A care home worker has expressed his gratitude for reassuring ‘brotherly’ support given by Royal Surrey’s Virtual Covid Clinic after his experience of catching the virus left him breathless and fearful. Joseph Joby, aged 36, caught Covid in January when he was looking after a resident in the care home where he works.
At one point during his month-long illness, Joseph felt so ill and breathless that he was admitted to the Emergency Department (ED) for assessment. Following his discharge, he became one of the hundreds of people cared for by an innovative Virtual Covid Clinic, organised by the Trust’s ED team. The team’s efforts have allowed Covid patients to stay safe but connected to vital help and monitoring.
Dr Hannily Cooke, an Emergency Medicine Trainee Registrar and Dr Carlo Arrigo, Clinical Director of the Emergency Department, set up the virtual clinic at the beginning of the pandemic, and have helped as many as 70 patients in two months at the height of the crisis.
Supported by ED team staff and the Ambulatory Emergency Care Unit (AECU) nursing team, one of the clinic’s main aims is to detect patients early on who are affected by deteriorating oxygen levels in the blood, which is a dangerous complication of Covid. To do this, they provide discharged Covid patients with a small device called an oximeter. The device, which measures oxygen levels in the blood, can pick up a potentially fatal drop in saturation levels, which is sometimes ‘symptomless’ so difficult to spot.
Dr Cooke explained: “A worrying complication with Covid is that some patients develop ‘silent hypoxia’ where the level of oxygen in their blood drops to a dangerously low level but the patient shows no obvious signs of being unwell, such as breathlessness or pain.
“This may mean that a patient can be unaware of the danger and might delay treatment until they are critically ill and in need of urgent medical help.
When Joseph, who trained and worked as a nurse, was monitoring his saturation levels, he said that at one point he called for an ambulance as the blood oxygen readout had dropped to 89 per cent (a normal readout would be 95 per cent). The ambulance crew arrived quickly, checked him out and gave welcome reassurance and advice, which meant he was able to stay at home with the knowledge that he was not in danger but could get back in touch if things worsened.
Although in Joseph’s case, the drop in oxygen saturation levels measured by the oximeter was accompanied by worsening symptoms, he knew that this was not always the case. He said that having the oximeter and the contact with the virtual clinic provided an essential layer of security, an extra safety net for him after leaving hospital.
Dr Cooke said: “The clinic has been extremely well received; the patients are universally grateful for the support and having the pulse oximeter gives another layer of safety if they are discharged from ED.”
“After leaving hospital, Covid patients are often feeling very scared and isolated and unsure of how to get help. They’re trying to hold their lives together with financial and other pressures – all while feeling the worst they’ve ever felt.
“ED doctors working in the AECU phone patients on day two and day five after they are discharged with the aim of checking their oxygen saturations and assessing how the patient is managing with Covid at home.”
Joseph said: “The follow-up telephone calls from the Covid Virtual Clinic doctors were really helpful. The doctors were so kind and supportive – it was like having brotherly support and reassurance and I felt very grateful. In fact, I can’t thank them enough for that support.
“It took me a long time to recover and there were some days when I felt I had no hope of getting better and that I was actually going backwards, but the support and encouragement from the clinic made a huge difference. At a very emotionally worrying time, it offered a reassuring lifeline of information and advice. I think knowing that the clinic doctors were in contact made it less of a worry for my family too, they knew I had that back up.”
Dr Arrigo said: “Virtual clinics and remote monitoring are buzzwords in health settings at the moment and are likely to become permanent features that will be relevant in many different forms going forward – definitely not just of help during a pandemic. I’m very proud of our quick-thinking teams and of how the Trust frequently leads the way with new and innovative ways of improving patient safety.”