COVID-19: Inside the children's ICU dedicated to saving adult coronavirus patients

Thursday 14th January 2021 07:45 GMT

Almost every bed on the ward is taken but no patient voices can be heard. The only sound is the constant bleeping of the life support machines.

I am standing in the children's intensive care unit at St Mary's Hospital in central London.

But there are no sick children here. It is full of critically ill adults. Almost every single one is on life support.

There are 13 beds and 12 of the patients are sedated and intubated. The ventilators help their virus-infected lungs to breathe but the healthcare staff must do everything else, 24 hours a day.

One nurse leans over an unconscious patient, dabbing the corner of his mouth with a cotton swab. She then gently wipes away the discharge that has pooled in the corner of his eyes.

This is tender, loving care administered to a patient who is in a deep induced coma, completely unaware of the nurse's attention.

Everywhere there are signs of this unit's previous specialism; cartoon motifs on the walls and the floor and specially commissioned paintwork to promote healing.

The last two children needing intensive care have been transferred to Great Ormond Street Hospital.

This is paediatric consultant Dr Simon Nadel's unit. He tells me he's worried children's care in London could be "compromised".

"It's important to realise we are a children's intensive care unit and as you can see we are full of adult patients which demonstrates the amount of pressure the system is under," he says.

"People have said this isn't a problem for children but the indirect impacts of this pandemic are affecting children really badly. The normal healthcare system we have for children in London is severely affected.

"I wouldn't say children are not being treated properly but clearly some of their care is compromised because of the changes we've had to make to accommodate the adults.

Dr Nadel believes this winter wave was likely to go on longer than the first.

"I think this is worse than the first wave. We know from the numbers there are many more patients being admitted to hospital and there are many more patients being admitted to intensive care.

"The issue is that this peak, whenever it comes, is going to take longer to dissipate whereas the first wave was short and sharp. This is going on for longer and there is going to be a higher peak."

The healthcare staff on this unit are all trained to treat very sick children. Now they must apply their life-saving skills to very sick adults.

The physiotherapists normally treat children who weigh about 10kg but now they are having to care for prone adults who can weigh 10 times as much.

All the paediatric staff have had to adapt. Family liaison nurses Helen Avila and Jo Williams have the impossible task of acting as the only link between these patients and their desperately worried families.

COVID-19 is doubly cruel, taking away lives and any chance of a final goodbye.

"Nothing can prepare you for seeing a loved one in intensive care with all the tubes and lines," says Helen.

"It can be quite scary so before we do it we have to prepare them. Quite often they are breaking down on the phone and normally you would hug them and tell them we are here for you. We can't really do that when we are on the other end of a camera."

She goes on: "It's hard and the end-of-life situation is the hardest when we may allow one family member to come in - so the family have to decide which family member is going to come in.

"They have to wear full PPE and we might have a FaceTime camera so that other family members can be there virtually.

"A year ago would we ever think that's normal to say goodbye to your mum on an iPhone or iPad? Now it's sadly happening quite a lot."

Her colleague Jo agrees. "We were all hoping desperately that we wouldn't have to go through this again. But I think we got through it the first time and we are hopefully we will get though it again intact."

The hospital's paediatric ward is now also full of adults with COVID-19. The emotional toll is beginning to tell.

Paediatric matron Hannah Deller works on a children's ward that now has only adult COVID-19 patients. She says the shock and sadness of losing a patient stays with her for a long time afterwards.

"There was one gentleman who just so sweet and we got to know quite well and he deteriorated overnight and passed away.

"He was talking about his boat and being on his boat. There were pictures of him on his boat. When he passed away we took his pictures down and I broke down then."

This deadly crisis that has gripped the country shows no sign of easing. It is real. The patients here would say the same except they are too sick to speak.

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