Chris Bailey is a haematology registrar and PhD student in the Cancer Evolution and Genome Instability Laboratory, studying cancer cells, tumour evolution and drug resistance.
I was re-deployed to Northwick Park Hospital to work on the inpatient haematology ward. I have been looking after patients with haematological malignancies and COVID-19 infection, and others who required urgent chemotherapy or had had complications of their disease. It was great to work with some old colleagues as part of a big effort to keep the service running.
During the peak of the pandemic, I helped put together a ‘COVID bulletin’ – a bi-weekly collation of information and the latest evidence surrounding coronavirus. This included serological testing, the history of coronaviruses and the evidence behind asymptomatic spread. Early on, we noticed the mounting evidence for asymptomatic transmission and this allowed us to publish a compelling argument for screening healthcare workers.
My experience during the pandemic period has reinforced my decision to train as a clinician scientist. Looking after patients is a privilege, as is working in science. The same impetus, innovation and collaboration being shown during this difficult period can be used outside of COVID-19, and I hope as a research community we can benefit from this, and in turn, our patients.
Bernard Maybury is a haematology registrar and PhD student in the Immunity & Cancer Laboratory, studying chemotherapy resistance in lymphoma.
In March, Birmingham was one of the most heavily affected areas, so I went to work in the intensive care unit (ITU) at Heartlands Hospital in the east of the city. Our induction included a crash course in ventilators and other ITU treatments, but we also discussed the psychology and fears of staff re-deployed to ITU. Some were to be expected (e.g. fear of catching the virus) but many staff were also afraid of throwing their usual rulebook aside.
When I arrived at Heartlands, ITU was three times its usual size and full of ventilated patients. In the early days, shifts were mostly spent turning patients on their front to improve their ventilation and changing the ventilator filters, which got sodden with virus-filled moisture and suctioning mucus to clear their airways. It felt more like an assembly line than our usual hospital medicine.
What has been great to see during this experience is the way staff from different fields have adapted and worked together. COVID will fade (though possibly not all together) whereas blood cancers will remain a cause of considerable death and morbidity. A clinical research career is a long project, so I wouldn’t say the pandemic has directly changed my focus.
Lucinda Tullie is a paediatric surgery registrar and PhD student in the Stem Cell and Cancer Biology Laboratory studying stem cells and tissue engineering.
I went to Great Ormond Street Hospital to work as a paediatric surgery registrar. The hospital was much busier than usual, since we were admitting children from across North London as local hospitals took adults only to try to accommodate the increase in COVID admissions. I did see a number of children with COVID however, they seemed to present with different clinical symptoms to adults – abdominal pain or general inflammatory symptoms, rather than respiratory symptoms.
From a personal perspective, the period of lockdown illustrated how much I struggled with staying at home, so I felt fortunate to be able to go to work and feel like I was being useful. Like many other medics I have spoken to, whilst there was uncertainty and stress, working different hours and being out of your comfort zone, the shared experience and teamwork certainly fostered a sense of camaraderie. There was also an immense amount of good feeling and support from the public.
The whole experience has validated my decision to pursue research alongside clinical medicine. A global pandemic certainly crystallises the importance of research and good quality evidence to underpin both medical practice and policy decisions.
Emma Wall is an infectious disease physician and a clinical postdoc in the Tuberculosis Laboratory, investigating how to improve outcomes from bacterial meningitis.
When the pandemic started to ramp up, I was asked by my clinical colleagues to return to the hospital as part of a huge team of academic physicians manning the front line. I was working at UCLH in acute medicine and we were incredibly busy, spending most of the day with sick COVID patients, donning and doffing PPE.
We worked very closely with our colleagues in the emergency department and the intensive care unit and together made some very difficult decisions about clinical care. Talking to patients about these decisions, including end of life care, while wearing PPE and without loved ones present, was one of the most challenging aspects of the pandemic.
During the pandemic, I have become even more of an advocate for translational clinical research, to inform both clinical decisions and policy. Over the last six months, the speed of sharing data, clinical reports, trials and vaccine development, has been incredibly impressive. I’m very aware that other infectious diseases, including meningitis, risk losing substantial gains made recently due to the focus on COVID. I am determined to complete my fellowship and support Crick science and UCLH clinical research to deliver the best for patients in the COIVD era.
I was re-deployed to UCLH on a COVID ward, treating adults of varying clinical severity. I worked alongside other clinical PhD students and between us, there was strong team morale. Our ward had the feeling that we were all in this together, which was a privilege to be a part of.
At UCLH, I was able to get involved with clinical research as part of Professor Michael Lunn’s neuroimmunology team. We analysed patient blood samples (known as cytokine blood profiling) and correlated these with markers of their clinical severity (e.g. oxygen requirements, need for intensive care). We found three biomarkers that are predictive of poorer outcomes – interestingly, these biomarkers are traditionally seen with bacterial rather than viral infections.
There is an argument that clinician scientists should switch their research focus to address COVID-19, which is the major healthcare crisis of our lifetime. COVID-19 has become a distraction and we need to find a careful balance within the research community. At UCLH, I was fortunate to see medicine at its very best. The pandemic has brought into razor-sharp focus the importance of translational research - without a vaccine, COVID-19 will be with us for a long time to come.