'A day I'll never forget': One year on from Wolverhampton's first Covid case

David Loughton will never forget March 7, 2020.

The New Cross Hospital boss was sitting at home when he got the call saying that the first Covid patient had been admitted to the hospital.

It was before the national lockdown was called, a time when there were just 200 coronavirus patients in a country that had no inkling of the scale of the crisis that was about to hit it.

Twenty-four hours later the first death at New Cross was recorded, and Mr Loughton began the process of leading 10,500 staff into the unknown.

One year down the line and the Royal Wolverhampton NHS Trust has nearly 800 deaths on its books. Hundreds of staff from all areas have been redeployed to care for Covid patients.

New wards have been built to aid the fight, thousands of non-Covid operations and treatments had to be cancelled or delayed, and the trust developed a sideline in manufacturing PPE.

Even for trust chief executive Mr Loughton, a health professional of 33 years, 17 of which have been at New Cross, all of this was unimaginable.

“That day, March 7, will stay with me forever,” Mr Loughton said. “At that time we didn’t know the challenges that would face us and I could never have dreamed of anything this bad.

“The situation developed rapidly. It was a month from the first patient testing positive to when we peaked on April 10 at 282 Covid positive in-patients.”

Ambulances lined up at New Cross Hospital

Mr Loughton vividly recalls the first patient lost to Covid, saying it was “like a military exercise” to get relatives into intensive care having gathered them together in the car park and given out PPE.

“We virtually never repeated that again and hard as it sounds, that was when we moved to restrict visiting.”

In the early days of the pandemic there was a lesson around every corner.

Contacts in Wuhan had been briefing Mr Loughton since late December, while by the end of January information was being gathered via consultants at New Cross with connections in Italy, where the virus had already hit hard.

“We had to learn quickly,” Mr Loughton recalls. “At the start we thought we would be dealing with something that predominantly affected the lungs. We had virtually no treatment, so it was a case of you either lived or you died.

“It started to become apparent that patients could do well with high volume oxygen therapy, but it was probably passed the first peak when we knew that.

New Cross Hospital medical staff wearing the visors

“We knew we had to ramp up intensive care capacity, and the way we were able to do that was that unfortunately we had to stop all the elective surgery because we needed staff for intensive care.”

He describes planning for the huge influx of patients as a “logistical nightmare”, which has seen 800 staff redeployed and retrained, and the usual blueprint of dealing with major incidents thrown out the window.

“If you have a 50 car pile-up on the M6 we have got a plan that swings into action to deal with that,” Mr Loughton says.

“You may have 20 or 30 people seriously injured. In a short space of time you are dealing with a crisis, but within a week you are coming out the other end.

“The difference with Covid is that it has gone on for months and we’ve had to adapt the plan as we have gone on day by day.”

Faced with chronic PPE shortages early in the pandemic, Mr Loughton recalls how 250 staff were redeployed to the medical library where they manufactured 250,000 full face visors.

“We were living hand to mouth for PPE, although we never actually ran out,” he said. “At the start we used to look forward to 6am on a Monday when the army turned up with a batch.

David Loughton

“We were heavily reliant on China and only two per cent of PPE was manufactured in this country. It is now up to 70 per cent.”

Mr Loughton is conscious of the heavy toll the pandemic has taken on staff.

Eye surgeons and dental nurses are among those who have been brought into intensive care, working long hours with severely ill patients, many of whom don’t pull through.

Three full time psychologists have been on hand to help out, and a former HR director was brought out of retirement to look after staff wellbeing.

But Mr Loughton says the intense pressure has rarely let up and many staff are mentally and physically exhausted. “No one came into this job to see death on this scale, and there is no doubt it has effected people greatly,” he said.

“The way the staff have dealt with it has been brilliant. They have been really flexible. For a lot of them, their job disappeared overnight. If you take a dental nurse, when Covid started we just stopped treating dental patients.

“But people from all over the organisation – people who had never worked together before – have really come together.

Vital

“It’s a complete shift from what we were used to doing, where the vast majority of people who walked into intensive care walked out.

“Even something like open heart surgery, the mortality rate is 1.4 per cent. For Covid at its peak it was nearer 40 per cent.

“At a hospital we deal with disease, and if we don’t cure it, we’ll give you a good end to your life. That is not the space that we’ve been in with Covid.”

Mr Loughton said the opening of a new 56-bed ward last July – built from scratch in nine weeks – has proved vital to the hospital’s ability to meet soaring capacity needs at the start of this year.

He said he signed off on the facility when it became apparent that oxygen supply was one of the key “limiting factors” to capacity.

“ITU (Intensive care) has plenty of oxygen supply, but we found out to our peril that you could only put four ventilators on a 28-bed ward,” he said.

“Every bed head had an oxygen supply but it wasn’t big enough to run ventilators, so I made the decision to build a new ward with a massive oxygen supply. It has 20 air changes an hour, so our staff are better protected.

“In January this year we wouldn’t have coped without it. It was the best decision of the whole of my very long career.”

Mr Loughton, who manages clinical research across the West Midlands, said he was proud of the region’s efforts in fighting the virus.

Important

“We thought this would probably go on until a vaccine was found, so we had a load of researchers from day one working on treatments,” he said. “That has helped the mortality rate drop significantly.

“There was also some really important work in recruiting patients for vaccine trials, which started in April.

“It has now gone on to be licensed and here we are, 20 million vaccines later.”

He said Wolverhampton had “come together” from the start of the pandemic, with public health chiefs, voluntary groups, other organisations and members of the public all playing their part.

“The vast majority of people have looked out for their neighbours,” he said.

“I think we have become more caring, and maybe as a nation we can learn something out of this.”

Mr Loughton said that with Covid cases now dropping sharply and hospital admissions also falling, there was hope that a better future lay ahead.

“We haven’t got the same levels in intensive care so we’re going in the right direction,” he said. “But people have got to continue to do the right thing so we don’t go back into another surge.

“That is unthinkable.”

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