"It wiped me off my feet. Totally."

Susan Searson is lying in her bed in Ward 3A at Cork University Hospital. 3A is a Covid-19 ward and Susan is reflecting on her covid experience.

She has a lot of reflecting to do.

Susan lives with her four children, 19-year-old Dylan, Jodieleigh, 8, Humphrey who is eight, and six-year old Mark, at Fernanes, outside Cork city.

They had been sticking strictly to Covid-19 restrictions, because Susan is asthmatic. However, Susan began to feel unwell in the opening days of the New Year.

On Sunday 10 January, Susan developed severe chest pains, she was coughing and she could not breathe properly. She rang her GP who called an ambulance and she was brought to Cork University Hospital.

Nobody suspected Covid-19 at that stage, why should they? Susan had not done anything she felt might have put her in the way of being infected.

Susan thought she had pleurisy; the ambulance crew thought she might have had a severe asthmatic attack.

She was brought to Cork University Hospital's emergency department and, given her symptoms, she was given a Covid-19 test there.

The results came back positive. Susan's condition deteriorated rapidly and within hours of leaving home, she was being treated in the intensive care unit, on full oxygen to help her with her breathing.

Susan was one of seven patients being treated in critical care at Cork University Hospital that night, and one of 135 Covid-positive patients being treated throughout the hospital.

That was one of many nights since Christmas when Cork University Hospital had more patients being treated for Covid-19 than any other hospital in the country.

Worse was to come, for Susan, and for Cork University Hospital.

Susan spent the next fortnight in intensive care, as staff there battled to help her with her breathing.

Like many other hospitals at this time, the number of Covid-positive patients at Cork University Hospital continued to surge.

Admissions were exceeding discharges consistently, day-on-day.

Hospitals were crashing through staging points of their surge capacity plans, until the hospital system eventually teetered. Or, if it did not teeter, it came damn close to it.

That the system did not tip over the edge, did not become overwhelmed, is testament to the staff who worked on the frontline in those days and weeks, and those behind them in supporting roles.

In the midst of all this, Susan Searson and the doctors and nurses who were caring for her continued to fight her battle until she turned the corner.

"I still get really, really breathless when I do things, and I get really exhausted very quickly, it has wiped me out completely"

Covid-19 was claiming the lives of many people, but Susan's team were working on the basis that she was not going to be one of them and that, if they kept winning individual battles, they would eventually save more lives.

Susan's breathing difficulties began to ease after two weeks in ICU. She was discharged to a general Covid-19 ward, where the requirements of her treatment would not be as intense.

She facetimed her family every day, but it was distressing, particularly for her younger children, so she texts now instead and sends them lots of virtual hugs. 

Her recuperation has continued. Small tasks make huge milestones, such as getting out of bed, sitting in a chair, or walking. 

She still suffers from breathlessness, but her condition improves every day and she can afford to think about going home. 

In the meantime, Susan reflects. 

"I went from doing everything, as soon as I got up in the morning I never stopped until I went to bed in the evening, to doing absolutely nothing," she explains.

"I couldn't lift my head up, I was tube fed. I couldn't feed myself.

"I couldn't raise my arms. I couldn't move my legs and then, this last week, I have been able to sit up in a chair ... I still get really, really breathless when I do things, and I get really exhausted very quickly. It has wiped me out completely.

"But I'm getting there now. I'm getting stronger every day."

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Susan describes her Covid-19 experience as scary. She feared she would die, leaving her children on their own.

She would like to send a message to people who are fortunate enough not to have contracted the virus.

"Adhere to the restrictions: they are there for our safety," she said. "We need to be very, very careful and cautious because it is very, very serious and dangerous."

If Sunday 10 January is a significant date in Susan Searson's Covid-19 battle, the following Saturday, 16 January, is a significant date for Jennifer Carroll.

Jennifer is Clinical Director of Medicine at Cork University Hospital. She is one of the physicians who has been treating Susan. She has treated scores of other Covid-positive patients.

As things happen, Jennifer was also on duty in Cork University Hospital's emergency department on the first weekend in March last year. A week earlier, NPHET had confirmed the first case of Covid-19 in this country.

Jennifer and her colleagues decided they would have to separate Covid-19 patients from other patients at the hospital. They devised Covid and non-Covid pathways through the hospital, which remain as dividing lines there to this day. 

She and hundreds of her colleagues have been at the frontline, as it has become known, since then. 

She speaks of how the hospital coped with the loss of 200 nurses who either contracted the virus or were deemed close contacts during the first wave of the infection.

Another 60 junior doctors were forced off the roster for the same reasons, while a smaller number of consultants were similarly hit.

Replacing those staff was an impossible job, Jennifer recalls. But the hospital pulled through. In fact, it managed well during the first and the second waves. Colleagues worked double shifts, and covered for each other. 

This third wave, though, beginning on St Stephen's Day, has been different. It has certainly been more difficult.

The third wave is over a month old now. It has already left its mark. 

Within the third wave, 16 January is significant for Jennifer Carroll. For her, it was the worst day of the pandemic. It wasn't that anything unusual happened that day, it was just its sheer intensity.

That night, there were 152 Covid-positive patients being treated at Cork University Hospital.

Yet again, CUH was treating more Covid-19 patients than any other hospital in the country. At 14, it was also treating the third-highest number of patients in critical care in the country.

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The surging numbers at CUH mirrored the national picture. At 8pm that night, 1,872 Covid-positive patients were being treated in the country's hospitals.

On a daily basis, hospital admissions for the virus continued to be greater than discharges. There was talk the hospital system might be overwhelmed.

In addition, people were dying, despite the best efforts of doctors, nurses and care teams.

Jennifer Carroll is not someone given to emotion, but she describes that day, into that night, and the following morning, as distressing for her and her colleagues.

Ward rounds alone took her nine hours to complete, not just because of the volume of patients, but because each time she interacted with a patient she had to gown up beforehand and gown out afterwards.

And when that was finished, there were the phone calls to family members - people who could not see their loved ones, even though their loved ones were approaching the end.

In many cases, there were multiple phone calls in relation to the same patient, because relatives were based in different places, some of them abroad, and it can be difficult communicating with families that the end is approaching when they cannot understand why their loved one cannot be kept alive longer.

"I suppose there are two types of pressure," Jennifer Carroll said.

"There is the professional pressure to get it right and make sure your patients are treated appropriately but, because of this illness, because of the unknown issues around it, there is a huge emotional pressure.

"We are trained to be resilient. We are trained to manage under pressure and we do that. I have seen nobody not managing because of Covid-19 and the pressure it's producing, but it does take an emotional toll."

"We cannot fail at the last hurdle, because we cannot manage in this hospital if we have a further crisis like we had two weeks ago." 

In the midst of the darkness, there are some heartening experiences too.

Just over a week ago, the intensive care unit at CUH reached critical capacity. There simply were not enough trained nurses to cope with the increasing number of positive cases presenting who required care in the ICU.

An appeal went out for staff from other areas to volunteer to work extra shifts to help out colleagues in intensive care.

Everyone from surgeons to physiotherapists responded, and worked as "runners" for the trained ICU nurses on duty. The intensive care unit, its staff and their "runners" pulled through: it wasn't overwhelmed.

"We are all human, and we all need that support from each other as colleagues," said Jennifer Carroll. "That is what a hospital is all about."

Jennifer is appealing to the public to show similar support for the restrictions recommended by NPHET and endorsed by the Government under Level 5.

She describes meeting a nurse earlier on the morning we meet, who told her she was physically exhausted, drained and weary. She wished it was over.

"That's where everybody is at, if I'm honest," Jennifer Carroll said of herself and her colleagues.

"I would like to emphasise again for the public, I know they are feeling the equivalent weariness. I cannot stress, I know we have only another hurdle to go.

"We have vaccines coming and I know it's difficult and I know people are frustrated, but it makes such a difference. Our numbers are falling now because people are adhering to the restrictions.

"We cannot fail at the last hurdle, because we cannot manage in this hospital if we have a further crisis like we had two weeks ago."

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