Behind the Mask

Admiring the strength of colleagues when leadership failed

For a Neurologist in the UK, reflecting on the 2020 pandemic effort leads to strong positives AND negatives, in how it has been handled in his country overall. At the top of his list of positives, he’s been able to see firsthand the strength of his colleagues.

“Despite years of working a very difficult and challenging and mentally and physically exhausting and draining conditions, the healthcare staff, when called upon, were still able to summon their much-depleted reserve of resilience and adaptability to confront the challenge.”

When the coronavirus pandemic started, the senior consultants were drafted to different teams to help support the coronavirus cases, as well as to cover non-coronavirus cases where other teams were understaffed. Many had not worked outside their specialty in many years, so they had to adapt quickly.

“Obviously this is a significant undertaking for us because a lot of us have not practiced general medicine for a significant period of time, and so it does become very difficult to refresh yourself of the knowledge that is required.”

He specifically noticed the strain that the junior staff were subjected to. Their training had been disrupted, exams cancelled, and what’s more, they had been re-scheduled to work in specialties they were not originally trained for, and often had no experience with.

“They are usually working at least 20 to 30 percent above their usual capacity, and that situation was obviously only made worse by the pandemic. So for them to be able to willingly accept the cancellation of annual leave, being put onto new rotas, and to confront this challenge head-on, despite inadequate provisions of PPE, and staff and equipment shortages… It is nothing short of outstanding achievement.”

What made these achievements even more impressive was the fact that they were accomplished against what the neurologist saw as a colossal failure to prepare at a government level.

“Despite being put into a very difficult position by the government, they were able to do the best they can for their patients, and I think that is something which is absolutely admirable.”

He was surprised and disappointed by the extent to which the higher authorities – the government, the Department of Health, and senior management in the national health service – had completely failed to protect the people of the country, the economy, and the healthcare workforce. He saw this happening at multiple levels, but at its core, the issue was foundational.

“I think really this starts initially from underestimation of the risks of the virus, adopting the wrong strategy of herd immunity, even though there was no evidence that even infection would give you lasting immunity, and general laissez-faire attitude of, we do not mind if some old people died because obviously survival of the fittest”

The other issue from his perspective was a significant degree of what he saw as corruption in how the system was then geared up to fight the pandemic. One clear example being the process for procurement of PPE.

“You look at the recent scandal where a friend of Dominic, the Prime Minister’s Chief Advisor, procured a contract worth 150 million pounds to purchase 50 million face masks at a cost of three pounds per face mask, which is pretty expensive, only for the equipment to then turn out to be faulty and below the standards expected. That means they cannot be used and that is 150 million pounds down the drain.”

Another example was in how the contract to build test and trace software was awarded to friends of those making the decision, instead of finding someone truly and properly prepared for the job. This led to a product which was unable to be utilized in the field.

“They were given the task of designing a test and trace app and it turns out they declined the source code for Google and Apple which allows close distance tracking of the GPS device, so they ended up making a test and trace service that could not measure distance properly.”

In his eyes, the pandemic taught him a lot about how his work environment actually works, and quite differently, that the senior management of the government cannot be relied upon as he previously thought. As you can imagine, this has been disheartening, as he feels he’s fighting on the front lines without proper leadership.

“That is a bit like fighting a war where you know your commander-in-chief is a bit useless…firstly it is not good for morale and secondly as the General or one of many Generals on the field you kind of have to make your own plans and that makes things more difficult.”

While some countries such as New Zealand have been applauded for their governmental leadership throughout the COVID-19 crisis, most, including the UK, have been criticized for not taking proper protective action while allowing medical professionals to bear the brunt of the risk to their physical and mental health.

“I think through this pandemic I have realized who are the people that the people of the country can rely on and who are the people that they cannot.”

As we continue into 2021, governments have the opportunity to implement the lessons they’ve learned from missteps throughout 2020, but time will tell if they will be able to earn back the trust of patients and HCPs who have been hit the hardest with the impact.