Following on from his account last spring, I spoke to Martin again to get an update on how the second wave has impacted the Heart of England NHS Trust. The hospital is once again dealing with a huge number of patients. The numbers grew slowly initially in late summer going from 7 Covid patients, to 15 and then 100. By September, they had 500 Covid inpatients and this number is yet to decrease as the impact of the restrictions remains to be seen.

Martin tells us that the main difference in this second wave is that the hospital is now twice as busy, because the non-Covid patients have not been sent home. It is incredibly hard work and arguably more intense this time round due to how many patients there are in the hospital. He is confident however that the lockdown will soon have an impact and lead to a reduction in the number of Covid patients coming in.

On a more positive note, the second difference that Martin has seen during this wave is that less people are dying and overall we have got better at treating the disease. Staff are now much more aware of what they are dealing with and the necessary infrastructure and protocols are already in place. Therefore, while there are still a lot of Covid patients, the percentage of those recovering and leaving the hospital has undoubtedly increased.

This is certainly a very encouraging development, and explains why the proportion of deaths to cases is much lower in this second wave. But how do we stop these waves from repeatedly coming back around? The answer, Martin says definitively, is a vaccine. Martin spoke very optimistically about the recent breakthroughs seen in the development of a Covid vaccine. In terms of rolling out a mass vaccination programme, he tells us that ‘it is difficult, but doable’ and he has every faith in the NHS being able to meet the expectations required and have the British population vaccinated as soon as it is possible. The speed with which these vaccines are being developed is incredible and once vulnerable groups of society receive it, the pressure on our hospitals will start to ease.

Covid-19 in Africa

While the pandemic has wreaked havoc and created a huge amount of work for Martin and the rest of our doctors, they have continued to provide invaluable support to clinical officers in Zambia and Malawi. Martin has been responding to roughly 15 cases per month but, interestingly, none of them have been for patients with coronavirus. While the disease does exist in Africa, it seems to have weathered the pandemic very well particularly in comparison to the rest of the world. There are many possible explanations for this, such as the African population being younger and having different antibodies. Furthermore, they are more accustomed to dealing with widespread pandemics while having little resource for medical supplies. They are used to taking very broad and rapid measures to stop diseases spread and protect public health. Perhaps there is a lesson to be learnt here in the West from how African countries have tackled the disease.

The bigger problem for Africa, is the detrimental effect that the pandemic has had on the fight against TB. This is a big issue worldwide and, Martins says ‘the TB program has now been knocked back by at least 3-5 years and it has been calculated that this COVID period will mean millions of excess deaths from tuberculosis.’ The shift in focus and prioritization of Covid patients is a major roadblock in the eradication of TB. Martin adds ‘It’s devastating because many countries have worked so incredibly hard on the WHO’s ‘Eradicate TB by 2050’ campaign and want to have it as a ‘not important disease by 2035’. That was going to be tough, but people were getting there, and I think it might be impossible now.’

It is fascinating to hear an expert insight into, not only the UK’s response to the pandemic and the impact being seen, but also that in Africa. It serves to show there is a lot to be learned from other countries. We are immensely grateful to Martin and the rest of our virtual doctors for their work on the frontline of the coronavirus response.