COVID-19 across the pond: Alumnus Fatimah Jaffer talks being a hospital pharmacist in England during the pandemic
“One of the doctors asked a senior pharmacist what blood work he should monitor for a patient who tested positive for COVID,” she says. “The pharmacist said she didn’t know. And how could she? No one knew anything about this new virus. One week, we were avoiding ibuprofen and a few weeks later it was being investigated as a treatment option.”
In England, where Fatimah has worked as a pharmacist since 2019, COVID-19 hit harder and faster than in Canada. The United Kingdom has a much higher population on a much smaller land mass, and this combination gave the virus ample opportunity to run rampant. As of early June, the country has seen over 40,000 deaths from COVID-19. Fatimah worked many long and hard days caring for patients and providing support to team members.
“Every day was incredibly fast-paced and anxiety ran high, especially in those first few weeks,” Fatimah says.
“At one point, the hospital was running dangerously low on oxygen. A normal month’s supply was now lasting only two days. But we worked hard and adapted, adding extra oxygen cylinders and approximately 70 additional ICU beds to accommodate for the influx of patients.”
The Royal Free Hospital is a large teaching hospital with over 800 beds, numerous specialty departments and expertise in caring for a variety of illnesses like infectious diseases, renal and kidney transplants and HIV. The hospital cared for Ebola patients a few years ago and it was one of the first hospitals in the UK to admit a patient with COVID back in February.
The Care of the Elderly ward at the Royal Free has a tree mural painted on the wall. Staff place paper butterflies with the initials of all the patients with COVID-19 who were successfully discharged.
Fatimah rotates through various clinical specialties, providing medication management expertise to colleagues and patients. She also reviews patients who are on COVID-related clinical trials.
“During the peak, we received almost daily emails on new clinical trials. It was challenging to keep up, as we were running seven COVID-related trials simultaneously.”
As a hospital pharmacist, Fatimah is responsible for reviewing and understanding the protocols that govern each trial. She assesses patients in the trials, ensuring that they are not on any drugs contraindicated by the trial protocol, and monitors their blood tests for changes. The Royal Free was the first hospital in the UK to try remdesivir for patients.
Outside the walls of the hospital, Fatimah has seen COVID-19 transform London. The metropolis of nine million people was under city-wide lockdown from March 26. Restrictions are slowly being lifted in some areas in a phased approach based on case numbers. Fatimah’s work hours changed with staff being asked to put in extra time on weekends and evenings. Her commuting time became significantly longer as trains and buses came less frequently.
“Sometimes I was the only person on the platform at King’s Cross Station — a major public transit terminus that is normally packed. It was incredibly eerie.”
Fatimah went from being responsible for fifteen patients a day to sixty patients a day during the peak. England’s National Health System (NHS) was the first universal health-care system in the world and no one is turned away. Those living in the area are very proud of it and each Thursday at 8pm during the pandemic people across England stopped to clap for their carers.
“The clapping is quite emotional to hear after a long day of work,” Fatimah says.
Sidewalk art that was painted outside the hospital
The Royal Free Hospital supported many COVID-19 patients through the worst of England’s spike in cases. Today, health-care workers are adapting to what the current caseload allows, returning staff to normal working hours and re-starting some elective surgeries. Visitors are still not permitted and the staff continue to wear masks and scrubs on the wards and visors when speaking to patients.
The hospital also implemented measures to support morale through those dark days. They offered counselling and support services to all employees and created rest lounges so that staff had a place to go to when they felt overwhelmed. Throughout the pandemic, the Royal Free’s CEO sent daily updates to keep staff informed of the changing situation.
The team spirit through all of this is part of what kept me going. We’re in it together, trying to survive and safely care for and discharge as many patients as we can. I went home every day knowing that I did the best I could given the information and resources I had. It was sink or swim, and we had no choice but to swim.
To keep swimming, Fatimah makes sure to take care of herself on her days off. She exercises, calls loved ones and is sure to bake some of that pandemic-staple banana bread.