COVID-19 EXCLUSIVE: Frontline NHS Medical Consultant reveals the big picture

Newly-assigned doctor steps up to the Covid-19 challenge

As many flock to hospitals all across the UK, because of the Coronavirus pandemic, 31 year-old Dr. Asif Munaf has stepped up to the role as the Frontline NHS Medical Consultant for the Covid-19 Ward(s), which makes him the youngest medical consultant in the UK. Furthermore, he works in acute medicine all across the East Midlands. Dr. Munaf said, “it’s a great source of pride that I was able to step up for a few weeks as a consultant and actually live my dream of seeing my own patients, having my own team behind me.” 

The Coronavirus pandemic is now worldwide and has affected many. According to the World Health Organisation “Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.”

Dr. Munaf said his new role entails “looking after a set of patients on a ward, which is specifically assigned to Covid patients, so that’s a 28 bed ward with patients testing predominantly positive for Covid.” With consideration to the fact that a lot of operations have been cancelled, Dr. Munaf said, “this has opened up a lot of wards, due to the pressures of the viral outbreak.”

“I start off my day by seeing my patients early in the morning, making plans for their future treatments, whether or not they need oxygen, steroids, or antibiotics, or whether they should actually step down and go home” – as they have recovered from the Coronavirus.

Dr. Asif Munaf, NHS Medical Consultant

Due to the nature and the dangers of Dr. Munaf’s new work environment that he is faced with, he has been placed in a hotel, away from his home and family, so that he doesn’t put his family at risk – his wife and two-year old son. Moreover, Dr. Munaf said this experience has made him realise not to take time spent with his family for granted.

“So for me – it’s made me realise it’s about quality, not quantity. So whenever I do get to see my family, it’s very rare and precious to me. So I make sure that my phone’s off, my notifications are off, and I’m fully in the moment.”

Dr. Asif Munaf, NHS Medical Consultant

Dr. Asif Mina with his son
Dr. Asif Munaf with with wife & son

Video featured above: NHS Medical Consultant Dr. Asif Munaf tells more of his new assigned role, what his new role means to him as he also has a minority ethnic background, what he experiences while on duty in the Coronavirus wards, and how this has affected his family – his wife and two-year old son.

Behind the scenes of the Covid-19 Ward

Dr. Asif Munaf said he and his team had no idea that the outbreak was going to be as big as it was. He said,”‘when we heard about this pandemic coming from Wuhan, we thought it would be 10 cases in the UK and that’s it, you know, like people who had recently travelled to China. We didn’t think there would be 50,000 cases with 10,000 deaths. We never anticipated the continuous amount of daily patients coming in April, which is normally a good month for us.” Furthermore, Dr. Munaf expanded on his new role and how it has been a challenge:

Every day has been a different challenge. The one thing that I am noticing is that patients are most certainly much more unwell than we initially thought, so patients have a tendency to really get unwell overnight very quickly.”

-Dr. Asif Munaf, NHS Medical Consultant

Dr. Asif Munaf said, ‘this is unlike any experience a doctor can go through.’ His daily routine, as a doctor, has changed significantly since he took on the Medical Consultant position and he is finding it challenging to comfort his Covid-19 patients, as opposed to his previous patients, because his Covid-19 patients are alone, and their families are not allowed to be with them. Dr. Munaf said, ‘this has added a whole new dynamic to a patient being in ITU (intensive care unit).’ 

 “I think day-to-day, the reason why patients are coming in is because they have self-isolated for two weeks and they haven’t got any better.

So, there’s a real fear there. My patients will ask me, am I going to die doctor’, ‘what’s going to happen to me’, ‘what’s going to happen to our families’, and ‘can my family come visit me?’

It’s a fear that’s never been there before.”

– Dr. Asif Munaf, NHS Medical Consultant

As Dr. Munaf makes his rounds in the Covid-19 Ward he said, ‘it’s hard for me to see so many of my patients in such distress.’ Thus, he constantly has had to make decisions that are not easy.

“There have been some tough decisions, and, as a doctor, you have to bear in mind the patient’s clinical picture. So, for me, just a couple of weeks ago, when I had to make the decision to consider ‘end of life’, which means I had to decide whether or not the patient can go beyond level one for care in other wards, that was hard.” 

-Dr. Asif Munaf, NHS Medical Consultant

The use of CPAP machines to treat Coronavirus

Dr. Munaf said, many nurses have had to be relocated to the Covid-19 ward. Most of these nurses are only surgically trained – looking after drains and post operative problems such as hip replacements; therefore, upon the nurses getting moved into the Covid-19 ward, they have had to get retrained in order to be able to use the CPAP (continuous positive airway pressure) machines.

So, for nurses to get trained on CPAP machines, it has been quite a life changing experience.  The medical nurses, the ones who typically deal with respiratory problems, such as asthma or bronchitis, know how to use CPAP machines and how to adjust the settings. But the new nurses, the surgical nurses, because operations have been cancelled, they have been reassigned to Covid wards and have had to get retrained on how to use a CPAP machine. 

-Dr. Asif Munaf, NHS Medical Consultant

CPAP Machines” by A.Currell is licensed under CC BY-NC 2.0

According to the NHS website, “a CPAP is the preferred form of non-invasive ventilatory support in the management of the COVID-19 patient. Its use does not replace invasive mechanical ventilation (IMV), but early application may provide a bridge to IMV.” Furthermore, Dr. Munaf said, he has had to make difficult decisions with regards to the use CPAP machines.

“For me, I have had to make difficult decisions and it has been real challenging, because my ward is what we call a level one to level two ward – meaning level one is a normal medical ward and then level two consists of usually 3 or 4 of 28 patients which are hooked up to a CPAP machine. The CPAP machine is a tight fitting mask, which delivers high full oxygen, so that’s happening in level 2 care, and in level 3 care is ITU (intensive treatment unit). So, for me, when I have to make decisions it revolves around entirely around certain age groups.”  

-Dr. Asif Munaf, NHS Medical Consultant

A doctor’s mental health

As this pandemic continues, doctors work together as a team and look out for one another. Dr. Munaf said, his colleagues are continuously checking in on one another to make sure that they are holding up well – and there have even been psychiatry professionals who have reached out to him and his colleagues.

“I think as doctors and nurses, you know we’ve come together. We’re constantly messaging each other asking, ‘how are you doing’, ‘do you want time off’, and ‘how are you feeling about work.’ We’ve had allied health professionals help us out as well. So, I’ve had a lot of messages from psychiatrist or psychologist that said, ‘Dr. Munaf if you want any free CBT let me know or if you need PTSD support’. So that’s been very good.”

-Dr. Asif Munaf, NHS Medical Consultant

Video featured above: NHS Doctor Consultant Dr. Asif Munaf tells more of what he experiences day-to-day as patients are testing positive for Covid, what are the difficult decisions he has had to make as a doctor, the shortage of PPE and CPAP machines, nurses getting trained to use the CPAP machines, how has the medical staff been able to manage their stress levels, and what type of things has he learned going through this pandemic

Dr. Asif Munaf offers the public a message of hope:

“First off, I think 2020 will be bad, very bad, but the second half will hopefully be, fingers-crossed, better. Please follow government guidelines, stay at home and only go out for essentials, which should be on a rare occasion.

Please minimise your shopping trips – and if you do go out, please respect the social distancing guidelines on two metres when you are shopping. Together we need your support – stay at home, protect the NHS, save lives.”

Dr. Asif Munaf, NHS Medical Consultant

Video featured above:  Dr. Asif Munaf shares his message of hope to the public during the Coronavirus pandemic.

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