Covid vaccination card

Fighting back

Fighting back

 

‘The firm commitment to viral sequencing and the RECOVERY trial have been beacons of light, and later the vaccination programme. I hope that one of the positive outcomes of the pandemic will be an ongoing commitment to high-quality clinical research in acute care.’

JdW, acute medicine consultant, London

Clinical trials, increased PPE supplies, effective medication and the celebrated vaccination programme gave relief and hope to healthcare workers and the public alike, creating a possible path through the chaos.

Behind the headlines, our survey respondents endured increased workloads to battle the virus in myriad ways, big and small. Whether contact tracing, revising clinical protocols, creating guidelines or adapting to new technology, they were united by a collective resolve to combat COVID-19 in any way they could.
 

‘It is amazing to think how little we knew about the virus in the beginning. Everyone was scared. Our only treatment options were oxygen and hope.'

MG, a gastroenterology registrar, south-east England

 

Feelings towards the clinical response to fighting the virus in the survey responses were overwhelmingly positive:

'I found the developing information and research about Covid-19 fascinating and found how the NHS coped and rapidly put new services and treatments in places astonishing.’

JB-M, geriatric medicine consultant, Scotland

Doctors at dinner round a table.

 

The Last Supper

The Last Supper, 17 March 2020

Donated by TS, neurology consultant, north-west England     

‘Things were closing down around our eyes… it felt a bit like the war… we knew the sh*t was really about to hit the fan… but we still couldn’t quite believe it… there was this gallows sense of humour... this was our last supper.’

Committees for the Medical Research Council and National Institute for Health and Care Research (NIHR) met in London to urgently review COVID-19 research grant applications from 2–17 March 2020, as society was about to lock down.

The committees decided to fund a proposal to develop a COVID-19 vaccine, and the plan for a national RECOVERY treatment trial. This photograph shows some members of the panel having dinner in an empty restaurant after the last meeting. TS, director of the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at Liverpool University, is second from the right.

Transcript: T S talks about the funding of the recovering trial and Oxford Vaccine

T S – Funding Recovering Trial and Oxford Vaccine

Anyway, we, we put out a funding call to fund COVID research, this went out in February, and then I chaired the first panel meeting. This was the 2nd of March so it was just as things were closing down, very much so. And we were in London, meeting in person, because that’s what you did back then, and literally things were kind of closing down around our eyes. I mean, I know the final Boris announcement was, I think, the 15th of March [corrected by TS to 23 March] but you may remember we had a run up to 2 weeks and you just knew it was coming and so we had a kind of last supper after the meeting and took a couple of photos. And it was a bit, it felt a bit like the War, you know, when you hear people talking about the start of the War and to begin with, you know, there was a degree of, kind of interest and excitement, and that, I guess, was January, and you were sort of watching this and thinking, ‘Oh gosh, what is this going to mean for us?’ And then when it was very close, we knew the shit was really about to hit the fan, and you’d seen what was happening in Italy, still couldn’t quite believe that it was going to happen here, so there was this sort of a gallows sense of humour in our last supper as we called it [laughs]. And then of course, you know, when we finally met again in person a couple of years later it was interesting to think how things had changed. But that meeting, actually, on the 2nd of March, [corrected by TS to 17 March] we looked at lots of research proposals and funded several, and two that we funded included someone from Oxford, Sarah Gilbert, a friend of mine, had put in a submission saying, ‘Oh, we’d like to develop a vaccine,’ so we decided to fund her vaccine. And also we decided to fund the Recovery Trial from Peter Horby and Martin Landry. So those were pretty important decisions. And that’s probably my most useful days’ work in my whole career [laughs] in terms of lives saved. 

[Additional information and corrections from interviewee, T S: Expert panels for the Medical Research Council (MRC) and National Institute for Health and Care Research (NIHR) met in London to urgently review Covid-19 Research Grant Applications between 2nd and 17th March 2020, as society was closing down. Among the work they decided to fund was a proposal to develop a coronavirus vaccine by Professor Sarah Gilbert and colleagues, and the plan for a national treatment “Recovery” Trial by Professor Martin Landry, Professor Peter Horby and Colleagues. The photo corresponding to this audio shows some members of the panel chatting over dinner after the last meeting, held in an eerily quiet London (left to right - Dr Anna Kinsey, Professor Graham Medley, Professor Eleanor Riley, Professor Paul Sykes, Professor Tom Solomon and Dr Joanna Jenkinson).

The national lockdown was announced by Prime Minister Boris Johnson on 23rd March, and the funding panels continued to meet online. Over the next few months, they reviewed 968 applications, and funded 79 projects to a total value of £71.5 million. This was part of nearly £300 million of Covid-19 research funded by the MRC, up to March 2021. Professors Gilbert, Landry, Horby, Medley, Solomon, and Dr Jenkinson all subsequently received honours from the Queen in recognition of their work during the pandemic.]

"We have recruited over 100 patients and have participated in the convalescent plasma and monoclonal antibody arms [ie treatment/study groups]. I have worked with 12 CRN [Clinical Research Network] fellows from a variety of clinical backgrounds in order to enable recruitment in the [RECOVERY] trial. I have been available to provide the research team with advice and support as well as their initial training and induction to the trial. I have spoken on local radio and national television about the RECOVERY trial and the positive outcomes it has provided so far.’

SF, respiratory consultant, south-east England

College of lab scenes.

 

Clinical microbiology team and laboratory

Clinical microbiology team and laboratory

Donated by RM, clinical microbiology fellow, north-west England

‘We introduced our first molecular platform into our lab […] as a result of COVID testing pressures. It became our “lab within a lab.” It required huge dedication, and commitment from our wonderful scientific staff, MLAs, chief scientist, lab manager and hospital management in general. Scientists had to train/gain competencies in PCR [polymerase chain reaction] in a super condensed period of time. The pressure to do in house testing and stratify patients based on their COVID status was immense.’

RM, clinical microbiology fellow, north-west England

Before moving to Manchester Royal Infirmary, RM worked at the Mayo University Hospital in County Mayo, Ireland. The photographs show the Mayo University Hospital’s large molecular platform for batch testing respiratory samples for the COVID-19 virus – the ‘lab within a lab’.

Visible are the benches in the main microbiology laboratory and the different new molecular platforms that were installed in response to the pandemic: Seegene (top left) and Thermal Cyclers (bottom left), and a Genexpert (top right). These devices can now be used for detecting other pathogens including bacteria.

RM appears in the centre of the group of three (bottom right). The other members of her team are microbiology laboratory scientists and a clinical microbiology registrar.

'The most positive experience of the pandemic has been uniting with researchers and healthcare workers from all over the world to combat a common overwhelming threat to life as we knew it. Working across borders as physical borders closed is how we will overcome this.’

XHSC, infectious diseases specialty registrar, UK

Covid Vaccine

 

AstraZeneca and Pfizer-BioNTech vaccine vials

AstraZeneca and Pfizer-BioNTech vaccine vials, 2020–2021

Donated by LL, general practitioner, south-east England 

LL assisted with giving over 20,000 doses of the COVID-19 vaccination at a health centre in Oxford. The vaccines from these vials were administered in December 2020 (Pfizer-BioNTech), and January 2021 (AstraZeneca). LL described some of the challenges involved: 

‘My practice was the designated site for storage and injecting vaccine […] The main problem was running out of syringes – we had been instructed not to use any other syringes than those supplied expressly for the vaccine […] It was a palaver getting hold of more syringes and needles but we did eventually manage it with the help of a CCG [clinical commissioning group] manager who personally drove around the county scrounging syringes from other sites which had not yet received [the] vaccine and whom we expected to be able to repay/restock in time for their own vaccine deliveries.’

Vaccine record card.

Vaccination record card

Vaccination record card, 2020

Donated by LL, general practitioner, south-east England, and AK, palliative medicine consultant, London

Everyone who received an NHS COVID-19 vaccination, including healthcare professionals, was given a vaccination record card. These cards record which vaccines an individual received, and when.

Many survey respondents recorded their relief and gratitude at receiving the vaccine:

‘I have received dose one of Pfizer/BioNTech. I remain hopeful that this has been the best thing for my wellbeing as regards my abilities to work.’    

  MA, palliative medicine consultant, UK

‘I am so grateful for science, scientists and the courage and hard work of the vaccine developers.’

AB, nephrology consultant, London

‘After Test & Trace was stood down, and we could no longer communicate with local council public health COVID response teams to adequately contact trace, we focused on education and information about vaccination; answering the myriad queries unvaccinated or partially vaccinated patients often had.’

KMH, associate inpatient contact tracer, north-east England and Yorkshire

 

Doctor holding vaccination certificate.

 

Vaccination certificate

Vaccination certificate, January 2021 

Donated by RM, clinical microbiology fellow, north-west England

 

RM shared her feelings after receiving her first COVID-19 vaccination:

‘The photo of me holding my certificate was taken on the day I received my first COVID vaccine in January 2021, very proud moment, and a cataclysmic moment for us all who were working on the front line.’

Transcript: RM speaks about getting the vaccine & SY talks about vaccinating patients in the community

RM – Getting First Vaccine

I remember the excitement when the Pfizer vaccine was released, so I remember all of us being super excited to receive it. I got my first dose of the vaccine in January 2021, and I’ve never seen so many healthcare workers queue for a vaccine. They had to kind of separate us and give us different times, like, to attend. What was interesting too was that the surgeons were, ‘cause the surgeons, their, a lot of their elective work had been cancelled so then, they were running COVID clinics with some of the nursing staff and they were vaccinating us. And it was just a different way to see them working, and it was a bit unexpected, but it was lovely.

Q: You kindly sent us a picture of yourself with the certificate in January 2021. Tell me more about how you were feeling about getting your first dose.

Elated. And I felt quite privileged as well because I’m young and I don’t have any significant health comorbidities. Say for example, like an older person or my parents. So, I got it, and I was living at home with my parents at the time so, I felt a bit guilty in a way that I got it and my parents weren’t getting it. My parents obviously did get offered vaccination later. Very privileged, very lucky. And I’ve always believed in vaccines, so it made it even more, it just reinforced it more for me.

 

SY – vaccinating vaccinating patients in the community early 2021

They took on vaccinating local care homes and housebound patients and so they needed volunteers for that and I was working with a nurse who volunteered too. The first man we went to was homeless and had been housed in a supported hostel room because he had severe COPD, and he thanked us for thinking he was valuable enough to get the vaccine and talked to us about, you know, life on the streets and, you know, I just thought, ‘I’m glad I live in a place where the vaccine wasn’t who could pay for it’. And ranging through, you know, to people who were so excited about getting the vaccine because it would mean that they could see an end in sight to being able to meet with their family, yet everybody we met obviously hadn’t been out of their houses for the best part of a year. Right through to somebody living in a very expensive part of London with the most amazing house who wanted to give us  bottles of champagne because they saw this as, you know, they soon would be able to go to the outside world. But, actually, as individual people they were all just so grateful. And so, yeah, that was a really interesting day.

Stock Room

   

LL diluting vaccine

LL diluting vaccine, December 2020 to January 2021

Donated by LL, general practitioner, south-east England

 

The process of storing, preparing and administering the COVID-19 vaccine was complicated:

‘We gave about 1,150 doses [of the vaccine] on Saturday 19 December – Monday 21 December [2020] […] I was personally involved in giving some of these but spent most of the day diluting the vials for others to administer. It was quite a tedious process mixing the vaccine – we had to get each vial out of the fridge (they had thawed out from frozen overnight) with someone countersigning the removal of the vial, then carefully invert it 10 times, add saline (checked by a second doctor or nurse), carefully invert (not shake) it 10 times again and then label it with the time of dilution and ‘expiry’ six hours later.’

LL proudly recalled that ‘we have not wasted a single dose of vaccine as far as I am aware.’

PPE stock

PPE stock

Donated by LL, general practitioner, south-east England

LL’s health centre in Oxford received increased deliveries of PPE during the early months of the vaccination programme, December 2020 to January 2021. Unfortunately this PPE was actually a cause of frustration for LL:

‘We have had deliveries of PPE which are vastly in excess of what is needed for the limited supply of vaccine we have had. If we had been given more vaccine we could have easily vaccinated more people.’

SH fire fighter helping at a vaccine centre.

 

Firefighter helping at a vaccination centre

Firefighter helping at a vaccination centre, 2021

Donated by SH, firefighter, south-east England

The multidisciplinary teams fighting the pandemic within UK hospitals included public sector workers from outside the healthcare profession:

‘During a Fire Service career of almost 22 years, my period of redeployment to the NHS assisting with the vaccination effort is probably one of the proudest periods of my career. Seeing the hope in people, some having not left their homes for a year, is an experience I will always treasure.’

Covid Test

 

Positive lateral flow test

Positive lateral flow test, 2020

Donated by TS, neurology consultant, north-west England     

TS caught COVID-19 in 2020. This is the rapid lateral flow test (LFT) he used to self-diagnose his symptoms. The test result reads as + (positive), confirming that antigen proteins from the surface spikes of the SARS-CoV-2 virus were detected on TS’s throat or nasal swab. 

COVID-19 rapid antigen tests like this can produce results quickly, are inexpensive, and can be used at home. Although they are generally less sensitive than other tests, such as the real-time reverse transcription polymerase chain reaction (RT-PCR) test, the development and availability of antigen tests helped society to function during the pandemic. People knew when to isolate themselves, and a negative result provided some reassurance that an individual was safe to leave home.

Some healthcare workers described the challenges that COVID-19 testing brought:

‘The provisions of PCR testing and LFTS added extra work load to the workforce.’

Anon, endoscopy unit manager, east of England

COVID-19 antiviral treatment packaging: Paxlovid

COVID-19 antiviral treatment packaging: Paxlovid, 2022

Donated by MW, a member of the public who was treated for COVID-19

 

The first oral antiviral treatment for COVID-19, Paxlovid, was developed in the USA by the multinational pharmaceutical and biotechnology company Pfizer. It was first available in December 2021.  

Paxlovid is a combination of two medicines, nirmatrelvir and ritonavir. Nirmatrelvir works by stopping the SARS-CoV-2 virus that causes the COVID-19 disease from growing and spreading in the body. Ritonavir helps prevent the body from breaking down the nirmatrelvir before it has had an effect. Together these medicines are used to treat early COVID-19 symptoms, and help prevent more severe symptoms.

MG, a gastroenterology registrar, recalled that ‘it is amazing to think how little we knew about the virus in the beginning. Everyone was scared. Our only treatment options were oxygen and hope.’

Feelings towards the clinical response to fighting the virus in the survey responses were overwhelmingly positive:

‘I found the developing information and research about Covid-19 fascinating and found how the NHS coped and rapidly put new services and treatments in places astonishing.’

JB-M, geriatric medicine consultant, Scotland

‘We became more stronger and determined to fight back this pandemic. We designed and developed new strategies to use effectively our current resources. We came out with advanced clinical protocols and research tools to help [the] wider population including virtual consultations and use of social media interface. Our morale was lifetime high to combat this unprecedented pandemic and do something extraordinary for society and human lives.’

HT, acute medicine consultant, south-east England

A display of vaccine vials in a heart shape.

 

Used Pfizer vaccine vials

Used Pfizer vaccine vials, December 2020

Donated by LL, general practitioner, south-east England 

After administering COVID-19 vaccinations, healthcare workers were advised to deface the vials to prevent vaccine fraud:

‘We were told to destroy the labels on used vaccine with indelible marker. We were told this was to reduce the risk of empty vials being obtained from sharps bins and fraudulently passed off as vaccine if refilled with fluid.’

In this photograph, the empty vials from LL’s GP surgery have been covered with labels with the expiry date written over the top. The arrangement of the vials into a heart shape gives a powerful indication of what these vials represented to the team.

‘My most negative memories [of working during the pandemic] are undoubtedly the COVID deniers and anti-vaxxers who sadden me.’

BH, endocrinology and diabetes with general medicine consultant, south-west England

'Bod's bulletins'

The president of the RCP shares a regular email bulletin with the RCP’s 40,000 members worldwide. During lockdown in 2020 this increased to one bulletin a week, with the then-president Sir Andrew Goddard updating doctors on trends in the spread of COVID-19, new developments in medical attempts to manage it, and issues affecting the medical workforce. You can read a copy of these by downloading the document 'President's Bulletin' from the bottom of this page.

Bod's bulletins

‘The paucity of accurate and reliable information in the media and the rapidly changing situation made the bulletins an ideal form of communication and I started doing them weekly, slowing down after the first wave to fortnightly, with occasional bursts of weekly again when needed. Many members have told me that the bulletins kept them informed and were a ray of light during some of the darkest days of the pandemic. If one should be proud of such things, I am, and while it has been at times a labour of love/hate I am glad it has created a strong connection with physicians across the UK and rest of the world.’

Andrew Goddard, president of the RCP, 2018–2022

Some members and fellows shared their thoughts about the bulletins with Sir Andrew:

‘Your bulletins were my lifeline during the pandemic when we were managing information from all

sides. Your summaries of the key facts about each COVID strain were essential reading.’

‘I have immensely valued your regular updates, and in particular, your refreshingly honest opinions on medical matters of the moment.’

‘I was so impressed when your weekly newsletter started. I’ve found it fascinating, informative and usually cheering.’

‘You have clearly stood up for physicians, asked difficult questions, challenged us to think and work differently and better, but also been clear on how we need to be protected and protect each other from the trauma and fatigue that has fallen on the nation and particularly healthcare workers.’

‘I cannot begin to tell you how invaluable, inspirational and educational your bulletins have been to me and I hope countless others as we struggle to keep up to date with changing times.’

The RCP also conducted regular surveys of the members during the COVID-19 pandemic, highlighting their concerns to government and others. You can find out more, including links to the results and key findings of each survey, by clicking here


Part of the exhibition Fortitude

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