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Stories from November, 2020


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Autumn 2020 Newsletter – Out Now


For the Autumn 2020 newsletter, please click here





Autumn 2020 Newsletter – Survival Quiz Answers

What’s the most important thing you need to survive in the wild?

Answer: Water – the human body needs a minimum of 2 quarts (1.9 litres) of water per day for good health. One day without water is cause for serious concern, and three days without water will lead to almost certain death.


Why should you try to avoid sleeping directly on the ground?

Answer: To keep from losing body heat – sleeping on the ground can lead to loss of body heat. You’ll retain more warmth by piling grass or pine needles on the ground to sleep on.


Why should you melt snow or ice before drinking it?

Answer: To avoid dehydration – eating frozen snow and ice will reduce your core body temperature and lead to dehydration.


How can you determine the distance of an oncoming storm?

Answer: By the time between flashes of lightning and claps of thunder – count the number of seconds between flashes and claps and divide this number by five to estimate how many miles away an approaching storm is.


Which symptoms determine if you are experiencing severe dehydration?

Answer: Vomiting and diarrhoea

A Jump to the Frontline

Article by Louise Beitverda, Lead Respiratory Nurse

Prior to the COVID-19 pandemic, my role as the Lead Respiratory Nurse at UCLH involved leading a team of clinical and research nurses. The research work included inputting information into the national registry for Idiopathic Pulmonary Fibrosis (IPF), participating in audits and assisting those involved in individual research.

In March, as the numbers of hospital admissions for COVID-19 started increasing, it became clear that most non-COVID-19 research would temporarily stop, and our clinical responsibilities would change. Around this time, due to our experience with non-invasive ventilation, some of the nursing team became involved in helping to deliver an education programme for Continuous Positive Airway Pressure (CPAP). This is a type of ventilation used to support patients in respiratory failure and it was used for COVID-19 patients. We helped to train over 100 clinicians on many different devices in just a few weeks. One of the devices was the life-saving Ventura CPAP designed by UCL very early on in the pandemic and sent to 30 different countries worldwide.

Once training was completed, we worked on the Respiratory High Dependency Unit (RHDU). This unit was set up to support COVID-19 patients requiring CPAP. Other team members were able to cover clinical posts remotely, which enabled patients to be able to continue to have vital telephone support during this time. One of our research nurses was able to help support the emerging COVID trials. Our administration team were asked to work remotely, but continued to provide support by ensuring that the nurses’ emails were attended to, and urgent messages relayed. Everybody played a vital role.

Working on the wards again was an interesting experience. There were certainly some challenging aspects. Long shifts and night duties (after 16 years) took some getting used to. I re-discovered the energising effects of ‘red bull’ at 3am, although it didn’t quite give me wings! Working in full PPE had its challenges, although it was reassuring and we felt protected wearing it. It took some time to ‘don’ on and ‘doff’ off, but fortunately there were staff to support us with this dressing task. PPE was incredibly hot, and the masks could cause considerable discomfort when worn for long periods. PPE made it difficult to identify people and to be able to communicate effectively, especially to people working outside of the COVID area. However, the challenges were overcome. We quickly started writing names on our gowns, and some even attached photographs of themselves. Barrier cream was supplied for our sore noses, and regular refreshment breaks were provided to allow staff to rehydrate; 2 hours was really the maximum time it was comfortable to spend in full PPE.

Communication issues were addressed via technology with varying degrees of success. It took some skill to master the walkie talkies which connected us to outside areas and sometimes it was just easier to write a note on pen and paper and hold it up against the glass entrance door when a message was needed to be conveyed to the outside world. Technology was of course very useful in terms of keeping patients connected with their families and friends at a time when visitors were not routinely allowed on the wards. Although there were some very difficult situations, it is easy to imagine how much harder this would have been had the pandemic occurred a decade or two earlier.

As a team, we will all have our individual memories of our time in the RHDU. Some of these memories will be about the intensity of the situation, and the experience of caring for patients with severe breathlessness on CPAP. However, many of these memories will be of positive events. It was always a lovely moment when patients were discharged and we were able to clap and say farewell to them, especially to those who had been on the unit for a long and difficult time.  For me, a special moment was seeing a patient being interviewed on the BBC, discussing his recovery with the physiotherapy team. I had been on duty the night he had arrived from Intensive Care, with a tracheostomy. It was incredible to think of the journey he had been on, and so pleasing to see his progress. It’s rare that ward nurses find out what happens to patients after they have been discharged, so this was very uplifting.

Despite the difficult situation, there was a great sense of teamwork throughout our time on the RHDU. It was a privilege to work with so many other members of the multidisciplinary team, many of whom were also redeployed and were undertaking roles so different to their own. The psychology team were available to support staff and I know that they were valued. We were well looked after on the ward, with constant deliveries of donated hot meals, and refreshments. Things like this really were appreciated and gratefully received, taking the little stresses out of the day. Other things that made life easier were incentives such as free taxis and parking, to be able to drive to work and not have to consider getting the underground for a few weeks really made travel easier and safer.

Guiding the team through this uncharted territory could have been a very difficult experience, as it was an ever changing landscape and it was not clear how long the situation would continue. However, each and every one of the nursing team showed an enormous amount of flexibility, patience and resilience, and they should be very proud.

Whilst we cannot be sure what lies ahead, we will continue to contribute to the research agenda, as this is such a pivotal part of healthcare. Never has there been a time when research was more important.  Research can and will save us from this fatal virus – there are now better treatments for COVID-19 and there are new vaccines on the horizon, and very soon we will feel safe once more.


Can COVID-19 cause lung fibrosis?

The interstitial lung diseases (ILDs) are a group of over 200 different diseases that may result in lung inflammation or (in the worst case) pulmonary fibrosis (PF). There are many different aetiologies for ILD/PF and in some cases,  we do not know the cause, so called ‘idiopathic’. One of the questions that we at Breathing Matters want to answer is can COVID-19 give you pulmonary fibrosis? There are a few clues that this might be the case. Other coronaviruses such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) have been reported to cause PF in a small percentage of patients, but of course the numbers of patients affected by SARS-CoV-2, the virus that causes COVID-19, will be much greater so, even if only a small percentage are affected, the numbers may still be very large. The diagnosis of ILD/PF is suggested by a clinical finding of breathlessness and abnormal lung function. The diagnosis is then confirmed with a CT scan of the chest.

Initial studies from China, Italy and the UK have remarkably similar findings. Of patients with COVID-19 discharged from a hospital in China, nearly half had abnormal lung function (Mo X, et al. European Respiratory Journal 55: 2001217, 2020).  Data from Leeds of patients with COVID-19 discharged from hospital showed that the majority (75% of those admitted to intensive care, and 65% of those admitted to the regular wards) still suffered from fatigue at 6 to 8 weeks post discharge. The number suffering from continual breathlessness was also high (70% of those admitted to intensive care, and 45% of those admitted to the ward).  (Halpin S et al. Journal Medical Virology, First published: 30 July 2020, DOI: (10.1002/jmv.26368).  An Italian study from Rome found that at 60 days around 55% of patients were suffering from fatigue and 40% from breathlessness.  It is unclear what is the cause of these high levels of breathlessness, but a study from Austria is following their patients up in more detail at 6, 12 and 24 weeks after discharge. So far, they have found that at 6 weeks 47% of patients are short of breath and this falls to 39% at 12 weeks. In addition, 33% have abnormal lung function suggestive of lung fibrosis, but this falls to 22% at 12 weeks. Of course, to diagnose lung fibrosis requires at CT scan of the chest and they found that CT scans suggested an interstitial lung disease (ILD) or lung fibrosis in 88% falling to 56% at 12 weeks. However, it is also important to know how much of the lung is affected, and many of the studies do not clarify this, but just comment on whether ILD is present or not. The result is that it is hard to know whether these patients had minimal or significant ILD changes on the CT scan. Clearly, Breathing Matters will be looking out for the 24 week data.

Our own experience is that of around 800 patients seen at UCLH with COVID-19, around 8% have persistent or slowly resolving CT changes at 5 months suggestive of interstitial lung involvement. Our main priority at the moment is to analyse our data from the ‘first wave’ to see how common the development of ILD/ PF is in these patients, how much of the lung is affected and what the critical contributory factors are. It may be that this virus and the enormous numbers of patients that have been infected will shed some light on the pathogenesis of other ILD/PF diseases.

We will let you know as soon as we have reviewed all these patients and their scans.


Bronchiectasis Fundraising Update

Update, by Jane Walker

Usually at this time, I am well under way with preparations for our main bronchiectasis fundraising event of the year, our annual Christmas Concert.  None of us imagined at our joyful concert last year that, little than three months later, our lives would be transformed by a pandemic.  Normally, by October, I would have run 5 or 6 stalls in the UCLH atrium which runs alongside Professor Brown’s Friday morning clinic. I miss all the preparation sourcing goodies to sell and making my cards and I miss seeing everyone at UCLH – some of our supporters come to every stall.  I will be restarting the stalls as soon as I am able to in 2021 and will keep you updated via the Breathing Matters website.  Fortunately, I was able to do my usual annual St Valentine’s Day stall, which was extra special this year as the actual date of the stall was Friday 14th February!

Whilst my fundraising activities at UCLH are on hold, I have been coming up with imaginative ideas so my fundraising can continue during the COVID pandemic.  During the lockdown in early May, I set myself a challenge to walk 3 miles each day over 7 days. With my lung condition, I manage shorter distances each day, but I was determined to do a much longer walk every day as a fundraiser.  I set up a JustGiving page and contacted friends, family and our concert supporters and on the JustGiving page, I posted notes and photos from my walks to share with everyone.  Through JustGiving and other donations, my walks raised a superb sum of £1000.  I was very touched by everyone’s kindness and generosity.

Our Christmas concert last year raised over £4000 for research by Professor Brown and his team of scientists at UCL.  We are very sad we can’t be all together for our annual concert this year – our friends in the Holst Singers are planning to put a small special treat together for us and I will be in touch with further details closer to Christmas.

A very big thank you to our bronchiectasis family of friends and supporters!


Are you a Christmas Charity Elf?

Christmas is a time to remember our loved ones that are sadly not able to join us at this family festive season. Christmas is also a time for joy and charity.

Many of you each year want to raise money and support a charity around this time of year, often in tribute to a loved one to keep their memory alive or to help make a difference.

It’s very difficult to plan this year for obvious reasons and many events will be virtual rather than real-time, but there are definite types of charity elves out there.

There are the ‘doers’, who organise charity events, such as mulled wine and stilton evenings, Christmas present-making arts and crafts afternoons, Santa runs, Christmas carol singing, and the good old-fashioned Christmas bazaars/stalls.

Then there are the ‘goers’, who attend all charity events, those with a voice for carol singing, those with a taste for mulled wine, those who love making things. The go-ers are as important as the do-ers as, without them, the charity events would flounder.

And then there are the ‘givers’, who readily donate bric-a-brac to the stalls, who bring food/wine to the evenings, who buy charity Christmas cards and those who give money to charity rather than buying too many presents.

Which type of Christmas charity elf are you? Do you like to get stuck in and organise Christmas charity events? Do you love the social whirl of going to all the Christmas dos, even if they are virtual this year? Do you love giving? Perhaps you are a combination of all the above. If so, we applaud you all!

Whatever your type, Christmas wouldn’t be the same without you!!!