Manveer Rahi
Dr Manveer Rahi is a junior doctor at the Western General Hospital in Edinburgh, working in colorectal surgery. He has previously worked at the Royal Infirmary of Edinburgh in cardiothoracic surgery. He also sits on the Management Board for Trainees in the Lothians, representing approximately two to three hundred doctors in the South East of Scotland.
Details
- Date of interview: 20 April 2021
- Archive reference: RCP/RES/2/12/17
- Interviewer: Daisy Cunynghame
Timestamps
00:00 Introduction
00:34 Changes to work patterns
03:47 PPE and equipment
05:36 Long term impact on NHS
07:38 Government response to pandemic
09:36 Public response to pandemic
11:52 Vaccines
14:40 Personal experiences of friends and colleagues contracting coronavirus
16:18 Effect of the pandemic and lockdown on home-life routines
18:19 Misinformation on the pandemic
21:21 Closing comments on Scottish election and NHS reform
Transcription
Interviewer:
Could we please just start off with you introducing yourself, saying your name, your medical specialty and where you work?
Manveer Rahi:
Sure. My name is Dr. Manveer Rahi. I'm a foundation trainee in the Royal Infirmary of Edinburgh and I'm currently working in the cardiology department.
Interviewer:
Thank you very much. Could you explain how the pandemic has affected your working hours and whether there's been a change lately in comparison to six months ago when we last spoke?
Manveer Rahi:
Sure. At the start of the pandemic, my working hours had changed, not dramatically, but significantly because I was forced to—well, forced is maybe the wrong word—but I was encouraged to take on extra shifts in the rota to kind of help our colleagues in respiratory medicine.
At the moment, I'm working pretty much normal hours as per a medical rota. So, whilst it's busy, it's not uncharacteristic of the kind of medical job that I'm working on at the moment. So, I don't think the pandemic has significantly changed my working hours on the current placement.
Interviewer:
Thank you. Something else we spoke about six months ago was your thoughts on the long-term impact of COVID in terms of both physical and mental health. I just wondered if your perspectives have changed or if you have any more thoughts on that?
Manveer Rahi:
Yeah. I think the impact on mental health has been significant. I think for clinicians, it's been significant, but also for patients, it's been equally significant. Stress and burnout amongst clinicians is something that we obviously really worry about in medicine, and we've taken a really forward approach to the well-being of doctors. We've made available counselling sessions and psychological therapies for doctors. Headspace, who run a kind of mindfulness app, have made it free to NHS (National Health Service) staff to use, and it's something that I've definitely utilised. It's been a fantastic resource to keep us kind of level at the moment.
Something that I've seen in patients is more patients coming in in mental health crises, which is interesting. My last rotation, which was paediatrics, I was doing that between December and just earlier this month, actually. What we were finding is that there were more children coming in with eating disorders and also with drug overdoses with the intention of suicide. My senior colleagues, including the consultants, had commented on the increasing rates of patients, particularly children coming in in mental health crises, and that's quite unusual. We think that a lot of this has been due to the stress of being off school, the stress of isolation and the stress of lockdown as well. So, there has been a significant increase in the burden of mental health in both clinicians and patients as well.
Interviewer:
Thank you very much. Something else that we spoke about was PPE (personal protective equipment) shortages and medical and equipment shortages, and I know some people were even having to go out and buy their own equipment. is that something which you have experienced over the last six months? Has there been a change at all in that way?
Manveer Rahi:
At the very start of the pandemic, there was very mixed messages with regards to PPE. So, our Italian colleagues were hit hard and early by the pandemic, and we saw our colleagues in Italy using FFP3 visors, aprons, and gloves. It felt strange to look at our colleagues and things on the news and not have any PPE in place at the very start of the pandemic. And there wasn't the ability to scale the production of PPE particularly quickly at the very start of the pandemic. So, there were individuals going out, buying their own PPE, GP practices having to reuse PPE, which is obviously not great working practice. It's actually quite unsafe, but they were forced to do that because of issues around personal safety. Now we have the capacity to produce PPE at a rate where we're able to produce it as fast as we use it and I think that's been a major change. So, there's no real shortages of PPE at the moment, which is which is really fantastic. I think the government have done a really good job, actually, in scaling up the production of PPE.
Interviewer:
Thank you. Another question is in terms of—and you've sort of touched on this just now—the long-term effect in terms of how the NHS is managed, how it's funded, and the government support for it, which you've sort of mentioned in terms of PPE. But do you think there are any long-term changes in terms of how you work and how the hospitals are managed as a result of COVID?
Manveer Rahi:
Absolutely. The pandemic has had some quite a few unintended side effects in the way that we practice medicine. One of those things has been accelerating reforms in digital innovation in the NHS. So, the use of technology such as ‘near me’ and digital clinics has been a dramatic change we've seen over the past year in the pandemic. That's been fantastic for patients because it meant that we've increased access to virtual clinics for our patients, which means that they, first of all, don't need to travel into clinics and they're more able to undertake those clinics from home or from work. It just reduces the burden that patients undertake to make hospital appointments. In terms of kind of organizational change, I think that is a that is a dramatic one and it's one I hope that that actually stays around as well.
In terms of service provision, we've definitely changed the way that we work in in hospitals. I think we have come to realize that staff well-being is really important, and we've focused on, you know, making sure that there's adequate rest facilities for doctors and nurses, because sometimes you can often feel a bit forgotten about. So, the welfare of healthcare staff has kind of been put at the forefront, which is a really positive change as well.
Interviewer:
Thank you very much. Kind of following on from that, do you have any additional comments in terms of the government's response to the pandemic? Obviously, we've talked about this before, but in the last six months, you know, the guidance that's issued to the public and the sort of regulations that are in place.
Manveer Rahi:
So, actually, I think the government has done a relatively good job overall. Generally, they've been led by science from early on and they've scaled the vaccination program aggressively, which I'm really grateful for because it's provided a lot of certainty in how we practice. At the start, I think the government faltered. They had a bit of a difficult time getting out of the gates because the communication was actually quite poor and at times, there's been mixed messages coming from Holyrood (the Scottish Parliament) and Number 10 (10 Downing Street, the office of the UK Prime Minister).
This was most true, obviously, around the Christmas time when we were promised a normal Christmas with our families and only three weeks later, there was a retraction by Number 10 there. I think that was quite a humbling experience for the government. It went to show that nothing can be taken granted and there's been no real promises from the government with a kind of prescriptive dates. They have offered suggestions in terms of dates, which we've been able to keep, which has been fantastic for morale. So overall, whilst they've been able to offer guidance, they haven't promised anything, which I think is really positive. Overall, I think they've done a good job. We often look to our colleagues in Australia and New Zealand who have been out of lockdown for much longer. They've held the Australian Open and we're a bit envious there, but I think we will hopefully learn from our colleagues who have done well and it will improve our pandemic preparedness, should anything like this ever happen again.
Interviewer:
Thank you. Following on from that, do you have any thoughts on the public's response to these regulations and these sort of guidelines in terms of lockdown, mask wearing, that sort of thing?
Manveer Rahi:
Yeah, it's there's been a lot of fatigue, I think, from the public. I think the majority of the public have been fantastic in their response. Lots of people are social distancing. Many people follow the regulations. But as you've gone on through the pandemic, we have noticed more people who are breaking the rules to drive out to the countryside, the Highlands, beaches, and local beauty spots, not staying within the five-mile radius that the government had advised. Less people wearing masks in public places because they feel that the threat of coronavirus has been diminished. So, there is definitely fatigue as time has gone on. I am thankful that the majority of the public has continued to has continued to adhere to regulations.
I have to mention small business owners because I feel like they've been hit particularly badly during this time. We had to furlough thousands of people across the UK, and small business owners have been asking why they haven't been able to open, and I really do feel for them. Pub owners have asked why we aren't allowed to go into pubs, and I really feel for them because the hospitality industry has been hit quite hard and I think for this reason, small business owners have a right to be to be upset. I can understand the overall fatigue from the general public with regards to kind of government guidance on coronavirus.
Interviewer:
Thank you. The biggest development since we spoke last is the vaccine or the vaccines. And I wanted to get your thoughts on how these this development has affected you in your role and if you have any wider comments about the implementation or the management of the vaccine rollout?
Manveer Rahi:
Sure. I think the vaccination programme has been a fantastic effort from the UK government. We have scaled our vaccine programme much more rapidly than our neighbours in continental Europe, which has been great because as a doctor it has given me more peace of mind. I was able to get the vaccine within, I think, the first three days of it being available to citizens in the UK. I was able to receive my second dose twelve weeks later.
Now, there has been, we have to mention, the change in the government policy from the typical three-week vaccination schedule that was prescribed by the drug development company. So, the trials were done with the first vaccine and the second vaccine three weeks later. The UK government has decided to deviate from that scientific evidence to move to a twelve-week gap between the two vaccines in the interest of vaccinating more people with the first vaccine instead of instead of the much more concentrated population that would have received both vaccines. I think in a way I understand that because actually the efficacy of the vaccine was that, you know, with a single dose of the vaccine, you may get 75% risk of severe disease or death. Actually, it probably did make more sense to try and get wider spread coverage over the population, but there was a lot of debate within the scientific community about whether deviating from the scientific protocols was the right thing to do. I think much more investigation of that is going to be needed in the future. So, I think that whilst it was done without certainty, it was probably the right move and as a doctor it allows me to work with more peace of mind because I know that my patients will be vaccinated, I'm vaccinated, so actually, the risk of the risk to personal safety is lower, which is great.
Interviewer:
Thank you. I'm now going to ask you some more sort of personal questions about your experiences. Again, if there's anything that you don't feel comfortable answering, please do just say so. Without naming individuals, since our last meeting, has anyone you know personally contracted coronavirus? And if you're comfortable talking about it, could you could you talk a little bit about that experience?
Manveer Rahi:
Sure. Three of my friends who live in the same house got coronavirus. Being twenty-something year olds they didn't experience any kind of severe side effects of coronavirus. Their symptoms mainly included loss of taste, loss of smell, fevers, and so they were able to recover in a relatively short span of time, which is fantastic. There were lingering effects, I know that one of my friends, it's taken over six months to get his taste back. He's still not able to taste things properly, which I imagine is quite difficult because everyone loves food and everyone loves, you know, being able to sample foods from other cultures and being able to explore and actually, it's a shame that he wasn't able to do that for such a long period of time. Fortunately, I don't know anyone personally who has had significant side effects from contracting coronavirus. And for that, I'm extremely grateful, because I have seen firsthand how damaging coronavirus can be to not just individuals, but families also.
Interviewer:
Thank you. Is your home life routine still being impacted by coronavirus or things sort of back to normal now?
Manveer Rahi:
No, not at all. Home life and work life feels very much like Groundhog Day. We go to work, come back home and it's become a very structured kind of routine where everything is done within our house. Whilst that's it's not a bad thing because I get to spend more time with my wife, it can be challenging because you are confined, you feel confined to home. So, we aren't able to go out to shops just yet. We expect that to happen on the 26th of April, which is just next Monday, a week from today. We aren't able to access gyms, so we bought gym equipment in the last six months so we're able to exercise from home. Actually, we're becoming a lot more self-sufficient, I find, at home rather than having to rely on restaurants, gyms, cinemas for entertainment. And whilst we've become self-sufficient, it doesn't mean that we always enjoy it. I think we're always looking forward to being able to go out and interact with the wider society in the community. I think, yeah, everyone is looking forward to beer gardens and pubs opening up soon also, just being able to interact with our families and friends in much more social setting.
Interviewer:
My last question, we talked before about access to information and the information that's being shared with the general public, and I wondered if you had any thoughts on the amount of misinformation that's out there? Do you feel like it's increased or decreased since we last spoke?
Manveer Rahi:
I think we live in an information age and the counterbalance to that has to be misinformation. Misinformation, I don't know whether, I can't say for certain whether it's increased in volume, but I can say that the debate is incredibly polarized on things like vaccines and lockdowns. So, whilst the misinformation may not have increased in volume, it's definitely increased in its veracity and its ability to spread.
Before the vaccine came out, I got a taxi from my home to work one night shift and I was speaking to the taxi driver who asked me about various whether, first of all, whether he should get the vaccine and whether his elderly mother should get the vaccine. Then asked me about various conspiracy theories surrounding the vaccine and it was really disheartening, actually, to see how much the wider public bought into conspiracy theories and misinformation.
I have to tell a story about a cardiologist in the [United States] who advised one of his patients not to get the COVID vaccine, despite having risk factors for severe disease, including heart failure. He did this on the basis that the patient had a lot going on and that he felt that the vaccine had been rushed through and he wasn't sure of its safety or efficacy. Now, I found that incredibly interesting because in medicine, we do everything on an evidence base. We prescribe drugs that have been signed off either by the FDA (Food and Drug Administration of the United States) everything has to go through the CDC (Centre for Diseases Control in the United States) or the MHRA (Medicines and Healthcare products Regulatory Agency) in the UK, these are governing bodies who regulate drugs and medicines. If there is uncertainty and anxiety amongst doctors about using drugs that have been deemed safe by our regulating bodies, then it is only to be expected that the wider public is also going to have anxieties about things like the vaccines, which have been moved much more quickly than they have previously and through the testing stages.
Interviewer:
Thank you very much. We're essentially done now. But before we wrap up, is there anything else that we haven't covered that you'd like to talk about?
Manveer Rahi:
I think that the government—we've got a Scottish election coming up, a general election. I think this is a brilliant opportunity for political parties to make reform, meaningful reform in NHS and in healthcare in Scotland. We have come into a time where the frailties of the NHS have been somewhat exposed. You know, the huge number of vacancies in the NHS, gaps in rotors, our aged digital infrastructure, incredibly long waiting times for certain services, and those have really been shown by the pandemic. So, I feel like we're at an opportune time as we come out of the pandemic to really invest in services, in our staff, in our infrastructure, to make sure that we are ready for should anything like this ever happen again. It is just a time for reflection from the wider public and political parties in being kinder to each other, listening to each other, listening to the other side of the argument and the debate, because I feel like everyone at the moment is just trying to shout over each other. I really wish that we can use this as a learning opportunity to kind of come together as a community.