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Hard-pressed frontline workers face intense pressure across every part of the health service. As the Express witnessed the daily battles at a major hospital, one critical care doctor summed up the startling reality of coping with the pandemic.

“I have never seen the hospital running at this intensity in the entire 13 years of my senior ­medical career,” Dr Karen Daly tells me as I put on protective gear before entering the Covid ward.

Virus hospitalisations and deaths are lower now than at this time last year and the success of the vaccine ­rollout is undoubtedly a cause for celebration.

But, as winter approaches, NHS staff ‑ already exhausted from the toughest 18 months they have ever faced ‑ now have more to worry about than just Covid-19.

The Daily Express visited St George’s Hospital in Tooting, south London. Dr Daly is one of the ­consultants overseeing care for 24 patients on Covid wards.

There are a further eight patients in intensive care. They typically fall into two categories. She said: “We have the frail elderly who are usually vaccinated and some of them have had boosters.

“For them, Covid is a relatively mild illness but because of their general underlying condition, it tips them over the edge and some don’t survive. The other cohort is unvaccinated young people.”

The number of patients is far lower than the peak of around 300 on wards and 100 in intensive care during the January wave.

But Dr Jane Evans, another ­consultant, fears the knock-on effect of cases rising.

St George’s has made good progress in reducing waits for planned treatment but if too many beds are filled by Covid patients, operations will have to be cancelled.

Medics are also preparing for added complications. Patients with Covid or flu types A and B all have to be quarantined separately.

Dr Evans said: “What you never want is mix any of those patients together because to have Covid and flu, or flu and flu, is disastrous.

“Trying to set up three isolation cohorts is really challenging.”

In the cardiac intensive care unit, staff are caring for those with heart and chest ­problems and isolated Covid sufferers. Dr Dominic Spray, clinical director of adult critical care, said 90 percent of those with the virus are unvaccinated.

But in a side room, we glimpse a vaccinated Covid patient in his 70s, sedated and on a ventilator, surrounded by tubes and monitors.

It is not clear how many doses he had but it is a stark reminder that infections do happen and boosters are vital for the most vulnerable.

There are plans to safely expand capacity, but again the worry is if demand grows, operations requiring an ICU bed for recovery will be delayed. 

Dr Spray said: “If we have someone who takes up 30 days with Covid, that’s 15 or 30 heart operations or cancer operations we can’t do. That’s quite frustrating.

“We’ll cope with what comes our way but it does impact on those waiting for intensive care.”

Matron Tammy Stracey says the past 18 months were horrific and staff are now bracing for winter, adding: “Managing multiple things rather than one makes it incredibly tiring and time-consuming.”

Dr Spray says the public should do everything they can to cut their risk of ending up in hospital.

He added: “Please get your flu vaccine, think again about your Covid vaccine if you’ve got any hesitation, and think about taking extra precautions out and about.

“Generally people coming in who have been vaccinated against Covid, symptoms are not as severe and they tend to recover better.”

See the latest Covid vaccine stats below and visit InYourArea for all the Covid vaccine latest

As we tour the A&E department, Dr Paul Holmes vents frustration that some people think coronavirus is the only problem. 

The consultant, a specialist in emergency medicine for 15 years, said a range of factors are piling strain on the system. Pent-up demand means people who delayed seeking help at the height of the crisis are presenting with more advanced problems which are harder to treat.

Patients waiting for surgery are turning up at A&E in pain and pressure on GPs means those who cannot get a quick appointment head for the department where the lights are always on. 

Dr Holmes said: “All emergency departments are under extreme pressure. We can’t get patients out into beds in the ­hospital ‑ and one reason for that is we can’t get people out of hospital into social care.”

Matron Daryl Desmond added that the strain kicked in earlier than usual, saying: “From August it felt like winter had started.”

Government funding for A&Es last year was used to create a more spacious and Covid-secure entryway and waiting area.

For serious but not life-threatening problems, capacity has been doubled. People with life-threatening injuries, such as stopped hearts or major trauma from a stabbing or car crash, are rushed into eight enclosed bays with sliding doors to cut the risk of coronavirus spread.

As we enter, the red phone ‑ made famous by Channel 4’s 24 Hours In A&E, which was filmed here ‑ is ringing. An adult male is being transferred to be seen by St George’s cardiac specialists. The hive of activity continues – but so does the mental drain.

Comment by Richard Jennings

There has been no rest at St George’s as staff deal with the very poorly and with Covid while ensuring routine surgery also takes place.

We are also looking after increasing numbers of Covid patients. Large numbers are unvaccinated and some end up in intensive care. They often regret not getting jabbed.

Many people who attend emergency have put off seeking help and are quite unwell. The NHS is here for you this winter, seek help as soon as you need it. If it’s not an emergency, call NHS 111 or go online for advice.

If you attend A&E when it’s not urgent you may well wait a long time. It’s been a tough couple of years for NHS staff and I would like to thank them all.

I want to thank the Daily Express for visiting our hospital, speaking to staff and patients and hearing first-hand what it is like on the NHS frontline as we head into winter.

This paper took the time to hear from those working in our busy emergency department on the challenges of giving care to ever-increasing numbers. 

Thanks also to readers who are getting jabbed and doing everything to keep well this winter.

Richard Jennings is chief medical officer, St George’s Hospital

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