On the Covid frontline: photo diary of an ICU consultant
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ICU consultant Dr Charlotte Summers has led the critical care surge response at Addenbrooke’s Hospital in Cambridge. She is also a leading research scientist in lung disease at the University of Cambridge, advising England’s chief medical officer Chris Whitty on which treatments to test in clinical trials. FT photographer Charlie Bibby followed her at work to record scenes on the frontline of Covid-19 treatment and research.
As the depths of a snow-speckled winter finally give way to the promise of spring, outside Addenbrooke’s Hospital in Cambridge a young couple wander past, laughing in the fresh breeze. Inside the hospital, a quite different scene is playing out. Behind the curtains of the greatly expanded intensive care unit (ICU), patients at the margins of life are battling Covid-19.
A six-day assignment inside Addenbrooke’s is enough to bring home the gulf between furloughed, locked-down Britain, with its inconveniences and hardships, and the hell being played out in hospital wards up and down the country.
In a small makeshift room in Addenbrooke’s, repurposed to cope with the surge in Covid-19 cases since Christmas, eight clinicians gather around to turn over a stricken patient. The idea of proning, as it is called, is to relieve pressure on the lungs. A cacophony of electronic bleeps is a constant reminder of the patient’s condition.
In a neighbouring ward, consultant Dr Charlotte Summers is making her morning rounds. Summers is a specialist in respiratory illness and part of a research group investigating cutting-edge treatments for Covid-19.
Even as the pandemic rages, patients are being tended to with grace and calm by the hospital’s weary band of clinicians.
“It is relentless,” says Summers. “They’re an amazing and inspiring bunch of people that have done things you couldn’t have imagined. If you had told me a year ago that we would be operating at over 200 per cent of capacity, I would have told you it was impossible.”
Covid-19 has taken a dreadful toll on hospital staff: across the country, hundreds of health and social care workers have lost their lives. At Addenbrooke’s, everyone knows a colleague who has been affected in some way. On our way between wards we bump into hepatologist, Dr Grace Dolman. She is on her first day back after a 10-month absence with “long Covid”, a condition lasting weeks or months.
Staff at Addenbrooke’s regularly help out on their days off. In ICU, consultant Dr Ruth Clay, an acute paediatrician, is stepping in as a healthcare support worker on a Saturday evening. “It’s just the stories from colleagues that’s made me want to volunteer,” she says. “It’s all hands on deck while there is that intense need for help.” On only her second day on the job, she admits to designing a crib sheet to help her with her new role. “My skills aren't transferable. I'm completely dependent on my nursing colleagues,” she says.
Despite the wave of Covid-19 patients, the hospital has continued to treat the ordinary caseload that still exists. There are designated “green zones” of the hospital where patients with emergency healthcare needs can still be seen. “Things have been very stretched,” says Summers. “But we are here, and always have been, for anyone who needs us, whether or not they have Covid.”
In a ward on the ninth floor, Terry Cooper, who specialises in deep cleaning, sterilises contaminated rooms with beams of UV light.
Back on ICU, Summers checks in with Brian Clark, who has just returned from abdominal aortic surgery — one of the many cases that the hospital will have to treat as the surge dissipates.
In a meeting room piled high with office furniture and whiteboards, a blow-up mattress rests against a wall, ready for use by staff on long shifts. After a morning handover, I find Summers coaching her team. It was in this same room on February 12 last year that she and her colleagues started planning for the arrival of a virus they had feared since January. “There were just 10 reported cases in the UK at this point,” she recalls. “It’s a bit like watching a train coming towards you.”
Then on March 15, shortly after the UK government launched its ‘ventilator challenge’, she learned with a growing sense of foreboding that the supply of mechanical ventilators was likely to run out at the end of the month. “Never before had it occurred to us that we might run out of kit to keep patients alive,” she says.
From ICU to the research lab
Summers studied medicine against the advice of a careers adviser who told her it wasn’t a profession for girls. Yet, it was in the lab that she found her calling. “Science is limitless,” she says. Researching acute respiratory disease syndrome has been her vocation for the past 16 years.
It is not only in the ICU that Summers is fighting the virus. Two floors and 100 paces away is the research group where she and her team are trying to understand their new viral foe. They are developing therapies that, they hope, alongside vaccines, can start to turn the tide of the pandemic around. Summers is part of the national panel that reports to Chris Whitty, chief medical officer for England, nominating therapy candidates to be tested in clinical trials.
Her PhD students scan the wards, recruiting volunteers for research, collating a catalogue of blood samples to take back to the lab to analyse and develop their understanding of Covid-19.
In one trial alone, more than 30,000 patients nationally are taking part. Research on that scale is possible only because of the scale of the NHS, she says.
In what was a potentially important breakthrough earlier this month, a combination of drugs being studied in the trial was shown to reduce mortality by between a quarter and a half. I spot the BBC’s Fergus Walsh interviewing Summers among a ward of recovering patients.
At the centre of the pandemic response, Summers is somewhat bewildered to find herself the centre of attention too. A letter from the prime minister Boris Johnson hangs partially hidden behind a filing cabinet on the wall of her office. While we chat, an email arrives from the vice-chancellor of Cambridge university, congratulating her on some recent news. “I didn’t even think he knew who I was,” she says. Attention has its downsides. She is often abused and anonymous messengers have threatened her life for suggesting that vaccines are safe and that lockdowns have been necessary.
The vaccine didn’t arrive in time for Sarah Miller. She thinks she caught Covid-19 from a plumber who visited her home. After three weeks of intensive care, she is simply glad to have survived. “There are people that didn't make it, it was frightening,” she says, recounting the vivid dreams, featuring Daleks and pink spiders, induced by the cocktail of drugs that kept her alive. She remembers Summers. “Thank you for everything you have done,” she manages to say, as her voice cracks.
Thankfully, vaccines and lockdown are starting to drive down the caseload, while clinicians have an arsenal of therapies to treat patients and Summers’ work continues apace. “What I do know is that science is our escape strategy,” she says.
Reflecting on the past year, she is blunt. “We have the highest death rate [per million population] in the whole world and it is a tragedy.” At Addenbrooke’s too, it has taken its toll. “They say all doctors carry a graveyard in their heads where they go and pray,” she says. “I've got a few more up there now.”