Treating patients during the pandemic was like responding to a daily terror attack, the Covid inquiry has heard.
Giving testimony, Professor Kevin Fong, spoke of staff he met during a hospital visit being in “total bits”.
The former national clinical adviser in emergency preparedness at NHS England recalled a conversation with an intensive care doctor during a visit in December 2020.
“I asked him immediately what things had been like and… I’ll never forget, he replied it’s been like a terrorist attack every day since it started, and we don’t know when the attacks are going to stop.”
Prof Fong described Covid as the “biggest national emergency this country has faced since World War Two”, and repeatedly broke down in tears on the stand while describing what he had seen and his conversations with other staff members.
During the pandemic, Prof Fong, a consultant anaesthetist, conducted around 40 visits of the “hardest hit” intensive care units on behalf of NHS England to offer peer support to the doctors and nurses working there.
He wrote reports which were sent back to senior managers including England’s chief medical officer Prof Sir Chris Whitty.
He said the “scale of death” was “very difficult to capture in the figures”.
“It was truly, truly astounding… We had nurses talking about patients ‘raining from the sky’, where one of the nurses told me they got tired of putting people in body bags.”
“We went to another unit where things got so bad they were so short of resources, they ran out of body bags and instead were stuck with nine-foot clear plastic sacks and cable ties.”
“These are people who are used to seeing death but not on that scale and not like that.”
‘Scene from hell’
Prof Fong said that “despite the best efforts of everyone in the system” the surge of demand for healthcare caused by Covid meant it was “not possible to deliver the standard of care that would ordinarily be expected.”
He described the situation as the worst he had witnessed: “I was on the scene of the Soho bombing in 1999, I worked in the emergency department during the 7th July suicide bombing with the helicopter medical service. And nothing I saw during all of those events was as bad as really Covid was every single day for every single one of these hospitals through the pandemic surges.
“It’s painful now because it was very clear what was happening to the patients, it was very clear what was happening to the staff. The staff were very injured by just how overwhelmed they were by the whole thing.”
In December 2020 as Covid rates were rising again across the UK, he said he was asked to visit an unnamed hospital with a medium-sized intensive care unit.
“I’ll never forget it,” he said. “It was a scene from hell.”
“This was a hospital in massive, massive trouble…. there were so few staff that some of the nurses had chosen to either use the patient commodes [or] wear adult diapers because there was literally no one to give them a toilet break,” he added.
“This was a hospital breaking at the seams.”
A ‘political choice’
At the end of his evidence, he was thanked by the inquiry’s chairwoman Baroness Hallett who said “it was obvious how distressing it was for you and reliving such an ordeal is never easy.”
England’s chief medical officer Prof Sir Chris Whitty, who was next to speak at the inquiry, said he agreed with the evidence “very powerfully laid out” by Prof Fong.
He said that NHS hospitals in England entered the pandemic in early 2020 with a “very low” level of beds in intensive care compared to similar high-income countries.
“That’s a political choice. It’s a system configuration choice, but it is a choice,” he told the inquiry.
“Therefore, you have less in reserve when a major emergency happens, even if it’s short of something of the scale of covid.”
Sir Chris suggested that countries like the UK had no alternative but to impose lockdown and other social restrictions to avoid a “catastrophic” amount of pressure on the healthcare system.
He accepted that “in many individual cases” doctors and nurses found the situation “incredibly difficult” but said without lockdown restrictions “the expectation is it would have got worse. Not a trivial amount worse, but really quite substantially worse”.
Asked about PPE for healthcare workers, Sir Chris said that messaging around which masks NHS staff should wear was “confused” at the start of the pandemic, leading to an “erosion of trust”.
He suggested that more research was needed to see if a higher grade FFP3 mask offered more protection than a basic surgical mask in real-life hospital use, rather than in a laboratory.
“The question is what happens when people are using it day-in and day-out in operational circumstances, and if it doesn’t hold up in that situation, it’s not doing a heck of a lot of good,” he said.
In a future pandemic, he said he would give healthcare workers the choice of which mask to wear “within reason”.