BORIS JOHNSON: 'First of all, let's be in no doubt,
'this has been a sad, sad day. 563 more cases, a record.'
REPORTER: 'Doctors and healthcare staff are saying that
'a shortage of kit and a lack of clarity over what should be worn,
'when and where,
'could potentially cost them their lives.
REPORTER: 'One trust said to me today that they've only got
'three swabs per day to test staff.'
'There are stories from the frontline of doctors
'living in mobile homes at the moment.
'They don't want to infect their families.'
REPORTER: 'You've got deaths rising in a straight line.
'We've had a big leap in cases.'
BORIS JOHNSON: Our thoughts go out to the families of the victims,
but let's be in no doubt that
if we can follow the programme that we're currently set upon,
then I've absolutely no doubt that we will begin to start to
push those numbers down,
and we'll turn the tide of the coronavirus.
ABBEY: OK, bank staff, agencies?
No-one at all?
ON SPEAKER-PHONE: 'I've tried them all, and they're all full.
What about DJC locums?
REPORTER: 'The issue of staff absence is huge.
'You know, staff themselves really want to get back to the frontline.'
ABBEY: No. God, no, it's fine. You just take it easy.
That sounds really...
ON SPEAKER-PHONE: 'Look, I'm really sorry, Abbey.
'I still can't even get a test.' Yeah.
REPORTER: 'Lots of hospitals are reporting unease
'that they may run out of oxygen, sedatives, anaesthetic.
'What system do you have in place?'
ABBEY: Yeah, but can Anj swing over to cover for me?
ON SPEAKER-PHONE: 'Anj is down too. I only just heard myself.'
Oh, shit.
So we can't cover the ward SHO bleep.
Firm A is down.
Half of Firm B is urology F1s.
And Firm C is basically just Sunil and Grace, so...
Hi, it's Abbey. Yeah, so basically just totally failed on that one.
All the staffing banks are empty.
Hi. Morning.
Hey. Hiya.
Thank God, you're back. Are you OK?
No, I'm shattered. I mean, it's not nothing.
No.
Staffing told me about the current shit-show.
I know. Half of the hospital is off sick or isolating.
You'll be lucky if you get an orthopod as an SHO today.
Save us.
Hi, Emma. Hiya.
Ant, how are you feeling?
Yeah, not bad, thanks.
So...
we had three deaths overnight,
bed four's in their last hours
and ITU are on their way to review 12 and 16,
but the pit's rammed, so...
Right. Yeah.
How's Divina?
Not great.
Emma, look, I...
I don't know if anyone is thanking you for volunteering,
but it really is wonderful.
Everyone in my year has. BLEEPING
I need some help in here, she's unresponsive. Coming.
Cardiac arrest, call, please. Emma, could you get the PPE trolley?
Get the defib, please.
Danielle Evans, 43, COVID day ten, Type 2 Diabetes.
She was stable on six litres, but in the past half an hour
she's needed more and now she's just crashed.
She's arresting. Compressions, please.
No, no, no, we need Level 3 PPE.
Why is there no supply by the beds? We don't have enough kit.
Where's that PPE, Emma? PPE's here.
Does this patient have an active DNAR?
No, she's for resus.
I've just had it. I could get on with compressions.
No, that's not allowed. They're aerosol-generating.
Get the pads on. Thank you.
We're running out of time.
I'll help you with that. Yep.
MACHINE: Connecting electrodes.
Ready? Yep.
Non-shockable rhythm.
We need to start CPR. We're wasting time here.
Ant, stop it!
Emma, curtain, please.
Nearly there, Ant? Yeah, seconds away.
No, Emma, outside. Droplets.
Get the EMI bag, please. Yep. Get ready.
OK, start compressions.
We've wasted too much time.
MACHINE BLEEPING
Are you OK?
Yeah.
Right, are you OK to call the next of kin.
Just let me know if there's any problems or if you need anything.
Thanks, Maddie.
Right... Shall we go round?
Yeah.
I think we should start with Mr Williams.
He had a bit of a rough night.
He's on the high flow now, but sats are still low.
Thank you.
Hello, Mr Williams.
LABOURED BREATHING
Emma's just going to quickly present your story.
She's keeping us all up to speed.
OK, this is Mr Williams, 81.
WHEEZING
I met Mr... Archie in the cupboard in EAU.
That bloody cupboard.
He had flash pulmonary oedema, went to resus,
and since then has been doing amazingly well, really.
But then seven days ago, tested positive for COVID,
and has sadly...
deteriorated since then.
He's got his wife Florence at home.
She's not allowed here, obviously.
Thanks, Emma.
She did well, didn't she?
Archie,
I think we need to talk about doing a bit more for your breathing.
I'm afraid catching COVID's really knocked you for six.
Your lungs are struggling a bit and you're getting tired,
so I want to give you a form of breathing support called CPAP.
What we do is we put a mask on your face that's strapped quite tightly.
Then the CPAP machine pushes air into your lungs for you.
Will it hurt?
I'm afraid it can feel quite aggressive,
quite claustrophobic, yes.
BREATHLESSLY: And if I don't?
Archie, I want to be completely honest with you.
Without CPAP...
...I'm not sure you can survive this.
COUGHING IN BACKGROUND
I love my life...
...but not at all costs.
Emma, can you get my photos?
OK. Of course. The code is...
It's 4th of April.
Wedding day.
I've had a blessed life
with Florence.
We met...
...in an orchestra.
I was a second violin.
BREATHLESSLY: She was...
...a cell... cellist.
Archie?
Shall we try this?
And if it's too much, then we'll talk about what we're going to do.
Yeah?
LABOURED BREATHING
Emma, how do you feel about phoning Mr Williams' wife?
You know him.
You could talk her through what's going on.
Er... yeah. Sure.
OK?
OK.
Good.
Moisturise you hand.
There we go.
All right, my darling.
Shall we get your cross out?
Is that any better, Divina, my love?
Hello, Mr Williams. How are you doing?
WHEEZING
I've got something for you.
We sent one of these to Florence too.
You have a matching one.
You're all right.
Hey, Mr Williams.
I've got the mask here that we spoke about earlier.
I'm just gonna change that round for you now.
There we go. Take this one off for you.
Well done. There you go. Straight on.
You let me know if that's too tight, OK?
There we are. How does that feel?
You're doing great, Mr Williams.
You OK?
Just hold your heart and think of Florence.
So, this might feel a bit of a powerful blast,
but it will stabilise, OK?
You'll get used to it.
A bit like having your head out of a car window on the motorway.
LABOURED BREATHING
You're doing really well. How does that feel?
Good?
Hi, Sally. Did you want to have a chat?
Is that gonna happen to me?
No. No.
You're doing well.
Yes, you have COVID.
But your sats are holding.
Is that good?
I'm confident.
Well, I'm glad someone is.
I thought it would be breast cancer that killed me,
not coming into hospital.
You got in before we knew.
I'm so sorry you caught it in here.
But no-one is giving up on you, Sally, I promise.
Look, I know you've had your restaging scan done,
so I'll speak to the radiologists,
see if they can hurry the report along while you're in,
and I'll come straight up to see you as soon as it's on the system.
Yeah?
OK. Great.
Hi, there. Hey.
Just checking in.
Yep, what's your name? Dr Abbey Henderson.
Yeah, got you right here. Staying with us for nine days.
ON VIDEO CALL: 'Mummy! Mummy, Mummy, Mummy!
Hi.
'Hey. Divina?'
'Mummy, Mummy, Mummy.
'Mummy, Daddy wouldn't let me watch any screens after dinner
'and he shouted at me for no reason.
'You said I was allowed cartoons when you were at work,
'so I basically hate Daddy now.'
'Can't win.
'Tom, say hello to your mum.'
Tom? Are you gonna say hello from under there?
Hey, love.
I miss you.
Are you OK?
'Tom, come on.'
What is it?
Please tell me.
'You shouldn't be there. You should be here.
'You've just left us to look after all the patients at work,
'everyone else's family.
'So, what do you want me to say?'
Look, I'm not gonna lie to you, Tommy. I know this is really hard,
but... 'If you catch it, you'll die.
'So that basically means you don't even care about us.'
Oh, my God, Tom, I am so careful. I promise you.
'You can't promise us you won't die.'
Sweetheart...
'I'm sorry, love. I told him you're fit and well,
'it would be like the flu.
'He's obviously scared, you know?' Have they eaten?
'Yeah. Yeah.'
I should eat, so...
'We'll try again in the morning, OK?'
MACHINE BLEEPING
Sats 60. Still falling.
58. Oxygen?
100%.
Let's prone her.
Emergency prone, please, in here. Quickly.
PPE on everybody.
Straighter, please.
All right, Divina, we're gonna pop you on your front.
This should help with your breathing, OK?
Quick as you can everyone, please.
She's a Ward ACA from Level 6, thank you.
Take that. Thank you.
That's it. One more. OK, secured.
On my pull we're gonna slide her in this direction, all right?
Happy everyone? Yeah.
Ready. Ready, steady, slide.
We're gonna put her on her side. Go.
Right, nearly there. Change over.
Nearly there, Divina, nearly there, OK?
You'll feel better on your front.
Everyone happy? Yeah.
Gently now. Go.
All right. Still ventilating.
Back on, please. Hold, please, everyone.
Probe back on.
45. Come on, Divina.
We tried to get her on the haemofilter
but her BP's too unstable.
43.
Come on.
43, come on, Divina.
Her sats aren't improving at all.
It's not working.
Hey.
Hi, Enrico, it's Metin Ozkul here again.
ON VIDEO CALL: 'Yeah, hi.'
So, we hoped the proning might help with Divina's breathing, but...
I'm afraid it stopped working for her.
The CT scan we did of her lungs
shows they really are very badly damaged.
We tried to put her on a machine a bit like dialysis,
but she was too unstable for that, so...
...I'm really very sorry, Enrico, but...
we've explored all the treatments we have.
Enrico,
I think it's time we consider stopping active treatments,
and move towards palliative care.
'What do you mean? What does this mean?'
Hi. Hi. Hello, Enrico.
'Hi, yeah.' It's Abbey Henderson.
What Doctor Ozkul is saying is that we've reached a point now
where we need to focus on Divina's end-of-life care.
'Mm-hmm.'
She's receiving a lot of invasive treatments at the moment
that aren't helping her
and we can remove a lot of that
which would make her much more comfortable.
SOBBING 'Yeah.'
Enrico, I'm so sorry to say you can't come and visit Divina.
The rules prevent any visits to ITU.
'She didn't have the right PPE but she wanted to keep going.
'She was so brave.' She was.
'We'll be praying for her.' Yeah.
'She will be so alone.'
Hi, Enrico.
Hi, I'm Jules. 'Hi. Yeah.'
I'm the nurse looking after Divina here in ITU.
We're gonna take such good care of her, Enrico,
that's my promise.
I promise you that.
I promise you she will not be alone.
'I know. Thanks. I know.'
I'm so sorry, my love.
'I need to go now. I need to go.' I'm so sorry.
CALL END TONE
...a 250ml bolus...
Yeah. ...and monitor his BP.
We've been told medically fit patients with a care home bed
have to be discharged straight away, no delays.
Is he unwell?
Well, no, but he hasn't been tested for COVID, though.
They said it doesn't matter, we're not allowed to wait for tests.
But we've had two confirmed cases in here today.
Yeah, well, just keep a close eye on him...
Don't you think we should be just a little bit more...
It's taking five days to get test results back.
He can't sit here until then.
We need to be sure that he's not positive.
If he takes COVID back to the care home,
the other residents are sitting ducks.
If he sits here for five days
he's probably going to get COVID, isn't he? Can I help at all?
Thanks, Abbey.
Emma and I were just discussing discharges to care homes.
All the discharge planners have been told not to wait for negative tests.
There's ambulances queuing to the roundabout.
Which patient is this?
OK, no COVID symptoms on admission.
UTI, treated with antibiotics, medically fit for discharge.
Is there a new suspicion of COVID?
No, it's just that we've had others confirmed in here today.
OK. The national guidances don't wait for negative COVID tests.
Yes, the patient's going home.
His care home is his home.
He doesn't have COVID, so...
Well, to be fair to Emma, we don't know that without testing.
So, what shall we do?
SIGHS
I don't think we have a choice, do we?
There's no tests.
He's going to have to go back to his care home.
BORIS JOHNSON: And we're also massively increasing testing
and I want to say a special word about testing
because it is so important,
and as I've said for weeks and weeks, this is the way through.
This is how we will unlock the coronavirus puzzle.
This is how we will defeat it in the end.
And what we need to do is...
Sally?
Sorry to wake you.
Oh, hi, Doctor.
Oh, God, what's going on?
Your scan is clear.
What? Really?
The scan report just came on the system.
There's no sign of cancer.
I think we can hope for the best now.
Oh, my God.
I'll go through it all with you in the morning.
I just wanted you to know.
And we'll get you away as soon as we can.
Oh, God, thank you, Doctor.
It's a team effort.
Thank you, thank you. Thank you so much.
Could you pass me my phone?
Are you heading home, then? No.
God, when do you all sleep?
We don't, really.
Hi. Hi.
Yeah, no, I'm fine.
Oh, my God, love. I'm clear.
Side room seven.
Thank you. No problem.
What's your name, Doctor?
Abbey. Abbey.
E-Y.
You're all done.
Thank you.
Let's talk later.
OK, Divina, we're gonna turn off some of these machines now.
MACHINE BLEEPS
BLEEPING STOPS OK.
There we go, Divina.
That's it.
You can rest now, my love.
No more pain.
"Divina, every day I came to work,
"your smile told me how to do my job.
"I'll miss you. We'll look after your family.
"Love you, Alison."
"I will love you forever, my darling, my beloved, Divina."
It's from Enrico.
Beautiful, wasn't it?
Now some from us too. Everyone's written to you.
This is from Lauren.
HUSHED SOBBING
"Dear Divina, I was still a student when we met.
"Your smile lit up the ward.
"I will always remember your love and kindness."
INHALES, EXHALES DEEPLY
This one's from Vicky.
She's just had her baby, by the way.
"I can't believe you're gone. We're gonna miss you so much."
HUSHED SOBBING
INTERVIEWER: 'Thank you, Mr Hancock. Could I firstly ask,
'how many frontline NHS workers have died from COVID-19?
'And secondly, could I ask when a healthcare worker does pass away,
'has there been some form of investigatory process put in place?'
Yes, I think this is a question for you, Ruth.
OK, thank you very much.
We know that any death, if it were due to coronavirus, is a tragic one.
'We do have numbers of people that have died,
'whether they're nurses, midwives, healthcare assistants, doctors.'
It would be inappropriate for me right now
to go into listing them and numbering them.
I'm so sorry to have to share this news with you all...
...but I'm afraid Divina passed away overnight.
Enrico and the kids send their thanks.
HUSHED SOBBING
There's some counselling being arranged.
I'll put the details on the board.
Please use it.
The trust is going to provide some extra ward cover,
so if anyone feels unable to work you absolutely must go home.
PAGER BLEEPING
Oh, sorry, everyone.
Abbey, can I just say something?
Please.
Look, I don't want to speak for anyone.
I don't know about you guys, but I know that
I know what Divina would have been doing today.
She would have carried on caring for her patients.
So I think I'm just gonna do that, if that's OK.
Thanks, Tracey.
We've seen, very sadly,
four doctors die so far and some nurses.
They've not even counted the nurses, Matt. I've got to have a
conversation with you. OK, we'll talk about that.
Sorry, Doreen, just say that again?
We haven't even counted the nurses yet
cos I keep asking for the stats on nurses that are ill and...
I didn't know that, we will sort that out. The... But...
You've killed him.
This place has killed him. You've murdered my dad.
Please keep the volume down. There are other patients here.
Hello, I'm Doctor Henderson, I'm the consultant on the ward.
My dad had COVID because of you. You've killed him.
OK, I just need to come up to speed. So you tell me...
You sent someone back to his care home with COVID,
now they've all got it.
This lady's father was admitted last night from Pennyfield.
OK. Dad, it's OK.
We recently discharged a patient from the cold zone back there.
She doesn't have a fucking clue what's going on.
OK, I'd really appreciate it if... Pennyfield House. ..you didn't use
language like that... Dad's the 11th resident...
...and threaten staff. ...to get it, did you know that?
I didn't know that, madam, no. Seven people are dead
because you didn't test them before you sent them back there.
And now you've got your beds for the younger ones.
Murderers!
She's right.
We're killing people with these discharges.
OK, I hear you... No, Abbey, they're dying.
...but can we not do this in the middle of the ward.
And it's literally us sending COVID in to kill people. She's right.
Ant, you need to calm down, now.
I'm going to talk to the CEO about this, OK?
What, like you did about the PPE?
We'll both go. Right now.
Abbey? Good to see you. Come on in.
Thanks.
So I'm just gonna jump straight in, if that's OK.
Suits me.
We need to delay these discharges to care homes
until we can ensure that patients have a negative COVID test.
Without symptoms?
Yes. They incubate the virus asymptomatically
and return to the nursing homes, and we're seeing admissions from
those same nursing homes down the line.
Is that causal? Sorry?
Have you demonstrated a causal link?
Yeah. The index cases are the patients coming in and out of here.
Are you serious?
I can't shut down hospital discharges on that scale.
You just need to authorise testing.
It would be risking skyrocketing hospital-acquired COVID infection
because of anecdotal community transmission.
It's not anecdotal.
This comes from the Department of Health.
Every single trust has the same set of orders.
Orders? Yes, get 15,000 people
out of hospital beds right now.
Clear them out. No need for negative tests.
Even if there were enough tests for clinically well people...
They have coronavirus. ..it takes five days to get results back.
We can't wait that long.
Then you need to come down and write that in the notes.
SCOFFS I'm sorry?
That you're taking over the care of these patients
from the clinical teams.
Abbey, these are not my rules.
This comes straight from the top.
Look, residents can be isolated once they're back in their care homes.
How about patients with dementia?
You're welcome onto the wards to show us how that might work.
Discharge them home or to isolatable beds,
but not to care homes or they're gonna die in their hundreds.
This isn't your decision. Please just do your job.
Doing your job down there is a potential death sentence.
Members of our team, the most exposed members of staff,
are wearing aprons and bin bags
and going home wondering if they're gonna die in the night.
I truly am sorry about your colleagues.
As a hospital trust...
Oh, it's just HCAs and staff grades to you, isn't it,
in the firing line? Do you know who's dying down there?
Certainly not the white people up here.
Sorry. I was out of line earlier.
No, no, it's...
Dad's got COVID.
He got admitted last week.
Oh, God.
I'm so sorry.
Yeah.
There's no plan, is there?
No.
They're just making this up as they go along.
Those live, those don't.
They're just numbers.
Have you made a will?
MACHINE AIR WHOOSHES
LABOURED BREATHING
GASPING
WHEEZING
Hey.
ON VIDEO CALL: 'Hi, love, you OK?
'Oh, is it three already?' Er, yeah.
'Yeah, we're just...'
She's gonna break her neck doing that.
'Robby, Robby, do a cartwheel for Mummy.
'She's really good.
'She's almost got it.' You're a nightmare.
'Talk to your mum.'
Hi, darling. 'Hi.'
KNOCK AT DOOR Abbey?
We're heading up now. OK.
VOICE ON TV: 'We are gathered here today to remember Divina,
'a loving wife and mother to her family.
'And I would now like to ask Enrico
'to come forward to say a few words.'
ENRICO: 'She died doing what she loved.
'Even in the last few weeks when she came home so tired,
'she would say to me...
'.."This is my work."
'Me and the kids are so proud of her.
'I don't know what happens now.
'It was Divina who knew how to take us through
'any dark times that came to us as a family.
'But I feel, I know...'
PAGER BLEEPS
'that we will find our way somehow.
'That with the help of God
'and our friends, we will continue in this world.
'But I also know that...
'..I will always be alone without you, my darling.'
BANGING, COMMOTION
CLAPPING, CHEERING
WHISTLING
BANGING CONTINUES
Oh, that looks so good on you. Thank you.
If in doubt, go all out. I know.
There.
How's that? There you go, you look gorgeous.
And here she comes!
CHEERING AND APPLAUSE
Thank you all so much!
I don't ever wanna see any of you lot ever again!
Florence.
Archie's finding CPAP too hard.
He's decided to stop.
And I'm afraid without it, his lungs can't keep going.
But even with it, we don't...
LINE BREAKING UP
ON VIDEO CALL: '..what to do.'
We just want to offer you the chance to come in and visit the ward.
You're allowed in now...
now that it's an end-of-life situation.
'I want to.
'But my arthritis, my rheumatoid arthritis...'
Right. 'I'm on immunosuppression.'
That's a really tricky situation, Florence.
You need to be careful.
'OK.
'I don't want him to be alone.'
COUGHING IN BACKGROUND
Hi, Mr Williams. I hope you're feeling a bit more comfortable now.
WHEEZING
LABOURED BREATHING
STRIKES NOTE
All right. All I'll say, Mr Williams, is...
keep your expectations low.
WHEEZING
PLAYS SHAKILY
Hope that wasn't too painful.
PAGER BLEEPING
All right then, Mr Williams.
Hey. Hey.
Heading in? Yeah.
I'll see you in there a bit later.
I'm just popping back for a quick shower.
Are you on again? Oh, yeah.
SIGHS
You're doing really well.
Doesn't feel like it.
No.
Don't suppose it ever does, but you are.
You were right about that patient.
The one we had to discharge back to the care home.
We shouldn't have sent him back.
Just because it's harm we can't see, doesn't mean we're not doing it.
Yeah.
And we're meant to do no harm.
All right. See you in a bit.
See you in a bit.
SHALLOW BREATHING
RASPY BREATHING
CALL DIALLING OUT TONE
I wake up and sometimes, honestly, it's like I've wet the bed.
Soaked.
How does that feel?
CALL DIALLING OUT TONE
VOICEMAIL: 'Hi, this is Nick Henderson.
'Please leave a message and I'll get back to you.'
JULES: 'Can't breathe.'
Sometimes screaming.
I wake the kids, actually.
COUNSELLOR: 'Can you say more about the feeling of drowning?'
SHALLOW BREATHING
JULES: 'There are bodies everywhere.
'They've all got masks on.
'Their eyes are really wide.'
'I'm scrabbling in the water to reach the surface...'
'..and I'm pushing away the bodies that are blocking my way.'
I promise you, I've never had a thought like that in my life.
Just terrified.
What are you terrified of?
Sleep.
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