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The WHO declared COVID-19 a pandemic on 12 March 2020.1 Within 2 weeks of the first identified case in the UK, the number of confirmed cases had increased from 20 to 1500.2 3 By 12 May 2020, the UK had the fourth highest number of cases in the world, and the second highest number of deaths due to COVID-19 infection, with 225 000 positive cases and over 32 000 deaths. London had the highest incidence in the UK with 25 980 confirmed cases,4 which was especially concerning given the population density in the capital.5 6 Hospitals in London, therefore, saw an exponential rise in patients presenting with COVID-19 pneumonitis, necessitating the formation of new wards and an urgent need to support those responsible for them in General Medicine and Intensive Care.
The arrival of COVID-19 caused huge disruption to the regular workflow of hospitals throughout the UK.7–9 Most specialties cancelled elective activities in mid-March 2020, and the Royal Colleges suspended training10 to permit redeployment of trainees. Doctors were transferred from both medical and surgical disciplines to maximise the total workforce pool.11 For many, this was a very stressful time, faced with demanding work outside their chosen specialty, placed on schedules at very short notice with no annual-leave permitted and with no clear endpoint.12 Research posts and placements integral to individuals’ training were suspended.
The Royal Free Hospital is a major university teaching hospital, and hosts the only high-level isolation containment unit in London. It provides healthcare services to a wide catchment population in excess of one million people. Additionally, it is a tertiary referral centre for centralised services such as cancer immunology, rheumatology, liver and kidney disease, transplantation, complex vascular surgery and other specialist disciplines. In anticipation of the added pressures from the COVID-19 outbreak, many …
PK and SS are joint first authors.
Contributors PPK, CH and AB wrote the first draft of the manuscript. All authors contributed to critical revision of the manuscript for important intellectual content, gave final approval and are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CK and CC contributed to revision of English language.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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