Banburyshire hospice doctor and national NHS campaign figure publishes extraordinary account of the Covid-19 epidemic

Breathtaking, published last week, is written by palliative care specialist, journalist and author Dr Rachel Clarke, whose normal work centres on Banbury's Katharine House Hospice.

Her account of the creeping threat of Covid-19 from China to Italy and then Britain contains some patients' stories of death. It records the differences between Covid-19 and other 'flu' conditions and Dr Clark does not flinch from recounting how 'we ambled, half-asleep into disaster'.

As a palliative care doctor, helping individuals to have the best possible death, she found herself spending less time in the hospice and more at the JR Hospital.

Unable to convey the intensity of her days, torn between helping patients and endangering her husband and children, and often unable to sleep, Dr Clarke began to write about her experience.

Her book describes the frustration at the lack of effective action by politicians and (along with others in the NHS) their deep concern about the consequences of delaying lockdown and a growing, abject fear at the perilous lack of personal protective equipment (PPE).

Breathtaking is her inside story of how the health service responded to coronavirus and it is often frightening and heart-breaking. But when she looked back over her writing, she found that what she had thought was an unrelenting stream of death and darkness was, in face, illuminated by pin-pricks of light - the clap for the NHS, Captain Tom's fundraising, rainbows appearing in people's windows, donations of food and treats for NHS workers, teachers using empty science labs to fashion visors and a huge community spirit with individuals making sure their neighbours had what they needed.

Dr Clarke's book records how Covid-19 began in China but from there, she also tracks its journey across the world towards Britain, where the NHS was in an already-weakened state after a decade of bed cuts and austerity.

She is scathing about government's handling of the crisis, its acceptance of an inevitable rise in the death count alongside the initial drive for 'herd immunity' and then a retreat from that tactic; the delay in the first lockdown; the continuation of huge public events such as Twickenham and Cheltenham Festival, the delay in demanding self-isolation, the abandonment of the early Covid-19 testing and a period of actually downgrading what inadequate PPE supplies there were.

"I choke down a sudden surge of bitterness and anger. Hasn't the government had since January to prepare for this?" she writes.

"I am overwhelmed by all the death to come and how resigned the government appears to be," she says as some colleagues share the terror of the consequences - colleagues with asthmatic children and vulnerable relatives whose sleep is also affected by fear at what is to come.

There are moments that would be comedic if they were not so serious - in the desperation for ventilators for the adult intensive care unit (ICU), an offer by the local university is made - for a ventilator designed for Macaques - a monkey the size of a toddler. Again the lack of investment in the NHS is felt.

"Compared to other European countries we are ranked only 25th out of 31. We have four times fewer ICU beds per head of population than Germany and ten times fewer than the US," says Dr Clarke.

She describes how her team insists that those who die do not do so alone. "Always, without fail, a member of staff will be there... amid the technological detritus of intensive care, someone will clasp a hand, whisper words of comfort, read messages of love from family members out loud and sit and wait until life in extinguished."

As well as the descriptions of the losses, Dr Clarke also recounts the survivors, who may still be affected by Covid-19 and who cannot contain their gratitude to the NHS.

In her epilogue written in August, Dr Clarke says a public inquiry will be called for. "Number Ten's strategy was initially shaped and backed by senior experts guiding the government. On the podium Johnson was invariably flanked by his chief medical and scientific advisers."

Breathtaking takes the reader only up to the pandemic at the end of April and is dedicated to more than 600 NHS and care workers who have died of Covid-19. Ten months later we are in the midst of the second wave.

This is an important publication - an essential, deeply disturbing account of the coronovirus emergency from the experience of one doctor working in our area, for which we must thank her. It is available in hardback by Little, Brown and also as an e-book and audiobook.