Glasgow pathologist on the challenges faced by team during Covid pandemic

At Scotland’s largest mortuary, staff have been working under increased pressures to perform a vital role: ensuring those who died during the crisis are treated with the utmost care and dignity while also supporting bereaved families.

In the basement of the Queen Elizabeth University Hospital, the mortuary services team had to quickly adjust working practices to keep staff safe and continue an ethos of treating the deceased and their loved ones with compassion.

READ MORE: Inside the covid wards: Nurses and patient speak about life in Glasgow's superhospital

Consultant pathologist Sylvia Wright works across three different teams at the hospital: head neck pathology, cardiac pathology and also in the autopsy team undertaking hospital-based autopsies and post-mortem examinations on behalf of the Procurator Fiscal. 

“At the beginning of the pandemic we didn’t really anticipate how much things would have to change,” Sylvia said, “And how long all of the different restrictions would go on for and the impact that would have on staff.  

“It has been a very challenging time. 

“Dealing with death and talking about death is really difficult but it is really important to have these conversations and let people know that in the mortuary everyone is treated with dignity and compassion.

“Everyone works really, really hard to care for the deceased and their family members at these difficult times.

“So we wanted to make sure the focus was on the deceased and their families and make sure everything was dignified and as smooth as we could make it.”

An awful reality of the impending pandemic was that death rates would rise and so one of the first concerns of health officials was body storage.

In NHS Greater Glasgow and Clyde (NHSGCC) there is capacity for around 600 spaces split across six sites with 300 spaces for the deceased in the Queen Elizabeth.  

Modelling data raised concerns that there would not be enough space so the team working with other NHSGGC partners and funeral directors in order to identify other suitable body storage. 

Queen Elizabeth University Hospital

Two other sites were identified and the team worked to help kit those out – but this meant additional staff and training was needed.

Sylvia said: “We had to ask for staff within the pathology laboratory who typically would deal with the biopsies from patients rather than with the deceased.

“We asked for volunteers to be redeployed to the mortuary to help with the other mortuary assistants in these body storage areas.

“They were fully trained and they were absolutely brilliant at helping us with the busy periods.”

Post-mortem examinations are what is known as “aerosol-generating procedures”, which increase the risk of transmission of Covid-19.

The mortuary set up was altered to make it a high-risk mortuary site, but that reduced the capacity of post-mortems that could be carried out and led to a backlog.

But, with families in mind, volunteers stepped up to help clear the backlog.

One pathologist returned to help out after 10 years of retirement. 

Anatomical pathology technicians (APTs) are highly skilled staff who assist with post-mortem examinations.

Due to their specific skillset, it wasn’t possible to redeploy staff to support their work and so Sylvia said those staff have been working “extremely hard” throughout the pandemic.

She said: “There aren’t really any other people who can do what they do without being fully trained.

“So in the pandemic that’s actually been quite challenging because there weren’t additional APT staff we could call upon so they have been working extremely hard and they’ve been extremely dedicated to the service to get all the work done that needed to be done so families were able to have their funerals.”

She added: “They’ve volunteered to give up annual leave or move it around or cancel at the last minute.

“And they are all tired but they have been absolutely outstanding really through good 
teamwork. 

“They are remarkable people.”

Sylvia, who is one of three NHS autopsy pathologists, said it was also vital for the service to find a way of continuing family visits.

Early in the first wave, viewings were suspended while health and safety protocols were put in place - but the mortuary team was alert to how important these visits 
are.

“When a family member dies it can be really comforting for families to go and sit with their relatives, spend some time with them and say goodbye,” Sylvia said, “Especially if it’s been a sudden death and they haven’t had a chance to do that in life.

“I suffered bereavements last year and I can say that being able to spend time with your relatives to say goodbye is really important for family members and their experience of their grief.

“So it’s great that we’ve been able to do that and that’s really down to the hard work of our health and safety team, our anatomical pathology technicians and our mortuary assistants.”

Family members are given PPE to wear during visits and, depending on the size of the room being used, visit in small groups.

In the mortuary, the increase in workload brought a physical burden and an emotional toll, but Sylvia said the close-knit team has been supporting one another.

“It has been very tough but mortuary staff are amazing,” Sylvia said. 

“They’ve dealt with very difficult situations in the past, such as mass fatalities, major incidents, but they haven’t had to deal with anything on this scale and for the length of time we’ve had these additional deaths.

“And you have to remember that some of these mortuary staff members have lost family members and that’s very difficult to come back into that environment having been bereaved yourself.

“They have coped with it admirably but they’ve done that due to the support of their colleagues, it’s a very strong team who are very dedicated to their jobs, very passionate and very caring. 

Family members are given PPE (stock photo)

“I’m amazed at how well they have coped with it and I’m really proud of them all, they’ve done a fantastic job.”

Some of the changes that took place due to the pandemic have benefited the service and will be continued.

Digital pathology has been used – instead of looking at tissue samples on a glass slide under a microscope, they are viewed on a computer screen and allow easier collaboration with other experts working elsewhere. Teaching has also moved online and means trainee pathologists can spend more time in their own hospitals without having to travel to the Queen Elizabeth University Hospital. 

While staff have found the second wave of the virus challenging, Sylvia said there is hope in sight. 

She said: “We generally see an increased death rate over winter so we’ve been more affected in the second wave than the first wave so that’s been hard. People haven’t had a good opportunity to rest but we’re hoping with the vaccinations coming that things will improve.

“It’s been a really tough time but the better weather and the reduction in deaths has been really heartening for people.

“It feels like we are turning a corner.”