Monday, April 27, 2020

Week 3

Monday 6th April

Arrive in work. Find out I'm so experienced at swabbing, that I'm now deemed to be a 'Trainer'. Word is that the Trust wants to open a second site and we need enough staff to work both on a 7 -day shifts. Given that a full shift is from 8am -6pm I agree to work four of these days a week, with 3 days off. This week I offer to work over the Bank Holiday  (Fri,Sat,Sun). We have a busy day today with 76 people swabbed. Get home tired, but feel I have achieved some good.

Tuesday 7th April

Just before we went into lock down, I'd had a trip through B&Q and bought a few packets of seeds/bulbs for growing a bit of food. I had a few spare containers and thought I'd try planting a few up.

Some of my grass cuttings get tipped behind a tree in one of the far corners of the garden (some goes in the green wheelie bin). Over time this has now composted down and looking good for filling the pots. So I set to work.

I manage to plant some Garlic, Shallots, Carrots and Parsnips. All the pots set up on the far patio. Head back indoors for a well-earned cuppa with my feet up admiring my handy work. Next thing see 'roly' rat again, running across the far patio and dart behind the tree where the compost heap was. I head back outside to see if I can spot where it went but no sign. This is getting serious, rats are normally nocturnal creatures. Head back indoors and straight on google. A wealth of information, all pointing to the fact that I've been unwittingly welcoming them into my garden by providing them with places to live, food (bird feeder) and sources of water.

Wednesday 8th April

A closer inspection of the fence around the garden indicated possible areas where they were accessing my garden from the neighbours. There was evidence of a few droppings in one area near to where the compost heap was.  One neighbour is in the process of renewing the fence and chatting to him about 'roly', he said his kids had spotted FOUR in his garden recently, some of which were trying to climb up his birdfeeder!

Spend the rest of the day clearing away any possible nesting sites (dead leaves/wood), empty the bird feeder and any possible water sources. Check round the house for any possible gaps for a way in. Block as many gaps in the fence as I can. Now realise that all my efforts planting up my pots were to no avail. All the soil could be contaminated by the rats. Ah well, I'll call it the practice year, see if anything grows and try again next year.

Thursday 9th April

Ring Bolton Council. Dealing with Rat problems is free to residential properties. Due to Covid-19 the Environmental Health office is closed. Another search on the Internet, comes up with a few private companies that might be still working. Send an email requesting a ring back.

Good Friday 10th April

Back in for the swabbing rota. They'd had a busy day on the Thursday having seen a record 80 people. We now have a live booking system, which is being updated on a regular basis as and when appointments are being offered to the persons requiring swabbing. Much better than relying on an email. Not as many today, but not too bad with 60 done.

Saturday 11th April

We're overwhelmed by people's generosity. We've got people dropping off visors they've made, washing bags for our clothes, and now we hear people are making sets of scrubs too. The majority of staff redeployed, work for services that don't normally wear a uniform. I'm lucky, I do have uniforms but I've made a little addition by making myself some identical buffs to wear to cover my hair whilst working. The head of the Health and Wellbeing department (they're the ones sending us the people to be swabbed) calls in and drops of a Easter Egg and some chocolate. Going to have to make a concerted effort to up my training with all the snacks. Only 36 swabs today. We think that most are out enjoying the sun.

Sunday 12th April

We definitely think no one's phoning in sick over the Bank Holiday weekend. I mean, why would you? Only 30 done today. But we have managed 425 for the week, and just over 600 since we started. An amazing achievement having started from scratch less than 2 weeks ago. Rotas are being planned for a few weeks ahead. I feel I need a bit of regularity to help with my running, so offer to do Weds Thurs Sat Sun as my new working week.

Start planning a off-road route from the house (well as near as I can get it). Time to re-visit Cutacre Country Park.

TF



Friday, April 24, 2020

Are we downhearted?  Never

How is everyone coping with the lock down? TF we know is very bravely active in helping the fight  against the virus.

Our  household went into isolation a week ahead of the  official start and we are thankful that we have the allotments to keep us busy most days, and the sunshine is a welcome bonus.

The initial disappointment of the cancellation of all races has passed because it makes sense.  More of a blow was the cancellation of the Fleet  half marathon on March 16th. It was to have been my second opportunity to wear an England vest having again qualified for the English masters half marathon championships  and secured a place in the England   team for the Celtic  nations event. We had travelled south in readiness for the  event only to hear less than 24 hours before the gun that  the race was off.

I try to run most days but with no challenges to aim for motivation is sometimes lacking.  Which takes me to EtU's  forward looking approach to a post lock down celebratory run.  My first choice would be the  last of our Lakeland passes outings from Seathwaite via  Sty head to Wasdale head, Black Sail, returning via Honister,  followed by, in no particular order,  the second Lakeland passes run in reverse (Rosset, Sty Head, Wasdale Head, Boot, Eskdale, Three Tarns and returning via the Band),  something in the Settle area, or a repeat of our Edale outing.

Now the  thought of that coupled to the sun shining through the window should provide some motivation







Tuesday, April 21, 2020

Week 2

Monday 30th March

Still getting used to the extended 'lie-in'. I'd stopped going to the David LLoyd Gym for my morning exercise (shower & coffee) 2 weeks before lock-down. I've had to completely reprogramme the heating and amount of hot water now that I'm having my morning shower at home. On the plus side, David Lloyd have frozen the membership, so hopefully that'll cover the increase in gas & 'lecky.

Decision made that I and some of our Dental Nurses are drafted in to help the swab team. A small van has been hired so we don't have to use our own cars, but someone will have to go and collected from the site where it is securely located.

We've practised putting on/off or in NHS terms 'donning&doffing' the PPE. We've had a look at the test kits but still haven't had a 'live' patient to 'have a go'. I sign up to offer to do a weekend shift as is seems that some of the current team are starting phone in saying they're self-isolating.

The training from Friday left us with a lot of online courses to complete. Make a start on these just in case I get called up to help with the District Nurse teams.

Tuesday 31st March

Arrive in work to find things have all changed again. One patient who is looked after by the District Nurse Teams has been diagnosed with Covid-19. There's a list on nearing 20 staff that have been involved in his care over the last week. Community Managers make the decision to swab all of these staff otherwise they'd all be off work.

So the Dental Department is designated as the most suitable site for these staff to attend. We (dental team) get a live demo of the technique and get some 'willing' guinea pigs to practice on.

I have to warn you that having a swab for Covid-19 is not pleasant if it's done properly. The one in the mouth has to swipe over the tonsils and the wall at the back, past the dangly bit (uvula). It'll make you gag/cough. The nose one has to go far enough up that it'll make your eyes water.

Image


By the end of the day, we've swabbed most of the day shift. Just some of the night staff to catch up with.

Wednesday 1st April

More changes. The central mobile swab team is going to be a fixed-site team for staff-swabbing to attend as a 'drive-in'.

The estates department have located an ideal site, a health centre not a million miles away (one, to be precise) where we will take over a pharmacy department which has recently closed down. We will be off there in the afternoon to have a trial run with a couple of staff who are currently off work, self-isolating for one reason or another.

So I and 3 of our nurses travel to our new site. We arrive to see that we have indeed got a ideal set-up. Facilities to make brews, a toilet, somewhere to sit in the dry and somewhere to store (and lock away) all the kit we'll need. Sorted! Some from IT is sorting out lap tops and wifi connection.

The staff car park has been commandeered for the drive-in. We have a security guard (in a cabin) with a remote door bell to announce an arrival, 2 disabled parking spaces right next to the front door for the cars to park up.

The first email with details comes through and the cars start arriving at 10-20 min intervals. Someone goes out to the car to check the details, and then reports back and the information is completed on the swab test. 2 members of staff go back out to the car (the swabber and buddy) and undertake the swab test through the car window. By the end of the afternoon we've completed 13 tests.


Here's the team at the end of the first day.

Thursday 2nd April

First full day at our new site. Now the process has started to feel a bit more comfortable the Trust is looking to increase the through-put. So we look at managing  2 staff to be swabbed every 10 mins. We calculate that we'll need a minimum of 6 staff to manage this, 2 pairs of swabber/buddy, one person checking details, 1 person admin checking for emails. The whole shift day is 8am-6pm, with staff doing 8-4, 9-5, 10-6 as well as a shift lead doing the 8-6 hours.

I volunteer to be a shift lead. Given that I nominally do a 37.5hr week this will mean a change from working 5 days of 7.5hrs to 4 days of 9 and a bit hours. I offer to cover weekends. So as I've already done 4 days this week, I'm having a day off tomorrow in lieu of working Saturday.

33 swabs done today. We have a couple of children to swab today as they're the ones with symptoms causing their parents (staff) to be off work.

Friday 3rd April

A relaxing day off. Or it was until I spot 'roly' rat run across the far patio. Mmh, will need to keep an eye on this if the bin collection becomes a bit more sporadic.

Saturday 4th April

Last time I worked a Saturday was over 25 years ago. How times change. We have some new members on the team, all eager to join in. We have a whatsapp group now, not something I'd used a lot, but getting used to it. Seems that a lot of the other community services use it a lot to keep in touch.

40 staff/family members swabbed today. It takes 48hrs for the results to come through, but could mean some of these will be back in work next week if the results come back negative.

Sunday 5th April

Another day off. The grass is looking a bit long and infiltrated with lots of moss. A nice sunny day so decide to tackle both instead of a run. I have 2 machines, one that cuts the grass and the other that scarifies it. 2 x the 'steps'. The amount of moss the scarifier pulls off is immense. It fills two of those large foldable plastic green waste containers. Would be perfect for filling hanging baskets, but I don't have any.

A glass of wine to finish the week.

TF

Monday, April 20, 2020

When This Is All Over...

… we ought to have a celebration outing, locally, in the Lakes, or anywhere interesting, but not too far away. Initial suggestions:-

1. The Lakeland Passes - as done previously, possibly with minor modifications.

2. Scafell Pike from Eskdale, ascending over Pen, descending the way the sheep did - see TF's recent post.

3. Coope's Dozen.

4. A route in north Lancashire - as (yet to be) determined by KLM, aka The Iceman.

Further suggestions, comments please.

I think it needs to be on a Saturday, to include those (few) of us who still contribute to the  UK GNP.

Tuesday, April 14, 2020

View from near the Frontline

I thought I'd pen a few lines as part of an insider view from near the frontline.

Mon 23rd March (First day of Lockdown)

All working as normal. 4 final year students arrive for a nearly fully booked clinic. By the afternoon any students with underlying medical conditions eg severe Asthma are advised not to be involved in clinical care.

Dentistry in the main is an 'Aerosol Generating Procedure' especially using the drill or scaler which is water-cooled ie the high-pitched whizzy ones.

The British Dental Association (BDA) and some of the other Professional Societies are voicing concerns and calling on the Chief Dental Officers (CDOs) for guidance. There are 4 of these one for England, Wales Scotland and Northern Ireland


Tues 24th March

This morning would have been our fortnightly GA list for treating our patients with special needs and learning difficulties. It has been cancelled, as has all elective surgery ie non-urgent operations.

In the afternoon we have 2 out of 3 student dental therapists attend to see patients. A few simple treatments that don't involve a drill or water-cooled scaler.

By the end of the afternoon we learn that all student clinical sessions at the Dental Hospital have stopped.

Management make the decision that routine care will now cease across our service. We will operate an emergency-only advice service, triaging over the phone and only see patients face-to-face unless they present with a facial swelling which may require anti-biotics. No 'Aerosol Generating Procedures' to be undertaken.

BDA are now getting very vocal on social media. The CDOs for Wales, Scot and NI are advising downing tools accept for emergencies. Not a dickie-bird from the CDO for Eng.



Weds 25th March

A busy day. Mainly phonecalls and emails. We have a large service, over 40 staff. Discussions are ongoing towards re-deployment to help other services. Each service within the Trust is asked to provide information for potential transferable skills. My health centre where I'm based has become one of the 'command' centres co-ordinating the community care. Being a senior clinician, I get to see first hand how the senior managers get to 'think on their feet'.

The RU Clear team (sexual health) were due to be disbanded at the end of March 2020 as their funding had run out. They are now the Community Swab Team. The plan is to run a service 7 days a week across Manchester to under-take Covid 19 swabs in peoples homes. I'm already thinking that swabbing is something that the dental team could help with. After all, we spend all day with full PPE on and are used to putting things in peoples mouths. We're also used to doing home-visits from time to time too. The clinical lead for our service is thinking on the same wavelength.

Stocks of PPE are being counted.

Finally we get notification from the CDO Eng that all routine and non-urgent dental care should be stopped. A remote 'urgent care' triaging service should be established. Those patients deemed to need care can be referred to the Local Urgent Dental Care System. Trouble is, there isn't one. Dental treatment is now deemed as high-risk. So essentially providing it will need the most protective PPE. This includes the special FFP3 masks. No one has been 'fit-tested' for the masks.

Before you can use a FFP3 mask you have to be 'fit-tested' for it. This involves putting the mask on, and then a special hood is then placed over your head and then some smelly substances is puffed inside the hood. The idea being that if the mask has a good seal it should filter out the smell and thus any virus particles. They are deemed as 99% effective.

You have to be 'fit-tested' for each make of FFP3 mask. There are numerous makes. Some will fit, some won't. For men with beards, these have to be shaved off as a seal can't be created.

I'm on a half-day today. I booked for someone to come and install some security cameras on the house. There'd been and an attempted break-in about 3 weeks back - broken padlock on side gate and an adjustable spanner left gripping one off the handles of the French windows. I ummed and ahhed about whether I should go ahead, but decided I could maintain the social distancing and given that my house would likely be the only vacant one in the cul-de-sac, it would be at risk.

4 cameras installed. With a good view of the back and front. If I hear a noise especially at night I can switch the TV on in the bedroom and check with out getting out of bed. When out of the house I can check via my phone, even has a notification system if something crosses a virtual line across the back garden.


Thurs 26th March

Another day spent refreshing the BBC news website. Emails read. Our service is planning to run with 2 sites (out of 8) offering emergency advice. A rota has been drawn up beginning from Mon 30th March.

Tidying out my office drawer I find my certificate for my FFP3 'fit-test' for 2009 in preparation for H1N1 (Swine 'flu). Re-read the government documents from the time regarding planning for an epidemic, mass deaths etc. Don't feel we're anywhere near where we were in preparation for H1N1 by this stage.

We've been skill-matched with the District Nurses. 10 of us have volunteered to be the initial trainees. A full day of training planned for tomorrow.

Fri 27th March 

Arrive at the training centre. Been a long time since I'd been at this particular health centre. When I first started the current job in 1998 we used to have a dental clinic here and I worked there 3 days a week until I moved full time to current Health Centre in 2001.

Full of admiration to the 2 District Nurse Matrons who have pulled together a training package for the dental team in less than 2 days.

An overview of wound care and dressings, injections and general medication. All bread and butter stuff to them but a real eye-opener to us especially the pressure-sore management.

Advise the trainers that I'd recently had experience of administering Heparin Injections for my Father (part of my Xmas trip duties). Admit that a bit nervy at first, got one a bit wrong but on the whole the patient tolerated it quite well.

Sat 28th March

A short local run. I'd set my bike up in one of the bedrooms on the turbo-trainer but haven't used it yet.

Sun 29th March

Catch-up phone calls with the family. 2/3rds have been on lockdown for 3 weeks now. The ones in France have to have a certificate to leave the house. Carers in Tenerife are looking after Ma & Pa very well, daily visit and doing the shopping for them.

Reflect with my Uncle (dad's brother, lives in Worsley) that cancelling the Cruise and selling the car are looking like 2 of the best things I have ever done. They would have been due back in Bristol on Tues 24th March. I was due to collect them from Bristol to bring them back to Bolton and then fly back to Tenerife on Sat 28th March.

One bonus, the 3 flights from Liverpool to Tenerife were cancelled by Easyjet. I'd written them off at Xmas but had left them booked just in case. A full refund acquired.


End of week 1 of Lockdown

At the end of the week, I reflect that it's all very surreal. I feel very privileged to still being paid a wage but want to feel that I'm doing something to help.


To be continued.........


ps if you want a 'fell' fix have a look at this programme that was aired on BBC4 on Mon 13th April at 7:00pm. You can get it on iplayer, called The Great Mountain Sheep Gather

https://www.bbc.co.uk/iplayer/episode/m000hb4r/the-great-mountain-sheep-gather

For the map nerds, I watched with my os map to hand

TF