London School of Hygiene & Tropical Medicine

The COVID-19 pandemic has placed under enormous pressure on global healthcare systems. In March 2020, LSHTM took the decision to release staff who wish to support the NHS and Public Health England with the response to COVID-19. Since then, like so many other experts from institutions around the world, they have been going the extra mile to support clinics and hospitals care for COVID patients.

We asked some of them to share their experiences and what they think is crucial going forward:

Shunmay Yeung, Professor of Infectious Disease and Global Health

Alongside her role as a researcher, Shunmay is a Consultant in Paediatric Infectious Disease at St Mary’s Hospital in London. During the pandemic, Shunmay has taken on additional roles in the Intensive Care Units as a ‘nursing buddy’, attending to adult COVID-19 patients in a repurposed paediatric ward, and volunteering as a vaccinator delivering vaccines to NHS workers.

During the peak of the first wave, Shunmay volunteered to take on more clinical duties, and was deeply involved in directly managing and consulting on children with the newly identified Multisystem Inflammatory Syndrome in Children (MIS-C). This is linked closely with her research interests which focus on improving the diagnosis of children with acute febrile illnesses.

Professor Yeung said: “It was a huge privilege to be able to play a part in supporting our amazing NHS, and disheartening to witness the toll the pandemic had, especially on nursing staff. We need to ensure nurses and care workers are appropriately renumerated for their extraordinary contribution.

“The pandemic has also had a massive lateral impact on children and young people, especially those from underprivileged backgrounds. In future public health crises, it’s important to ensure they have a voice and are taken into consideration for decisions.”

Dr Robin Basu Roy, NIHR Academic Clinical Lecturer in Paediatric Infectious Diseases

Robin’s research normally focuses on childhood tuberculosis. He is also a Paediatric Infectious Diseases registrar at St Mary’s and Great Ormond Street Hospitals in London. During the peaks of the pandemic, Robin was one of the many clinical academics who returned to help clinical colleagues deal with the increased demand. Although, thankfully, the vast majority of children are not severely affected by COVID-19, he has contributed to the care of paediatric patients with Paediatric Inflammatory Multi-system Syndrome (PIMS) temporarily associated with COVID.

Robin also acted as a ‘blinded’ outcome reviewer for the Oxford-AstraZeneca vaccine trials, and contributed to clinical research projects into PIMS temporarily associated with COVID-19.

Dr Basu Roy said: “The NHS is working hard throughout to keep services for children functioning safely. Don’t be afraid to get your children checked out by a healthcare professional if you’re worried about them, whether COVID-related or not.”

Dr Rachael Burke, Clinical Research Fellow

Rachael normally works as a researcher into HIV and tuberculosis, and is an Infectious Disease and General Internal Medicine registrar in the UK. Currently she is working in Malawi as a part-time doctor alongside her research.

In response to the current public health crisis, Rachael has been part of a team – led by Malawian colleagues – acting as a “mighty female force united against COVID-19”. Together the team from the Department of Medicine have opened three new COVID-19 wards to deal with the demand - they have increased capacity for COVID-19 patients, sourced PPE, developed triage and treatment protocol, implemented evidence-based medicine for COVID-19 patients and developed procedures to keep staff safe.

Dr Burke said: “Taking on shifts in the new Malawi COVID wards was my small contribution to an amazing effort by the team at the Department of Medicine. While we have increased capacity to care for patients with the virus, the only way out of this is a vaccine. It’s crucial that vaccine distribution is equitable and fair. No-one is safe until we’re all safe.”

Professor Alison Grant, Dean of the Faculty of Infectious and Tropical Diseases

Alison works as a physician specialising in HIV medicine, and her clinical work informs her research into tuberculosis care and prevention in setting with high HIV prevalence.

During the first wave, Alison volunteered at the NHS Nightingale Hospital London, where she helped set up COVID-19 clinical trials. Recently, she has been working in the Intensive Therapy Unit at University College London Hospital, working a 13 hour shift each week, helping the nurses care for patients with COVID-19.

Professor Grant said: “This pandemic has demonstrated what an amazing and precious resource the NHS is. It’s staff have worked unbelievably hard to get us through this public health crisis. It’s crucial we take better care of the NHS and its staff.”

Dr Phil Gothard, Course Director for Professional Diploma in Tropical Medicine & Hygiene (East Africa Partnership)

Course Director for one of LSHTM’s intensive professional development programmes in Africa, Phil is also an Infectious Diseases consultant. During the pandemic, he has been working on the wards at  University College Hospital, looking after patients on continuous positive airway pressure (CPAP) due to COVID-19 respiratory failure.

Dr Gothard said: “Many staff have lost friends and family to COVID-19, and understand the fear and helplessness relatives feel when their loved ones are admitted to hospital. The thing that has struck me most are the many small acts of personal kindness, from porters looking after lost families, to a nurse staying on after her night shifts to hold the hand of a dying patient.

“COVID-19 disproportionately affects minorities, highlighting the inequalities in our own society. As the focus moves to Africa, where conventional public health interventions are almost impossible, LSHTM and the international community must support global equitable access to the COVID-19 vaccines.”

Dr Oghenebrume Wariri, Clinical Research Fellow at the MRC Unit The Gambia

Additional to his routine research, Wariri helped coordinate the staff testing, contact tracing, quarantine and isolation system in LSHTM’s MRC Unit The Gambia during the initial peak of the pandemic in The Gambia. More recently, with the number of clinical staff redeployed to care for COVID-19 patients, he has also covered these roles as a paediatric consultant for the Clinical Services Department.

Dr Wariri said: “It’s important to remember that these aren’t just numbers, they are people who have been affect by, or died of, COVID-19. They are real people with real lives like us all.

“My experience has made me more committed to answering research questions around to the impact of COVID-19 on the provision of routine clinical services, especially the impact it has on maternal and child health.”

Dr Helen Brotherton, Clinical Assistant Professor and PhD candidate

Normally Helen’s research focuses on kangaroo mother care for preterm newborns in The Gambia. Between April and September last year, Helen took a secondment to support clinical services, working full-time as a Medical Consultant at the Clinical Services Department to manage and care for children and adults with suspected and confirmed COVID-19.

She was also part of the department’s COVID-19 leadership team, helping adapt the clinical service to prepare for COVID-19 patients and mitigate COVID-19 risks. This included restructuring the in-patient and out-patient services into COVID ‘hot’ and ‘cold’ zones, development of guidelines and procedures and training of staff.

Dr Brotherton said: “COVID-19 is a devastating disease for those severely affected, and the long-term effects from long-COVID are not yet fully understood. There has been a huge indirect impact and collateral damage for newborns and children during the pandemic, with global disruptions to newborn and kangaroo mother care services.

“Great strides have been made in the clinical management, and prevention through vaccination is key. I encourage the public to have the vaccine when offered to protect themselves, their families and communities.”