Almost all of the beds in the ward are taken, but no patient voice can be heard. The only sound is the constant beep of the survival machines.
I am standing in the children’s intensive care unit at St Mary’s Hospital in central London.
But there are no sick children here. It is full of seriously ill adults. Almost all are on life support.
There are 13 beds and 12 of the patients are sedated and intubated. Ventilators help their virus-infected lungs breathe, but healthcare workers have to do everything else around the clock.
A nurse looks at an unconscious patient, dabbing the corner of his mouth with a cotton swab. She then gently wipes away the discharge that has accumulated in the corner of her eyes.
This is tender and loving care given to a patient who is in an induced deep coma, totally oblivious to the nurse’s attention.
Everywhere there are signs of the earlier specialization of this unit; cartoon patterns on the walls and floors and specially commissioned paintings to promote healing.
The last two children requiring intensive care have been transferred to Great Ormond Street Hospital.
This is the unit of the pediatric consultant Dr Simon Nadel. He tells me that he is concerned that custody of children in London may be “compromised”.
“It’s important to realize that we are a pediatric intensive care unit and, as you can see, we are full of adult patients, which shows the pressure exerted by the system,” he says.
“People said it’s not a problem for children, but the indirect effects of this pandemic are really affecting children. The normal health care system that we have for children in London is seriously affected.
“I wouldn’t say the kids aren’t being treated properly, but it’s clear some of their care is compromised because of the changes we’ve had to make to accommodate adults.
Dr Nadel believes this winter wave will likely last longer than the first.
“I think it’s worse than the first wave. We know from the numbers that a lot more patients are admitted to the hospital and a lot more patients are admitted to intensive care.
“The problem is that this peak, each time it occurs, will take longer to dissipate when the first wave was short and strong. It lasts longer and there will be a higher peak. ”
The nursing staff in this unit are trained to treat very sick children. Now they have to apply their life skills to seriously ill adults.
Physiotherapists normally treat children who weigh around 10 kg, but now they have to take care of prone adults who can weigh 10 times more.
All the pediatric staff had to adapt. Family Liaison Nurses Helen Avila and Jo Williams face the impossible task of acting as the only link between these patients and their desperately worried families.
COVID-19[feminine[feminine is doubly cruel, taking lives and any chance of a final farewell.
“Nothing can prepare you to see a loved one in intensive care with all the tubes and lines,” says Helen.
“It can be pretty scary, so before we do it we have to prepare them. Quite often they break down on the phone and normally you give them a hug and tell them that we are there for you. We can’t really do that when we’re on the other end of a camera. ”
She continues, “It’s difficult and the end of life situation is most difficult when we can allow a family member to come in – so the family has to decide which family member is going to come in.
“They have to wear full PPE and we could have a FaceTime camera so other family members can be there virtually.
“A year ago, would we think it’s okay to say goodbye to your mom on an iPhone or iPad? Now this is unfortunately happening a lot. ”
His colleague Jo agrees. “We all hoped desperately that we wouldn’t have to go through this again. But I think we went through it the first time around and we hope we find it intact. ”
The hospital’s pediatric ward is now also full of adults with COVID-19. The emotional toll begins to be felt.
Pediatric matron Hannah Deller works in a children’s ward that now has only adult COVID-19 patients. She says the shock and sadness of losing a patient stays with her for a long time.
“There was a gentleman who was so nice and we got to know each other well and he deteriorated overnight and passed away.
“He was talking about his boat and being on his boat. There were pictures of him on his boat. When he passed away we took his pictures and I broke down. ”
This deadly crisis that has gripped the country shows no sign of easing. It’s real. The patients here would say the same thing except that they are too sick to speak.