“It maybe feels like we don’t deserve all of this… It hasn’t hit the surge yet” – Dr Claire McLaughlin

“You’re having to tell relatives, ‘You’re going to have to sit and wait in the car. This could be the last time you see your relative, right now’.”

At 8pm, last Thursday, hundreds of thousands of us, across Ireland and the UK, took some time out to give the carers, emergency services and healthcare workers a rousing round of applause. For those of us not on the frontline of the COVID-19 battle, it was a small gesture of support and solidarity.

For Claire McLaughlin, who works as a doctor at Ulster Hospital’s Accident and Emergency department, the applause and fireworks echoing around Belfast was moving.

“It feels a privilege to work for the healthcare service and being able to get that sort of appreciation; it does mean a lot,” McLaughlin tells us. “I was sitting in here last Wednesday night, on the phone, and I heard cheers outside, and I was like, ‘What is going on out there?’

“So I went out on the balcony and there were so many people lined along the street, clapping and cheering, and then there were fireworks going off. And it was just… it brought a tear to my eye. I was pretty emotional with it. It was so nice.

“And even just acts of kindness from local businesses, and people bringing in food and coffees, and loads of different things, to the guys in A&E and within ICU… We’re just seeing loads of people being really, really generous and really appreciative for what’s going on.

“And I guess at the minute, it maybe feels like we don’t deserve all of this. Like, it hasn’t hit the surge yet and it hasn’t gotten bad yet. But it is lovely to see that people are behind us and really supporting us.”

The fact that McLaughlin feels the lavish attention is not fully deserved speaks of two things. Of the Ulster and Ireland rugby international’s modesty and the chilling fact that the worst is yet to come.

McLaughlin comes from a farming background in North Antrim and got into rugby through tag, at 16, before joining a newly established ladies’ team at Ballymoney RFC at 18. Within the space of a year, she was lining out for Ulster Rugby and has played the best part of a decade with them.

Along with Grand Slam winner Ashleigh Baxter, McLaughlin was one of only two Ulster representatives of Ireland’s squad when they hosted the 2017 World Cup. Like her Ulster teammate, McLaughlin has been able to play in the centre and back row for Ireland such is her adaptability.

As recently as March 5, the 28-year-old was named in the Ireland squad ahead of the Six Nations game with France, which was later postponed like the rest of the tournament. Around that time, McLaughlin got back to the family farm to see her parents, John and Pamela.

“Dad has sheep and he’s in the middle of lambing at the minute,” she says, “so they’re currently in self-isolation at the minute, which is perfect. They’re not leaving the farm!

“I went home, just before all of this kind of kicked off, because I knew this was coming and I knew I’m not going to want to go home and see them once I’ve been working in hospital. You could see from the other countries that they were going into lockdown, which we’re now in as well. I knew that would be maybe one of the last times I’d see them. I guess that weekend I tried to bring it home to them how important a thing this was and how bad it could get.”

The past two to three weeks, says McLaughlin, has been all about adapting at Ulster Hospital and preparing for the COVID-19 cases to dramatically increase.

She continues, “I think we’re still experiencing the calm before the storm, in terms of the Coronavirus… we’ve been restructuring the whole A&E department. We’ve now got two separate A&Es. There’s one for COVID patients and there’s one for regular patients who don’t have any symptoms of COVID. So there’s been a whole change-up in how we do things, which has been hectic enough.

“We’re now starting to see more and more patients coming through with symptoms of COVID, and more sick people as well.”

McLaughlin has worked for the past few years as a Locum, a doctor that stands in for another when they are sick or on leave. That often allows her to work her training and playing schedules into work commitments but all of that has been pushed to one side for now, and for the foreseeable future.

Asked to give a typical day at Ulster Hospital’s A&E, McLaughlin comments:

“In A&E, you tend to do nine or 10 hour shifts and within that you’d do four or five hours in the COVID part of A&E. so that’s wearing the PPE (Personal Protective Equipment) – the mask, the gown and gloves. After those five hours, you’ll have a break and then usually go into the regular part of A&E.

“And then we also do an hour basically acting as bouncer on the door of the hospital. So that’s just screening patients to see – Do you have symptoms of COVID? Checking their temperature, checking their oxygen levels and deciding which end of A&E they need to go in.

“So it’s quite enjoyable, doing that bouncer job, but it’s also difficult because if they’re coming in with symptoms of COVID, they can’t have any relatives go in with them. You’re having to tell relatives, ‘You’re going to have to sit and wait in the car. This could be the last time you see your relative, right now’. They wouldn’t be allowed into the hospital if that patient then gets admitted. So it’s tough enough, in that regard.”

As most doctors would attest, there needs to be an element of counsellor in their make-up to help assure patients, and family members, that the very best is being done for them.

“It is difficult in that sort of scenario, where you don’t know if that patient is going to be admitted,” she adds. “The patients themselves and the family, they don’t know.

“So there’s just a whole lot of uncertainty and fears. I think it’s just an anxious time for everyone. Never mind those people that are coming up to A&E. There definitely is fear and part of that is expected and I can totally see why people are feeling that way. And it can be difficult, at times, to try bring that down and talk them around.”

One of the big talking points, in recent days, has been healthcare staff and carers having access to proper Personal Protective Equipment, and enough of it. We are seeing, the world over, increased cases of healthcare workers contracting COVID-19 and others that are working with inadequate supplies.

After the death of American doctor Dr Frank Gabrin, who picked up COVID-19 when seeing to patients in New York, his friend Debra Vaselech Lyons declared that sending frontline workers out without proper PPE was ‘like asking a soldier to go to the frontline and giving them nothing… nothing to do their job’.

“Personal safety is definitely one of the things that is being emphasised for us,” says McLaughlin. “Every morning we’ll have a safety briefing and we’ll go over everything that has happened in the department overnight.

“And it’s always emphasised that your Personal Protective Equipment is so important, washing your hands and making sure you’re doing everything you can to prevent the spread yourself.

“One of the consultants in the A&E we’re working in, she said that a positive outcome from this would be that none of her staff end up in ICU (Intensive Care Unit) or dying from it, so I think that sort of brought it home. That this is a big deal and we do need to be really careful here.

“We’ve been told that we should be wearing gloves, apron and mask. That’s what the public health agency has said, that that’s what is adequate for us, to protect us. I’m not sure with regard to the stocks of it or whether there’s enough for us. I’d hope that there is and, if there isn’t, I’m sure that we’d get more in. So I’m hopeful that we are going to be well enough protected.

“Obviously, there’s different levels of PPE that you have to wear. Within the non-COVID A&E, we’re wearing masks because you have to be suspicious that anyone without symptoms of COVID could have it. So there’s been patients that have been coming in through the regular A&E that have then developed a fever or cough on you. Then you have to stand back a bit and think, ‘Okay, we’re going to have to move you down the other end of A&E’.

“So we’re just wearing a mask in there and in the COVID end of A&E, it’s the three bits of equipment – the mask, the apron and gloves. And then you have the full gown, the visor and the FFP3 mask for the aerosol generating procedure. I haven’t actually had to wear the full gear yet. I haven’t been in a scenario where I’ve had to. No, hopefully there will be enough and, if not, that they’re getting it in over the next week or two.”

McLaughlin now has a heightened appreciation of the team that work and her hospital, and care centres around the country. “It’s not just the doctors and the nurses,” she comments. “It’s the allied healthcare professionals, it’s the porters, the cleaners. Just so many people that are coming together, who are so important to make this all work and keep it running smoothly.

“We’re all having to adapt to new things. And I guess, with working in the hospital, you’re used to adapting to changes, but this is really showing that everybody’s coming together and there’s a real team effort there.”

“And I suppose for our nurses,” McLaughlin adds, “they had strikes not so long ago and they got an increase in their pay. And I think this will just show how important everyone is within this. Not just the doctors and nurses but everyone else within that team, within the hospital.”

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Working long, laborious days and facing an oncoming wave of admissions, Claire McLaughlin admits that it occasionally tests her will when she hears of members of the public not adhering to government advice to stay at home as much as possible.

“It does [get to me] a bit. And I don’t think it’s because I work in a hospital. We’re being told, everyone is being told what they need to do to try and slow the spread of this. And it’s even just… I feel it’s stupidity and people should be following what they’re being told. And I don’t understand why some people aren’t because we’re being told to do it and we’re being told why we need to do it. So I just don’t… yeah, it frustrates me a lot!”

For McLaughlin, and many others in health services, there is that grim but practical realisation that the worst is yet to come. The Ireland rugby international and all of her colleagues at Ulster Hospital are doing what they can, but they need our help.

“I’d say this whole self-isolation and quarantine from people, and staying home,” she says, “has probably been a bit of a novelty for the past while, and people have probably been enjoying it. But it is going to become more difficult and it is going to become the new norm, as everyone keeps saying.

“So I think it’s even more important, over these next few weeks, to stay at home and to do the things that we’re being told by the government. Stay at home. When you’re going out, social distancing is so important. There’s people going out to beaches and parks and huddling in groups. I know that [distancing] is going to be enforced over the next while.

“It’s just so important to do these things because it these little things that are going to make the difference.”

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