It’s difficult to pinpoint precisely where it’s all gone wrong. Recent weeks have seen a rapid spread of Covid-19 cases throughout the UK, with increasing pressure on NHS services.

I’m one of a number of frontline NHS doctors currently self-isolating due to contact with a Covid-positive colleague.

Working with the Doctors’ Association UK, we have heard numerous cases of doctors facing uncertainty with regards to testing, caught in the middle between conflicting local and national guidance. 

Make no mistake, we are currently in the thick of the coronavirus “second wave”. Wards are full, and many are becoming dedicated Covid-19 zones. The numbers of patients in ITU beds and on ventilators are increasing, meaning planned surgery is having to be cancelled again.

The lack of clarity on testing for healthcare workers is leaving hospitals understaffed and underprepared when the NHS and the public needs them most.

On paper, the rules are simple: we should wear personal protective equipment (PPE) at all times, stay distant from each other, and follow rigorous hand hygiene. Only stay home if you test positive, develop symptoms, or are told to otherwise by NHS Test and Trace.

In practice, as the general public has found with coronavirus guidance, confusion has reigned supreme. One doctor, who wished to remain anonymous, was initially told they must return to work despite having a confirmed exposure. On arriving in their hospital department, this doctor was told they must return home to self-isolate immediately.  

Others were told to return early and await contact from the dysfunctional Test and Trace scheme – in the news recently for missing 16,000 cases due to using old Excel spreadsheets – only for advice to never arrive. 

More worryingly, other doctors have spoken about coercion by hospital management to get them back into hospital and out of isolation, risking a repeat of the silencing of healthcare workers in the early phase of the pandemic over the issue of PPE supply.

In one instance, a doctor isolating due to a symptomatic housemate was brought back to work prior to their test result and placed on a cancer ward with patients undergoing chemotherapy. An outbreak of Covid-19, in areas with such vulnerable patients, could spread like wildfire with fatal consequences.

It’s difficult to accurately portray the impact of absences on hospital wards. Given the chronic shortage of NHS staff, even in normal times, wards often work on a knife-edge. Even minor reductions in staffing numbers can lead to increased stress of colleagues, missed diagnoses, and sometimes, tragically, deaths.

With an already exhausted workforce, all must be done to maximise the workplace conditions of NHS workers, with clear isolation guidelines and a fully functional test and trace system integral to this.

There could be an argument for leniency when it comes to judging the impact of Covid’s first wave – it was an unprecedented novelty, despite clear and obvious warning signs from previous pandemic planning in the form of Exercise Cygnus.

There can be no such excuse second time around. The government has had five months to improve on past mistakes — they have failed in this regard. On the frontline it feels like a depressing deja vu.

The first wave saw NHS healthcare workers going off sick en masse as they were unwittingly exposed to the virus due to a lack of safe and effective PPE.  Valued colleagues lost their lives.

At the Doctors’ Association UK, we called for an immediate inquiry into these failures – to prevent the same errors from recurring.

To date, the government has been unwilling to commit to an independent judge-let inquiry on this failure. The reluctance to initiate an inquiry represents a lost opportunity for the UK to learn from previous missteps and improve its response to Covid-19 this winter. It implies a need to put politics ahead of lives.

The first wave of coronavirus was a gut punch to the country and the NHS.

Without clear local and national guidance for healthcare workers, a second wave may be even worse, with grave consequences for NHS and care workers as well as the public.

Matt Kneale is a foundation doctor working in the North West of England, and previously worked in global health. He is a committee member of the Doctors’ Association UK.

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