Many people have heard of doctors and nurses who have taken covid-19 at work, but one of the categories of hospital workers most affected is that of janitors and janitors. In the text below, doctor John Wright, from the Royal Infirmary in Bradford, UK, tells the story of a cleaning lady who became ill and now feels guilty for taking the virus home, which had a trafficking outcome.
The first person I see very early in the morning when I arrive at the hospital is cleaning lady Karen Smith. During ten months of uncertainty during the pandemic, Karen was the only constant, except for a few weeks in the spring, when she fell ill with covid-19.
Normally Karen cleans the offices of the hospital’s Health Research Institute, but in the first wave of the pandemic, in the first half of 2020, she was summoned to the wards of patients with covid-19. It was a scary time for everyone, but Karen volunteered for an extra shift on Good Friday because there was a shortage of staff – and that day she thinks she got infected.
We know that working in hospitals increases the risk of infection by a factor of three, but that risk is not evenly distributed.
Antibody tests carried out at many NHS hospitals (the British SUS) during mid-2020 showed that it was not the ICU or “red zone” health professionals who had the highest infection rate, but the janitors and porters who worked in those areas. The risk of infection was twice that of his clinical colleagues.
This high risk for hospital staff also applies to your contacts at home.
When cleaning the hospital in April, Karen was afraid not for herself, but for her family. She and her husband, Mal, had moved into a trailer in Mal’s parents’ garden while her mother had cancer, and they stayed there after she died, to support Malcolm, Mal’s 80-year-old father.
Her husband, a hospital porter, was protecting herself at home because she has chronic obstructive pulmonary disease, and her father-in-law was clearly vulnerable because of her old age.
Stopping work, however, was not a luxury Karen could afford. And unlike some hospital workers who stayed in hotels to protect their families, she came home every night.
She fell ill in late April, followed by her husband in early May. The weather was hot, she remembers, as they coughed and fanned themselves in the trailer.
“It was like being in a can,” she says. “I took covid and I couldn’t get over it well. And then Mal did and his was on another level compared to mine. But then his father got sick, and it was a completely different game.”
The couple had to go home to cook and use the bathroom, but they did their best to stay away from the elderly, who went to another room whenever one of them entered the house.
“We tried very hard not to pass it on to him, but he fell ill and stayed in bed. Honestly, he was like a child, confused under the bedspread. Then the chills started and we called 111 (British health care phone). to take you to the emergency room to get tested, and we couldn’t believe it when it was positive, “said Karen.
He was later taken to the hospital. I have fond memories of meeting Malcolm in the infirmary after he was admitted, struggling intensely against the symptoms of coughing and shortness of breath due to the covid infection. He was a kind, good, stoic and patient man.
He was adamant about keeping his distance from Karen and Mal in the house, but he admitted that he was going to show them articles in the Telegraph and Argus, Bradford’s daily newspaper, whenever I was mentioned in it. I felt strangely guilty for being the cause of the transmission.
Malcolm made a good recovery and was looking forward to being discharged. But covid is an unpredictable disease and it can happen that improvements in the patient’s condition are followed by a severe deterioration. And that was what happened to Malcolm shortly after he got home.
“He didn’t want to go back to the hospital – he said to get some pills because they would help him breathe,” said Karen. “But nothing could help him, he was so, so sick. We had to say to him, ‘No, you have covid and you need proper medical care.’ He was such a lovely man, God bless him. “
Malcolm was readmitted after two nights at home and died on May 28.
Karen went back to work. But, like many people who have had this disease, it has suffered side effects, both physical and mental. She is now using a pump for shortness of breath, can barely taste some things seven months later and is constantly tired. She is also receiving medication for anxiety because of the fear of having to go back to the covid wards, where he could potentially get sick again.
And in her case, it adds to the pain of having lost a loved one, mixed with feelings of guilt.
“When I start thinking about him, the tears come and sometimes I cry almost all day, cleaning and crying. If I’m having a bad day, I can’t even speak,” she says.
“The guilt is always there, since I will never know for sure where he got his covid from. Mal’s father didn’t put his feet out the door, so in my head I feel so much guilt, because we had to enter the house, we had no choice. I think about all that, but it’s hard to escape it, because I took it, Mal took it and then his father took it. Basically, I think that’s what happened, and it will take time to accept all of it. “
Karen has been referred for psychological counseling, but there is a long waiting list.
She and her husband also had to wait for the vaccine, although both have already received their first doses. This was a great relief to Karen, as anything that reduces her chance of reinfection also helps her deal with her anxiety.
If those responsible for NHS units take the scientific information we have seriously, then they should undoubtedly vaccinate janitors and porters first.
The fear of transmitting the virus to our loved ones at home is the ghost that haunts all frontline employees coronavirus. Many were isolated during the first wave of the pandemic, but this has never been a sustainable approach and, with such a contagious virus and an environment in which it is so prevalent, transmission to family members is unfortunately common.
Karen and Mal embody this occupational risk and its potentially deadly impact.
John Wright, a doctor, professor and epidemiologist, is the head of the Bradford Health Research Institute, and a veteran of fighting cholera epidemics, while HIV and ebola in sub-Saharan Africa. He has written a covid-19 pandemic diary for the BBC News website and recorded reports for BBC Radio. His Twitter profile is @docjohnwright.