Dr. Charlotte Summers and Professor Rashida Ferrand have spent more than 18 months tackling Covid-19 at the frontline. We speak to them about their experiences, the impact Covid-19 has had on healthcare workers, and what must be done to prepare for pandemics in the future.

What has been your experience working on the frontline during the pandemic?

Charlotte: I started 2020 realising this train was coming towards us whether we wanted it to or not, and it was just a matter of time when it arrived. There's something exhausting about planning for something with so much uncertainty around it, and it was all consuming in March-April of last year. We spent last summer dealing with the consequences of the things that were put off to make room for Covid-19 patients. Then things started to deteriorate again, and we had the second enormous wave. It feels like things are calmer again now, but it's estimated there are about 5 million patients who need care that was postponed as a result of the pandemic. They're the unseen second victims of Covid-19.

Rashida: When you're faced with such an immediate existential problem, you can either cave in, or make do with whatever you've got and do your best. I know that doesn't sound like a very perfect solution. But that's what I'm sure many of us have done, within the resources, the context that we have.

The way we addressed Covid-19 in Zimbabwe was to start with the simple things that were feasible in our context, like getting fluid management and antibiotic stewardship right, making dexamethasone available, trying to get reliable and sufficient oxygen supplies, reassuring healthcare workers and developing rotas. The focus on trying to get critical care for or upscaling management of people who had very advanced Covid-19 was something that followed later.

Charlotte: You're absolutely right, simple things save lives. And even in the most advanced of intensive care settings, we know that simple things like good infection control and prevention via hand washing, distancing, wearing masks, getting the dexamethasone in – all of these small incremental gains add up to the majority of the benefit.

The other thing that we learned is that it's really easy to think we need this machine, or this presumed structure. But actually, it's the people that have saved lives, it's the staff who have stepped up and done things, because there was no other choice.

Rashida: When I started at the hospital, we had industrial action. There wasn't a blood pressure machine, there wasn't a pulse oximeter and we had flooding because the pipes were broken. AlI I know is that you always can do something. I'm not saying that to sound like a heroine, but because there are people who have done things. I've had doctors work 16 to 18 hours a day to try and get blood transfusion fluid, in the face of discrimination and stigma. But I think that we as human beings do have a sense of altruism. We are able to change things, maybe not to perfection, but if it was perfect, we wouldn't have anything to do. So I feel that, despite all the fatigue that many of us have experienced, people have reached out, worked together and made a difference.

Read the full article about COVID-19 frontline workers from Wellcome.