Few could have predicted the sheer scale of the Covid-19 pandemic when the first cases of a new disease were located in China at the end of 2019.
However, as cases of the virus spread across the globe, health chiefs scrambled to try and understand what was happening and how it would affect day-to-day life.
By the time the first positive tests in the north-east were identified a year ago, senior officials at NHS Grampian knew the novel coronavirus would have a profound impact on society.
However, deputy chief executive Adam Coldwells says lessons were learned from across the globe – and believes the time it took for the novel coronavirus to arrive on these shores bought vital weeks which allowed detailed plans to be put in place.
“We were watching the news and my memory of it was seeing the terrible situation in Italy when their health system appeared to not be coping very well,” Adam said.
“People were really struggling and they were having temporary tents put up outside their hospitals.
“As a leadership team, we had a gathering in mid-February to ask ourselves how we got ready for it. It really built over a number of weeks of thinking how to respond locally and getting some helpful level of direction from the government about the type of scenarios we should expect.
“My strongest memory was that it was a really anxious time as we got our plan together. When you are working up the plan and don’t feel totally in control, it is absolutely anxiety-raising. I remember a moment when we agreed on our first plan that looked realistic I felt a real sense that we were not totally out of control. Suddenly we had a plan, and that means you can get everyone shooting in the same direction.
“We have extremely professional, capable staff. However, everyone was about to face something we had never faced in living memory.”
In the early weeks, after the pandemic took hold in the UK, fears rose over shortages of personal protective equipment (PPE) in hospitals across the country – but in the north-east, those concerns proved to be unfounded.
However, Adam admitted instilling confidence in the health service’s workforce was key to ensuring the outbreak could be tackled effectively.
“It took us a few weeks to get our minds to the enormity of the scale of the challenge ahead of us,” he said.
“We were preparing for intensive care to be at three, four and five times the size it would normally run at, and we were preparing for staff to come from every part of the system. The other thing that was really apparent in the early part was PPE. We always had a supply but there were reports of real shortages so it was really anxiety-raising.
“The other thing we had to think about as a senior leadership team was how we got the confidence to our staff so they weren’t concerned about coming to work, and knew they would have the equipment they needed. A lot of people were very worried, but there was real professionalism from a lot of people.
“We had never dealt with anything of that scale, so it was really important we helped people move from the training they had to being able to put that into practice every day. PPE is a really good example where people needed to be face-fit tested, then we had to do refresher training on taking it off and putting it on correctly.”
In March last year, the UK was plunged into lockdown – severe restrictions designed to limit social interactions as much as possible to prevent the disease spreading and the health service from being overwhelmed.
Since then, further national lockdowns have followed, as well as local measures – most notably in Aberdeen in August when a cluster of cases linked to hospitality venues led to a spike in numbers.
According to Adam, the restrictions worked; although services were busier than many staff had ever seen, NHS Grampian was able to continue operating.
“There was no point where we were at risk of being overwhelmed, but we absolutely got busy,” he said.
“Particularly in the second wave, it has felt extraordinarily busy for a protracted period of time, which made it extremely difficult for staff to work in that environment. It started in mid-November but by late December and over Christmas and New Year, we saw very significant peaks which were extraordinarily high and made the system very busy.
“However, I always look at the activity graph and look at how protracted it was. We are near the bottom of the curve and hopefully, there won’t be much recurrence, but from mid-November to mid-February we had three months of a lot of activity on top of a lot of the normal winter pressures. The staff have done a phenomenal job.
“At every stage, we could always go further in our plan, so we didn’t get too full – but it was pretty close. It was a really good testament to the planning the teams had done that they knew how to keep stepping up capacity.”
For more than 12 months NHS workers from all departments have made huge sacrifices on the front line of the fight against Covid-19.
Now, with a glimmer of light beginning to appear at the end of the tunnel, Adam paid tribute to the thousands of workers across the north-east for their tireless efforts.
“We have learned a lot about our staff and how to support and look after them, especially around psychological resilience,” he said.
“We have seen real adaptability in staff to reorganise how they deliver their particular expertise, and I hope one of the things we hang onto is how we continue that.
“We want to say the most heartfelt thanks to all our staff across the whole health and care system. Everyone has played a really important role, from our front-line clinicians and care staff through to all the support staff who allow that to happen, and all the many non-patient-facing workers.”
Read the second part in our Covid One Year On series here: