Mark Brown talked to Dr Sebastian Kalwij at the Waldron Health Centre in New Cross in June 2021.
TRANSCRIPT
Mark Brown: This is Mark Brown for Lewisham Vaccination Stories. I am deep in the heart of the Waldron vaccination clinic. I’m here with…
Sebastian Kalwij: Sebastian Kalwij. I’m a GP in Amersham Vale Practice and also the Clinical Director for North Lewisham PCN, Primary Care Network.
MB: You’ve been intimately involved in this amazing six months of vaccination endeavour. Tell me the story a bit, from your perspective.
SC: Yes. It’s interesting. It started last December 2020, when we were asked to look for a building or premises where we could potentially vaccinate a large number of people. Having worked on COVID before, we served a hot hub in this particular suite, I thought this suite would be the best suitable.
There’s enough space. It’s a clean space. It’s well designed. It’s also well designed for a good patient flow. I thought we could use the same layout as we did for the hot hub, way back last year in March. It worked really well.
We decided to team up with a neighbouring PCN. We are North Lewisham PCN, which comprises of 10 different GP practices. We teamed up with Lewisham Alliance; they are more towards the Blackheath area of Lewisham. They’ve got six practices. Together, we are a group of 16 practices, and we look after 125,000 people in Lewisham. That gives us the scope to scale things up and offer a better service.
MB: It’s been an amazing endeavour. I’ve been involved as a volunteer. There is lots of working parts to making sure that we can make people as safe as possible through vaccination. I think, for a lot of people listening, they probably won’t be aware of all of the working parts. How does everything fit together?
SC: First of all, there is organisation at different levels. You’ve got NHS England. Then you’ve got the CCG, the Clinical Commissioning Group. We are part of the South East of London Clinical Commissioning Group. There are different players. Then we go down to general practices. We have to supply staff and, of course, we rely on volunteers who live and work in Lewisham. There are different levels.
Then, of course, you have to deal with the logistics of the vaccine. We’ve got two vaccines. Pfizer, the cold chain is quite tricky for Pfizer. It needs to be stored, especially in the very beginning, at low temperatures. In the beginning, the expiry date was very narrow, only a few days upon receipt.
AstraZeneca gave us a bit more flexibility. We could also use AstraZeneca for patients who are housebound. We could run housebound clinics from these premises. That gives us an extra advantage.
Now we mainly deal with two vaccines. The main challenge is actually to deal with the logistics. We only know a few days in advance when the next vaccines will be coming.
MB: It’s a complicated business. I think we’ve probably all learnt over time how to do it better. Thinking back to those very dark and grim days at the start of the year, at the start of 2021, what was it like during those first couple of weeks?
SC: Yes. In a way it was, like you said, dark and grim indeed with the second wave. It affected many people. It was also the heart of winter. It’s always the peak season for respiratory infections.
But on the same hand, there was also hope. That’s the one thing which we saw from the very beginning, the enthusiasm of people to be involved in this. From local doctors, nurses, volunteers, but also patients. They really were coming out of a dark shell to get vaccinated.
Especially the age groups, at that time, they were — Can you stop it? What was I saying?
MB: The age group.
SC: Yes. The age group. The very vulnerable people, the over 80s. They had been home for a long time. They also know a lot of their peers who have been really ill with COVID. For them, it was really a big event to come out to get vaccinated. It was a very upbeat atmosphere really.
MB: Yes. You’ve been right at the heart of this. How has it felt looking outwards?
SC: What was I saying?
MB: You’ve been very much at the heart of this effort. For the general public it’s been looking inwards at the effort to combat COVID and vaccinate everyone. How has it felt for you looking out over the last six months?
SC: Yes. There are two parts to this answer. In many ways, as a practice, we continued to provide services, so my life hadn’t changed very much. I was still going to work into the same practice, I worked with the same colleagues. It almost felt like COVID was there, but also we managed to carry on with our business.
Some days we didn’t always realise how much anxiety there was amongst patients. Some patients really said have never left home. “We get food delivered, we get shopping delivered, and we just stay indoors.”
Sometimes, the scope of the fear amongst people, that’s something I didn’t grasp until I started working here and people have been sharing their stories. They would say they were so relieved to be able to come out. It was really a sense of relief.
If you look back a year ago, a year ago we could not have foreseen that there was a vaccine so quickly. I think that has been trying for science, but also given us the tools to actually do something about this pandemic. That thing has been really exciting and to be part of that, that’s great.
MB: What do you think you’ll always remember about this time, looking back on it?
SC: Many things. Above all, working with a lot of my colleagues. It’s really cross-practice work. Worked with a number of volunteers from such a variety of backgrounds. Really, the joined effort to make this work.
So many volunteers work on their spare weekends. The same with doctors and nurses, who come in an extra day in the week just to help out with vaccination. I think the camaraderie, the joined effort to attack this pandemic, that’s something that I will remember.
MB: Have there been any frustrations at all?
SC: The number one frustration is the lack of vaccines. That’s the main one. We could do this 7 days a week, 1,000 people per day, if there would have been a good supply. But that’s not just us, it’s nationwide. It’s a worldwide supply issue.
When you think about it, we are very fortunate that we are able to vaccinate. There are so many countries in the world where they haven’t even started. I think we are ahead of the game and it’s good to be part of that.
But also, there were some hiccups. The logistics of the vaccine delivery could have been a bit smoother.
MB: Have you seen much of the effect on the community around here. We’re in New Cross now, Deptford/New Cross: Have you seen much of the effect of the pandemic on the community?
SC: Yes. The demographics are quite young. Young people living in this area. First of all, all the cafes are closed, the university closed down. It has a big impact. On the streets, it looked empty. Who was it, the Rolling Stones said this is a ghost town? It really felt like that. Cycling into work, crossing the A2 with no cars, it seemed very surreal.
What I was struggling with all this time is, it’s so quiet. You could hear birds singing, was a good thing about it. But also, it felt unreal. It felt there was something missing. People were missing.
Normally, you go to work, you can buy a sandwich, you can go have a coffee. It all has disappeared. So many business, I think they won’t come back. People have moved out. People have moved from, especially from rented accommodation. They have moved, either back to where they came from, the countryside perhaps, or moved to places with more space. It definitely felt like it was a bit of a flux out of London.
MB: Yes. It’s been a very, very strange and very, very weird time. For me, as a volunteer, I’ve been very, very happy to be an unimportant person in one of the most important human chains I think we’ve built in the last 50/60 years. That sense of what we’re doing is, we are part of a machinery to make sure that we can make people as safe as they can possibly be.
SC: I think nobody is unimportant. I think we all play a big part in this. I think, if you look at the volunteers, how much time they spend talking to patients, making them feel comfortable. That’s part of it, a lot of patients, they come in anxious and being welcomed by a friendly volunteer wins them over.
That experience will translate to further — They will talk about it to friends. When they come back, they will go home, they say, “I went to the Waldron, there are so many volunteers that help you. You don’t have to be worried about anything, they will guide you through the whole system.”
I think everyone plays a big part in this. Of course, getting the vaccine is a bit uncomfortable, but it’s the whole experience. That has been very positive, I think.
MB: Have you got any final thoughts as we’re still possibly coming into maybe a third wave or a fourth wave?
SC: Yes. I think the waves will keep on coming. The future will reveal how bad it will hit us. I think vaccines will protect us, no doubt. It may move towards the groups who are not vaccinated against it, the younger people.
We must make a real effort to vaccinate all the young people as well, over the summer. Especially Pfizer has been given the go-ahead for people over the age of 8 to 12. There is a real scope there. The working together, especially with 16 GP practices and delivering this, I think has been a great experience. That’s the thing I will remember.
MB: Excellent. Thank you for that, Seb.