Panic is a thing of the past at Northwick Park Hospital but pressure to juggle the Covid virus is here to stay, according to medics on the frontline.
Consultant Ganesh Suntharalingam and Matron Marvin Santos are looking to the future and balancing covid and non-covid patients in London North West Hospital (LNWH) Trust's hospitals.
On March 22 2020 the government put the whole country into lockdown in a bid to save lives and protect the NHS.
But in Northwick Park Hospital work was already under way in what became a highly stressful and exhausting year for staff members who vividly recall the dire situation as the country marks a year since the first lockdown.
Dr Suntharalingam, the clinical lead for critical care at LNWH, said: "We had our first suspect case in February, so for us is started quite early both in terms of preparation and in terms of possible patients coming.
"By this time in March we were already in the full swing of it and we were going to get a lot of patients into the hospital. We were admitting 6 to 10 patients a day into the intensive care unit (ICU) and started to transfer them out to other hospitals in large numbers so we were already in the thick of it by this time."
The ICU trebled from 22 beds to 65 and four different areas of the hospital were converted into intensive care wards.
One ICU-trained nurse had to be assigned to up to four patients, where usually it would be only one.
"Staff in ICU were having to work in completely different ways to usual with a new disease. And for the people coming into help, a lot of them hadn't worked in intensive care before," Dr Suntharalingam said.
"A new environment, a new disease, for all of us working in PPE full time, so communication was harder. It was a very challenging time but there was a lot of team work and collaboration."
Mr Santos, interim matron in critical care, said it was busy between February and June then quieter over the summer time then busy again in September.
"At the beginning some of the staff contracted Covid, even myself, so we needed to get support from the different wards," he explained.
"It was so difficult, a lot of people were worried. The first weeks were totally different, you're not prepared, we were overwhelmed with the number of patients coming to our door.
"But you need to do what you can do to keep people safe and keep patients alive."
"By the second wave people were more familiar with the disease and the ways of working but it was equally challenging as the numbers were higher and people were exhausted from the first time round," Dr Suntharalingam added.
On January 4 the government announced a third lockdown. Soon after vaccine centres opened across Brent and the country.
"The last couple of weeks numbers have come down markedly but that's because of the lockdown, rather than vaccines. We admit people of all ages and we're just beginning to vaccinate the over 50s," Dr Suntharalingam added.
"If lockdown ceases and everyone starts mixing before we've achieved high levels of vaccination in the 40s and 50s we could easily see another spike.
"Stay prepared. It's going to be important to keep up some levels of social distancing and make sure people are vaccinated.
"The virus itself is not going to go away in the short or medium term. We're trying to control it with vaccinations but it's difficult to know when normality will come. We may see further surges.
"For the next couple of years it will be pretty uncertain."
Central Middlesex Hospital is a completely covid-free hospital taking elective patients.
"For the foreseeable future we're going to have ways of working where the trust can go on treating covid and non-covid patients and making sure one doesn't infect the other. That's going to be relevant for the next few years," he added.
"The vaccine is a big thing, without it things would look a lot bleaker but we can't be complacent."
Both medics praise the support they got from staff and the public who sent hand made cards and pictures to lift the morale of the staff.
"We want to say thank you to all the public who supported us," they added.
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