Facing coronavirus on the frontline: Dr Hamed Khan

Published: 20 May 2020

Dr Hamed Khan is a Senior Lecturer in Clinical Skills lecturer at St George’s, working closely with first year students on the graduate entry medicine programme. As well as fulfilling his teaching duties, Dr Khan is also working on the frontline in General Practice and in Paediatric A&E at St George’s Hospital.

Dr Khan recently featured in a BBC News broadcast answering questions from the public on coronavirus, including topics on testing for the disease. He has also written a paper describing the University's approach to delivering clinical skills training remotely. We caught up with him to hear more about his experiences and how the current pandemic is affecting life on the ground.

How has coronavirus affected your work?

It’s changed the way we work entirely. We’ve reconfigured the way we see patients in general practice to reduce unnecessary face to face contact  to minimise the risk to both us and our patients.

In General Practice we see large numbers of patients every day, and before the outbreak the vast majority of our consultations were face to face. If we had continued in this way, there would have been huge potential for the virus to spread both amongst patients, as well as between doctors and patients, within our practice. Moving to remote consulting was a brilliant idea by NHS England, and one which has vastly reduced potential transmission within practices. It was also a challenge in some ways, as many of us are not used to remote consulting on this scale.

However, GPs are incredibly adaptable and creative, as we see patients across the entire spectrum of medicine, of all ages and specialties, and in a variety of settings. We have risen to this challenge by upskilling, and devising innovative ways of assessing patients. Most patients I have spoken to seem broadly supportive of this move, as they appreciate that it reduces their risk of acquiring Covid-19. I expect that this period may well revolutionise the way in which General Practice works in the long term beyond the pandemic.

In Paediatric A&E, we are discovering that Covid-19 can manifest in a variety of different ways, and with different levels of severity in children. It has been a steep learning curve for me, and I am trying my best to keep up to date with the latest research and guidelines, and learn from the experiences of my colleagues. The Paediatric A&E team at St Georges is brilliant, and we are constantly sharing information and ideas on how we can improve the way we assess and manage our patients. There has also been a lot of discussion about the role that children may play as asymptomatic vectors, potentially spreading the infection without showing symptoms themselves. This further reinforces the need for rigorous infection control processes, both in healthcare settings as well as in the community.

What are your biggest concerns and your biggest hopes at the moment?

Something that we have been increasingly concerned about is the possibility of patients with serious non-Covid illnesses not seeking help due to a fear of acquiring Covid-19 in healthcare settings. Whilst we appreciate this concern, it is crucial to emphasise that conditions such as heart attacks, asthma exacerbations, sepsis and cancer could lead to fatal outcomes, and it is vital to seek help for these. Whilst Covid-19 can make people very unwell, most patients get the milder form of illness and do not require admission to hospital- but the outcome of untreated heart attacks or cancer could be far worse. Hence if you are very unwell, you must seek help. In that sense, we must not allow the fear of Covid-19 to lead to worse outcomes than Covid-19 itself.

My biggest hope is that this brings us together as a society and encourages people to recognise and value the hard work that our key worker colleagues do, often under very difficult circumstances.

How are you looking after yourself physically and mentally?

From a practical standpoint, one of the most important things I am doing is being extra-strict in adhering to infection control policies and practices. For example, I now carry very few things to work, to minimise the risk of spreading the virus from work to my home and my family. I also try my best to have ‘downtime’ and detach psychologically from work.

I am fortunate to have a fantastic supportive family, and spending time with my baby son is priceless, in the truest sense of the word. I also try to rationalise the amount of time I spend watching the news – keeping up to date with Covid-19 is obviously important, but ‘switching off’ from work and doing something different, like watching movies or sport, is also important to avoid burnout and maintain mental well-being.

How can other people help?

There are lots of opportunities for people to help out and volunteer in different ways and at different levels. I expect that the NHS website will have some useful information, and for St George’s students there is a dedicated section on Canvas.

The one thing that everyone should do is to follow the Government guidelines and advice with respect to social distancing and personal hygiene. If we all do that, then we can all play our part in saving lives, by reducing the spread of the virus and pressure on the NHS.