Coronavirus series: a medical student’s work experience

In the penultimate article of the coronavirus series, Tharani Ahillan describes her experience on the respiratory ward of a District General Hospital, and questions whether many university students have had the coronavirus already.

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One Monday back in March, a student woke up to a fever. As coronavirus cases were just beginning to rise, he put it down to an off-day. “I didn’t think it would be coronavirus” he said. He went about his week, struggling with exercise, but was relieved to find himself better on the third day. Yet soon enough, the fever returned with full rage and he started to develop a dry cough. At this point he realised that there was a possibility that coronavirus was spreading in the community, and called 111 (NHS helpline). “I was put through to an automated machine,” he recalls, “there was no way of knowing that I might have Covid-19.” He notified UCL, who recommended that he start self-isolating. He found himself shivering, feeling both hot and cold, unable to stop coughing and extremely tired. It sounds like a pretty typical picture, but the lack of early testing meant he had no definitive way of telling if he actually did have Covid-19.

Another UCL student went on a night out before lockdown. The next day, he woke up and found that he was unable to smell or taste anything, which lasted a few days. At the time, this was not an official symptom according to the NHS website, so he carried on with his week and did not think much of it. Only now does he wonder if he had coronavirus after all.

“Students are often unsure whether they have had Covid-19, something else, or nothing substantial altogether”

Fast-forward seven months, the landscape is very different. A change in sense of smell or taste has become an established symptom and it is easier to request a test, although unconfirmed reports from some students off-campus suggest they are still being sent many miles away to do so. At the beginning of the 2020-21 academic year, UCL themselves have launched its UCL Connect to Protect tool to report potential cases of coronavirus on campus. The higher prevalence of testing has highlighted that university students may have an overall higher rate of asymptomatic cases than the general public, and UCL could be experiencing this too. 

Recent figures by Public Health England suggest that one in eight Londoners could have antibodies against Covid-19. Those who were unable to report their symptoms or were unaware, could be included in this figure. To complicate this further, UCL Professor Tali Sharot at the Department of Psychology & Language Sciences describes a phenomenon of positive thinking mixed with anxiety leading people to think that they contracted Covid-19 prior to its official discovery. With all this playing into force, it is no wonder that students are often unsure whether they have had Covid-19, something else, or nothing substantial altogether.

“While I did not need to see Covid-19 patients as a medical student on the wards, I was aware that the vast majority of the staff had caught the virus during the pandemic, and that transmission was plausible”

In response to the asymptomatic cases amongst university students, the University of Cambridge and the University of Nottingham are introducing Covid-19 screening programmes using pooled testing to help prevent outbreaks and allow campuses to stay open. This is when several samples are mixed together after which the pooled sample is tested. If the result comes back positive, the people in the group then need to be tested individually. However, some experts have raised concerns over whether the costs, benefits and harms of such programmes have been evaluated, calling for advice from the UK National Screening Committee. UCL have announced no plans to introduce this programme yet. 

Still, while students as a whole have experienced milder symptoms and side effects than the general public, I have seen the other side to the coronavirus pandemic during my rotation in a respiratory ward at a District General Hospital outside of London.

“It was only when I was done with the placement, and had a mandatory Covid-19 test, that I was able to meet anyone from my family”

One morning, I found myself arriving onto the ward amongst a flurry of activity. A Covid-19 patient, who the day before had seemed fairly well and I had assumed would be a straightforward case, had become acutely unwell overnight. Her care was quickling escalated, a sobering reminder that people can become very sick with coronavirus.

It was also impossible to visit my family on the weekends. One doctor had told me that at the peak of the pandemic, the patients he saw in the intensive care unit were generally South Asian and middle aged - exactly like my parents. While I did not need to see Covid-19 patients as a medical student on the wards (the staff were very clear to me that there was no obligation to do so), I was aware that the vast majority of the staff had caught the virus during the pandemic, and that transmission was plausible even with personal protective equipment. It was only when I was done with the placement, and had a mandatory Covid-19 test, that I was able to meet anyone from my family.

“The patients often felt breathless when exercising and were severely tired through the course of their illness. It was often much clearer after a week or so which way they could go”

It wasn’t all doom and gloom though. One elderly lady with an array of comorbidities had been very close to death with coronavirus. However, thanks to some excellent hospital care, and recruitment onto the RECOVERY trial, she was literally saved from death. Yet, in a period where it is clear that we still have so much to learn from the virus and clinical approach is dependent on emerging data, it is evident that Covid-19 remains a threat to our loved ones, even if we are fortunate not to be the ones directly affected. 

What was interesting was seeing that all the Covid-19 patients whom I encountered had the classical symptoms mentioned on the NHS website: a high temperature, a continuous cough (often dry), and sometimes a loss in their smell or taste. The patients often felt breathless when exercising and were severely tired through the course of their illness. It was often much clearer after a week or so which way they could go. One had even returned a negative coronavirus test, despite having classical symptoms. This is not common, but it is a reminder that the non-specific nature of Covid-19 is exactly why people should continue self-isolating if they have symptoms.

Given this, the advice to UCL students is fundamentally still the same as back in March. Adhere to social distancing, keep washing your hands and watch out for symptoms of the virus. As we head into the winter and an increase in coronavirus cases, it’s still our best shot at curbing the spread of the virus.

Tharani Ahillan is a UCL medical student and a regular contributor to Pi Media, who has been reporting on the pandemic since its beginning. Read the rest of her Coronavirus series here: