Sullivan
Nathalie MacDermott, a paediatric infectious diseases doctor, she says: 'If we had another pandemic tomorrow, I think we would make the same mistakes again'
Nathalie MacDermott is a paediatric infectious diseases doctor and clinical lecturer at King’s College London. While working on a Covid ward at Great Ormond Street in May 2020, she contracted Covid, leading to a spinal injury that impairs her ability to work until this day. She is part of Long Covid Doctors for Action, an advocacy group that is filing a class action lawsuit with the NHS for not adequately protecting healthcare workers from the risks of infection.
Here, she explains to i why she’s part of the movement to sue the NHS.
I do a mixture of research and clinical work, and in March 2020 I went to work at Great Ormond Street during the Covid pandemic. I was initially looking after children with infectious diseases and immunological conditions, and got Covid for the first time at the end of March, likely through a shared office.
At the time, we weren’t permitted to wear surgical face masks or PPE in offices, just on the wards, I think due to concern over the availability of PPE – it was prioritised for use on wards. But because we couldn’t socially distance in offices, people were understandably concerned. By the time I recovered and returned to work, they’d introduced a mask policy in offices due to pressure from the staff.
After I recovered, I went back to work on the Covid ward for children with multisystem inflammatory syndrome, a condition associated with acute Covid. It was not an intensive care ward where staff were allowed to wear full PPE, but a standard ward where the level of PPE was lower.
I was very concerned about the level of PPE that we were provided with at the time, and raised my concerns repeatedly over five weeks, trying to get to the people who would actually listen. But they just kept saying they were following the guidance from the NHS, and we didn’t really know where that guidance was coming from at that time. We were just given surgical face masks, small aprons to cover the torso, and a pair of gloves.
The reason given was that they were prioritising PPE for people exposed to what they consider aerosol generating procedures [medical procedures that lead to aerosols or air being released from a person’s respiratory tract] like being on a ventilator. The crazy thing is that the concept of aerosol generating procedures is a fairly nebulous one: at the time they were saying resuscitation (where you’re pushing on someone’s chest) wasn’t AGP, but someone on a filtered, closed circuit ventilator was. We now have fairly solid data that shows coughing is probably the biggest generator of aerosols, above and beyond other procedures.
I think there was a denial at the time [from the NHS as a whole, not the individual NHS trusts] that Covid was airborne. Plus, there wasn’t adequate ventilation on the ward because it was a repurposed building that didn’t have the air filtered at appropriate intervals; we couldn’t open the windows because there was dust everywhere from building works going on, and it was cold.
I worked at the forefront of the Ebola epidemic in Liberia and my PhD investigated the community spread of Ebola in Sierra Leone. It meant I was even more aware that there were risks of after effects with a viral infection. We know that just because you survive something like Ebola or glandular fever it doesn’t mean you won’t have ongoing symptoms for a long time afterward. I think it meant I was more willing to fight for better PPE and was very familiar with infection prevention, control procedures and personal protective equipment. Despite that, people still didn’t want to listen to what I had to say.
It was incredibly frustrating, not so much for myself but because I was very concerned about my colleagues. Around the time I was on that ward in 2020 we’d just lost one of the most senior nurses in my department to Covid. And even that wasn’t enough to convince people that we should have a better grade of PPE.
I continued to challenge the PPE guidance until I got Covid again in May 2020. After my initial acute Covid symptoms settled, I noticed I was still getting a lot of nerve pain in my feet, which then developed into limiting my ability to walk. It’s thought that Covid somehow damaged my spinal cord, but it’s not entirely clear how or what exactly happened.
I now struggle to lift my legs off the ground, so I can only walk very short distances on my own, and a bit longer on crutches. I also suffer from fatigue and get tired easily, I have bladder and bowel impairment, I have issues with dry eyes and mouth. Are they Covid related? Who knows, but that’s when they started for me. Either way, these symptoms haven’t changed in the last three and a half years.
The impact has limited me. I’m able to work nowadays, when many of my colleagues aren’t, but I largely work from home and do research. A full-time clinical job is physically too demanding for me. I did have a mobility scooter to help me get around wards, but even that was quite exhausting. Even going up a flight of stairs some days is a real challenge.
My passion has always been doing disaster and epidemic response with a non-governmental organisation, and obviously it’s quite difficult to send a doctor who’s disabled out to a war zone or epidemic situation. This has cost me my career in some respects, as I won’t be able to be the paediatric infectious diseases consultant I was hoping to be.
The whole purpose of our class action lawsuit is to prevent this situation happening again and we encourage any healthcare worker who has been affected to join the action.
We now understand that the NHS guidance on PPE had been issued by the Infection Prevention and Control cell that was part of the NHS pandemic strategy. Unfortunately, the IPC cell remains somewhat shrouded in mystery because its membership and minutes have never been made public. We have no idea about the decision making.
Despite the fact we now know that there is clearly aerosol spread of Covid, the PPE guidance still hasn’t changed. They’re recommending that full PPE should only be worn for aerosol generating procedures, even now when there are no more concerns about shortages.
There’s a study that was conducted at Cambridge University Hospitals that showed once they introduced full PPE (high grade masks) on their Covid wards, they went from having a relatively high incidence of infection in healthcare workers to having almost no infection. There’s good evidence now to suggest it certainly would have protected us on the ward.
But if we had another pandemic tomorrow, I think we would make the same mistakes again.
We’re bringing this action because we want doctors and all healthcare workers to feel represented. We want the NHS to recognise that it had a duty of care and still does have a duty of care to its staff, and that means providing the absolute best it can for its staff, not a halfway measure.
We want long Covid to be recognised as an industrial disease by the industrial injuries advisory council, meaning it’s eligible for an industrial payout through a government scheme. As yet it’s not being recognised as it’s very difficult to define what long Covid actually is.
For me, this isn’t about money – it’s about holding people accountable and ensuring we don’t make the same mistakes again in the future. For some of my colleagues, though, who have lost their livelihoods and their jobs and have been unable to work for many years, and are unemployed and applying for universal credit, and using food banks, then I think a pay out is justified and of significant benefit to them because of the struggles they have at the moment financially.
By Sadhbh O'Sullivan
Nathalie MacDermott, a paediatric infectious diseases doctor, she says: 'If we had another pandemic tomorrow, I think we would make the same mistakes again'
Nathalie MacDermott is a paediatric infectious diseases doctor and clinical lecturer at King’s College London. While working on a Covid ward at Great Ormond Street in May 2020, she contracted Covid, leading to a spinal injury that impairs her ability to work until this day. She is part of Long Covid Doctors for Action, an advocacy group that is filing a class action lawsuit with the NHS for not adequately protecting healthcare workers from the risks of infection.
Here, she explains to i why she’s part of the movement to sue the NHS.
I do a mixture of research and clinical work, and in March 2020 I went to work at Great Ormond Street during the Covid pandemic. I was initially looking after children with infectious diseases and immunological conditions, and got Covid for the first time at the end of March, likely through a shared office.
At the time, we weren’t permitted to wear surgical face masks or PPE in offices, just on the wards, I think due to concern over the availability of PPE – it was prioritised for use on wards. But because we couldn’t socially distance in offices, people were understandably concerned. By the time I recovered and returned to work, they’d introduced a mask policy in offices due to pressure from the staff.
After I recovered, I went back to work on the Covid ward for children with multisystem inflammatory syndrome, a condition associated with acute Covid. It was not an intensive care ward where staff were allowed to wear full PPE, but a standard ward where the level of PPE was lower.
I was very concerned about the level of PPE that we were provided with at the time, and raised my concerns repeatedly over five weeks, trying to get to the people who would actually listen. But they just kept saying they were following the guidance from the NHS, and we didn’t really know where that guidance was coming from at that time. We were just given surgical face masks, small aprons to cover the torso, and a pair of gloves.
The reason given was that they were prioritising PPE for people exposed to what they consider aerosol generating procedures [medical procedures that lead to aerosols or air being released from a person’s respiratory tract] like being on a ventilator. The crazy thing is that the concept of aerosol generating procedures is a fairly nebulous one: at the time they were saying resuscitation (where you’re pushing on someone’s chest) wasn’t AGP, but someone on a filtered, closed circuit ventilator was. We now have fairly solid data that shows coughing is probably the biggest generator of aerosols, above and beyond other procedures.
I think there was a denial at the time [from the NHS as a whole, not the individual NHS trusts] that Covid was airborne. Plus, there wasn’t adequate ventilation on the ward because it was a repurposed building that didn’t have the air filtered at appropriate intervals; we couldn’t open the windows because there was dust everywhere from building works going on, and it was cold.
I worked at the forefront of the Ebola epidemic in Liberia and my PhD investigated the community spread of Ebola in Sierra Leone. It meant I was even more aware that there were risks of after effects with a viral infection. We know that just because you survive something like Ebola or glandular fever it doesn’t mean you won’t have ongoing symptoms for a long time afterward. I think it meant I was more willing to fight for better PPE and was very familiar with infection prevention, control procedures and personal protective equipment. Despite that, people still didn’t want to listen to what I had to say.
It was incredibly frustrating, not so much for myself but because I was very concerned about my colleagues. Around the time I was on that ward in 2020 we’d just lost one of the most senior nurses in my department to Covid. And even that wasn’t enough to convince people that we should have a better grade of PPE.
I continued to challenge the PPE guidance until I got Covid again in May 2020. After my initial acute Covid symptoms settled, I noticed I was still getting a lot of nerve pain in my feet, which then developed into limiting my ability to walk. It’s thought that Covid somehow damaged my spinal cord, but it’s not entirely clear how or what exactly happened.
I now struggle to lift my legs off the ground, so I can only walk very short distances on my own, and a bit longer on crutches. I also suffer from fatigue and get tired easily, I have bladder and bowel impairment, I have issues with dry eyes and mouth. Are they Covid related? Who knows, but that’s when they started for me. Either way, these symptoms haven’t changed in the last three and a half years.
The impact has limited me. I’m able to work nowadays, when many of my colleagues aren’t, but I largely work from home and do research. A full-time clinical job is physically too demanding for me. I did have a mobility scooter to help me get around wards, but even that was quite exhausting. Even going up a flight of stairs some days is a real challenge.
My passion has always been doing disaster and epidemic response with a non-governmental organisation, and obviously it’s quite difficult to send a doctor who’s disabled out to a war zone or epidemic situation. This has cost me my career in some respects, as I won’t be able to be the paediatric infectious diseases consultant I was hoping to be.
The whole purpose of our class action lawsuit is to prevent this situation happening again and we encourage any healthcare worker who has been affected to join the action.
We now understand that the NHS guidance on PPE had been issued by the Infection Prevention and Control cell that was part of the NHS pandemic strategy. Unfortunately, the IPC cell remains somewhat shrouded in mystery because its membership and minutes have never been made public. We have no idea about the decision making.
Despite the fact we now know that there is clearly aerosol spread of Covid, the PPE guidance still hasn’t changed. They’re recommending that full PPE should only be worn for aerosol generating procedures, even now when there are no more concerns about shortages.
There’s a study that was conducted at Cambridge University Hospitals that showed once they introduced full PPE (high grade masks) on their Covid wards, they went from having a relatively high incidence of infection in healthcare workers to having almost no infection. There’s good evidence now to suggest it certainly would have protected us on the ward.
But if we had another pandemic tomorrow, I think we would make the same mistakes again.
We’re bringing this action because we want doctors and all healthcare workers to feel represented. We want the NHS to recognise that it had a duty of care and still does have a duty of care to its staff, and that means providing the absolute best it can for its staff, not a halfway measure.
We want long Covid to be recognised as an industrial disease by the industrial injuries advisory council, meaning it’s eligible for an industrial payout through a government scheme. As yet it’s not being recognised as it’s very difficult to define what long Covid actually is.
For me, this isn’t about money – it’s about holding people accountable and ensuring we don’t make the same mistakes again in the future. For some of my colleagues, though, who have lost their livelihoods and their jobs and have been unable to work for many years, and are unemployed and applying for universal credit, and using food banks, then I think a pay out is justified and of significant benefit to them because of the struggles they have at the moment financially.