The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was probably the greatest recent challenge to health and healthcare delivery internationally.
First identified in Wuhan, China, the spread of the disease is well documented. The World Health Organisation (WHO) declared the disease a public health emergency of international concern in January 2020, and declared it a pandemic in March 2020. The first documented death from COVID-19 in the UK was in January 2020, and that ‘first wave‘ of cases in the UK was (at the time) one of the largest outbreaks.
Coronavirus posed a series of unique problems to patients with kidney disease. An immediate re-organisation of services (based on extremely limited data) was undertaken with the aim of protecting as many patients as possible from the potentially devastating consequences of contracting the disease, and maintaining life-sustaining services as safely as possible. Finding the balance between these two objectives was difficult. While individual renal units felt their own ways through many of these difficulties there was a tremendous, nationally cohesive, effort to share practice, experience and (as it was gained) expertise.
This effort was led by the newly formed UK Kidney Association (UKKA), spear-headed by Paul Cockwell, Sharlene Greenwood, Katie Vinen, Claire Sharpe, Graham Lipkin and many others. A dedicated section of the UKKA website hosted relevant documents, guidelines, and links to trusted external resources. Regular communications aimed to upskill clinical teams as data emerged to inform practice. Zoom meetings and webinars, such a foreign concept just months before, became weekly staple.
The UK Renal Registry, under the leadership of James Medcalf and Dorothea Nitsch, worked with units to capture and report cases and fatalities in prevalent renal populations to describe the patterns of disease for patients with kidney disease across England, Wales and Northern Ireland. Professional organisations worked closely with major patient charities (Kidney Care UK and the National Kidney Federation) to ensure patient-facing documents and communications were consistent with the most recent advice, in the early days with a particular emphasis on ‘shielding’, how to access support, and ensuring patients who were identified as ‘clinically extremely vulnerable’ (CEV) had been identified as such for all available support.
For dialysis patients the need to continue attend for life-sustaining therapy was clear, but it seemed likely that they would be more likely to develop a severe manifestation of the disease (a fear that was unequivocally proven to be correct; Williamson 2020).
For transplantation services the issues for the prevalent transplant population and acute transplant programs were also clear. Unlike dialysis patients though, prevalent transplant popu““`
Last Updated on January 7, 2025 by neilturn