NHS boss: ‘We may have been complacent, but we have a duty to each other to fight this virus’

After emerging relatively unscathed from the first wave of the coronavirus pandemic, Hull is now firmly in its grip with the worst infection rates in the country. In this, his first in-depth interview since the outbreak began, city hospitals boss Chris Long tells Simon Bristow what went wrong, and why everyone has a shared responsibility to bring the virus under control

“Complacency” and the “weariness” of Covid-19 restrictions may have contributed to Hull having the worst rate of infections in the country, the city’s NHS boss has said.

Hospitals chief Chris Long also said “things are going to get worse” as he warned the crisis gripping the city could last into February.

Mr Long, chief executive of Hull University Teaching Hospitals NHS Trust, said he understood public frustration at the safety measures imposed to combat the virus, but urged people to comply, saying everyone had an “equal responsibility” to help limit and reduce its spread.

Hull barely registered on the list of worst hit places during the pandemic’s first wave, but has since provided a shocking example of how easily and quickly that can change. Last week it was named the worst affected place in England, with infection rates soaring well above 700 per 100,000 people.

In the hours or days ahead, the trust is expected to pass the grim milestone of 300 Covid-related deaths at its two hospitals, Hull Royal Infirmary and Castle Hill, since the outbreak began. Some 50 of these have died in the last two weeks.

It is also expected to soon double the number of Covid patients it is treating from the 110 hospitalised at the peak of the first wave in April.

As of yesterday, the trust had 188 patients who had tested positive for the virus - up 21 since Friday. Fourteen of those are in intensive care.

Asked how Hull’s infection rates had changed so drastically, Mr Long said: “I think what we are seeing is a lot of the areas that got off relatively lightly in wave one have been hit hard in wave two.

“That might be a degree of complacency. I think it might also be a degree of weariness with the restrictions of lockdown, with being unable to lead normal lives. And I think we also knew there was going to be a second surge in winter, but equally I think we’ve been quite surprised by how rapidly it’s occurred and how widespread it’s become.”

He added: “I’m anticipating things are going to get worse before we reach a peak and then it will start to trail off, but I think it will trail off quite slowly, and I think it’s likely that there will still be a lot of Covid around even in February.”

‘THE WORST IS YET TO COME’: Chris Long

Like many other cities, Hull has seen a number of demonstrations by people opposed to wearing face coverings and opposed to vaccines.

Asked about non-compliance with Covid safety measures, Mr Long said: “I fully understand that people are sick to death of the situation and sick to death of the restrictions that it imposes upon them, but we take these precautions for two reasons – one, to protect ourselves from the virus, and two, to protect other people from the virus, and I think that’s an equal responsibility that everyone should adhere to.

“I would also make the point that if we were talking about Ebola and not Covid people would be much more willing to adhere to the rules, because they know Ebola will kill them.”

In an interview with Sky News on Sunday, Mr Long said tighter lockdown restrictions may be needed, which may include the closure of schools. He told The Hull Story: “I’m clearly extremely concerned about the infection rates in the city, and the number of deaths and the amount of illnesses we are experiencing.

“We do know that the first lockdown was effective in reducing transmission of the virus and I do not think we should discount the imposition of another harder lockdown as we continue to see rates either maintain the current levels or rising even more.”

The trust’s response to the crisis has been made more difficult by sickness absence rates among staff running at more than three times those normally encountered at this time of year. It is currently 11.7 per cent [1,183 employees absent], up from 3.5 per cent. A total of 6.7 per cent of those missing are Covid-related absences.

Mr Long said: “On top of the current sickness rates we have an absence of 1.6 or 1.67 per cent because of maternity, which is to be expected with a workforce which is primarily women. And on top of that we have about 660 to 670 members of staff self-isolating because they have got symptoms or their families have got symptoms, or they’ve been picked up by track and trace.

“We try to get these staff tested as quickly as possible to get them back to work, but there’s an inevitable number that are going to be affected by this. We encourage staff to report even the mildest symptoms because this illness is so infectious and it’s safest for patients that we adopt that approach.”

This has led to staff redeployment on an unprecedented scale, including non-clinical staff being drafted into ward support roles, and others working in areas or with groups of patients they are not used to.

Mr Long said: “Clearly, we’ll make sure they have got the right support in place to help them care for those patients, but nonetheless that can be quite challenging. Our primary purpose is the care and safety of our patients and what we need to do is make sure we can fulfil that no matter how challenging the circumstances.”

The chief executive is acutely aware of how demanding work has become for staff, with the first wave coming hot on the heels of the traditionally busy winter season earlier in the year.

‘IT’S INCREDIBLY TOUGH FOR STAFF BUT THEY HAVE RESPONDED MAGNIFICENTLY’: Chris Long

He said: “Staff are tired, they are apprehensive, they are working under incredibly difficult circumstances, and they are all human beings who have their own homes, their own families, and their own lives, but they have responded magnificently.

“They are continuing to provide the best service that they can and in the most caring and compassionate way. I couldn’t be prouder of them.”

Mr Long also acknowledged there is unlikely to be any let up soon. He said: “For our staff nothing will stop, and as we get over the Covid crisis and start to resume normal operations there’s no opportunity for anybody just to stop, draw breath, and get some energy back; it’s just going to be continuous, and the recovery, I anticipate, will take up to three years.

“It’s going to be demanding. It’s not just getting through the winter, through Covid, it’s how do we start to resume a good service for local people once all of this is over.”

The trust has introduced extra measures to support staff, including psychological support.

“We are already putting in a good deal of support for staff around pastoral care,” Mr Long said. “I think the need for that will continue for a considerable time after the Covid crisis is over.

“The chaplaincy are heavily involved in supporting staff. We are doing the best that we can to provide them with good, visible leadership. We are looking at enhancing training in debriefing for those who have been in very unpleasant circumstances, and anything else that we can do. We are working very closely with the trade unions to support them in any way we can.”

‘THERE IS HOPE, BUT IT’S HOW WE ACT NOW THAT WILL DETERMINE OUR FUTURE’: Chris Long

It has of course been difficult for Mr Long too, being not only ultimately responsible for the patients in the trust’s care, but also for the welfare of the staff treating them.

It is only when you learn a little of his background that you realise his use of the word “challenging” is probably something of an understatement.

Mr Long, who turned 60 last weekend, has been in post for the last six of his 29 years in the health service. That followed a 12-year Army career in which he was a Captain in the Royal Regiment of Fusiliers, serving in the First Gulf War and extensively in Northern Ireland during The Troubles.

Has his military background helped? “I think it has,” he said. “I think the knowledge of discipline, the planning, the leadership training; they are all very transferable. One of the things the Army instils is a high level of resilience and we all have to be very resilient to get through this particular campaign.”

The burden of responsibility does weigh heavily at times. “I do have sleepless nights,” he said. “It’s more [than anything] just trying to work through the options and trying to do all that we can to minimise harm.

“The thing that concerns me as much as dealing with the immediate crisis is dealing with the aftermath of this. We have a large number of patients having their surgery cancelled, who are having to defer their cancer treatment. We are going to have to recover this and that is going to be a very long and complex operation.”

But however hard the challenges ahead, Mr Long is cautiously optimistic about the future with the news that an effective vaccine may soon be available. What trials and tribulations Hull will have to endure until then depend on the actions of its citizens, he said.

“My message to the public is there is hope,” he said. “We are fighting something of a holding battle until we can start to deploy the vaccine. In the meantime it’s all of our behaviours on a day to day basis that is going to determine how widespread this virus becomes.”