She plays lacrosse for her country and juggles motherhood with being a GP. Now Dr Emma Hawkins is preparing for the biggest challenge of her life

Emma Hawkins has played for Wales since she was 17 and has been a GP for nine years (Twitter: Wales Women Lacrosse)
Emma Hawkins has played for Wales since she was 17 and has been a GP for nine years (Twitter: Wales Women Lacrosse)
21:06pm, Tue 31 Mar 2020
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Wales lacrosse player Emma Hawkins is preparing for the biggest challenge of her life, but it's not taking place on the field.

She has been a GP for the last nine years, working part-time at a practice in Banbury, north Oxfordshire.

And when NewsChain spoke to her this week, she told us that she and her team were bracing themselves, the calm before the inevitable coronavirus storm.

"We're a couple of weeks behind the curve in terms of the London outbreak, so in terms of coronavirus stuff we're fairly quiet. But there is a lot of preparation work being done to try and plan for the big wave of very poorly patients who are about to come our way," she said.

"We're processing prescriptions so we aren't doing time-consuming prescriptions in a few weeks time. We're setting up local infrastructure with other practices in what we call a hot hub. What that means is all the practices [in the local area] will share responsibility for staffing a new centre for symptomatic coronavirus patients. 

"We're also setting up a rota of clinicians to visit patients in their homes if they cannot leave for whatever reason.

"Unfortunately we are also having to do a lot of palliative care planning as well. Setting up processes to try and set up end of life planning for poorly elderly patients over the next few weeks, which we hope won't be necessary.

"But it is better to be prepared. We have to plan for this situation, looking at the rest of the world, we'd be naive to think it wasn't going to be necessary."

And while planning for the impact that coronavirus will have is taking up the bulk of their time, the 37 year-old doctor is  quick to point out that their normal practice  workload will continue to need their attention.

"You still have people having strokes, heart attacks, things that as GPs we can't manage safely in practice.  It's about making those decisions, whether or not you expose that patient to the risk of going to hospital.

"That's another instance of the coronavirus mortality that we won't be able to quantify very easily. The people who sadly die or become very unwell as they won't be able to access healthcare because of coronavirus. We'll probably never know how much affect it has or how many numbers that is."

Emma's practice has locked its doors and gone from seeing 32 patients in person every day to just one. And while the much talked about Personal Protective Equipment (PPE) has been provided for the staff, the supply isn't extensive.

"We've got simple surgical masks, no eye protection, simple plastic aprons and gloves. We had 200 sets of masks given to our surgery two to three weeks ago and that's to share between four GPs, three nurses and admin staff (though admin are not currently seeing patients face to face).

"The guidlines say you are not supposed to wear those unless a patient is symptomatic (visibly showing symptoms of the virus) of coronavirus, but that doesn't sit well with the evidence that we with science backgrounds understand.

"It doesn't make sense that we are being asked to socially distance because of the concern with asymptomatic (not showing symptoms of the virus) spread but guidelines say that you don't have to use your PPE to examine a patient." 

The confusion between different guidelines is down to the lack of NHS funding, according to Emma.

"I think there is a background of such chronic under-funding in the NHS over the last 10 years that we don't have a stable base to deal with these sorts of crisis. I think decisions are being made about stockpiling equipment with the cost benefit analyses on what PPE has been stockpiled already. 

"The cynic in me says the guidelines have been made knowing what resources are available rather than the best case scenario because we look at the news. There are pictures of people all over the world in full PPE with filter masks and eye protection and full cover gowns which has to be the gold standard.

"No one is saying we need that level at GP yet. But pretty soon we will be in a situation where we will be asked to visit patients in their home, where a family of four could be coughing in the same room for a week. It seems illogical to me, where you have the virus in the air, and we're being asked to go in without PPE."

Hawkins is a GP who is preparing for the peak of the coronavirus (Emma Hawkins)

The Government has faced criticism that it reacted too slowly to the pandemic and lockdown measures that are now in place should have been imposed sooner. 

Emma agrees and cites New Zealand, where reaction times were a lot swifter.

"From my lacrosse background, I know someone who plays for New Zealand and lives there. She said they were given 48 hours notice of a lockdown when the country had 100 cases and that sounded fantastic to me.

"Certainly everyone I know with a medical background has been saying for the last few weeks, since this [lockdown] has come in, we needed earlier intervention. There's no point in moaning about it now and it's about getting on with the situation we've got, but it's safe to say most of the medics I know wouldn't have gone down this route."

Despite a late reaction, lockdown measures were enforced on March 24 in the UK.

In similar scenes across Italy and Spain, Britain celebrated their NHS with a Clap for Carers that saw thousands of people standing by their front doors, hanging out of windows or standing on their balconies to come together to applaud the workers who look after the nation.

The gesture was emotional for many who took part, so how was it for Emma - one of the people the nation were clapping for?

"Yes it was very emotional, it was just lovely, a real outpouring. We were out there clapping as well. We were particularly clapping for our Sainsbury's delivery driver who was bringing food to an elderly couple who live a door away.

"It's them, at the moment, who are the unsung heroes. As much as everyone remembers the NHS staff, it's key workers like that who are keeping things going.

"Being able to bring food to the vulnerable population who are isolating is important so we were clapping for him who happened to be outside."

Key workers are the only employees in Britain at the moment who are being encouraged to go to work, with others working from home or being unable to do their jobs.

With many thousands incapable of working, the Government asked for 250,000 NHS volunteers to help ease the pressure on the health service. The response was astonishing and to date more than 700,000 people have come forward.

Emma said the response is something NHS workers are very appreciative of.

"It's fantastic, isn't it brilliant?! I know when it was announced our Wales lacrosse group was just pinging away with almost everyone volunteering to do one thing or another.

"My team and other NHS workers have just felt so well supported which is just fantastic."

Emma with her husband, James and children, Elsie who's five and Rex who's 18 months (Emma Hawkins)

She has felt supported by the public outpouring of affection towards the NHS but no one supports her more than her family - husband James and their children Elsie, five, and 18-month-old Rex.

Emma said Elsie's biggest struggles are being away from her grandparents and not being able to go to school.

"She has had a lot of questions about the coronavirus and we have these Alexa devices that flash up the news and we've had to switch that off as we were getting uncomfortable questions. 

"She had a cold in February and she asked 'mummy, have I got the coronavirus?' So, she is quite switched on and she knows the situation.

"The children have struggled with being away from my parents.

"My dad is in his 70's and he has asthma and he and my mum live about 20 minutes down the road from us. We made a decision to shield them, so they've been in isolation for two to three weeks now. We haven't seen them face to face which is difficult, especially for the children. 

"They've both struggled with that. We see them on Facetime or Alexa which is lovely and amazing that we can do that now. 

"The biggest change for her is her school. Home-schooling your own child is an awful situation! They are argumentative and whingey and trying to do it with a one year-old running around at the same time has definitely been one of the biggest challenges!

"But she's been okay. She's probably getting more spoiled at the moment because we've ordered a lot of garden equipment. A swing and a basketball hoop.

"She'll get spoiled on her birthday in a few weeks because her party has been cancelled. But she generally understands the situation and why things are happening so she's been okay I think."

With Emma's parents isolating and her husband working from home as a barrister, if her GP practice need her to go full-time in a few weeks another problem will arise - childcare.

"I've got a 18 month-old and I'm still breastfeeding him so that's a limitation for me, that will be a challenge to be pulled in different directions. 

"At the moment we are reliant on nannies coming in and out. We've gone through four nannies in three working days due to self-isolation.

"It's difficult because you want someone you trust and know really well to be coming and looking after your kids. You also have that extra element of anyone coming into the house [being a risk], you can't social distance from a 18 month-old.

"So you take on that degree of risk for your family as well as the risk from work too but those are all calculated risks."

Emma in her Wales kit with her children (Emma Hawkins)

As well as using her family as a support base through these challenging times, Emma reaches out to her lacrosse team-mates. She has been playing for Wales since she was 17 and has built strong relationships with the girls in the team.

Five players, as well as her, are NHS workers and they use apps, such as WhatsApp, to remain in contact with each other to share information and to emotionally support one another.

"There's private messaging, particularly between me, another GP and Ellie [Gaastra] our captain and a critical care anaesthetist.

"It's a combination of sharing useful medical information and getting support. Asking how each other's days have been, finding out if each other have had to deal with difficult things and helping each other de-stress. We send funny things as well because it's easy to get trapped in the negative things and there's plenty of funny jokes online, humour is needed."

While she can rely on her friends in the squad, Emma does admit that the NHS workers within the side hide their worries about the coronavirus from those who don't work in the health service.

"We try to keep the support stuff between us medics, away from the main group. I think we're all putting up a bit of a front and trying not to appear worried, trying to look calm and professional.

"But all of us are struggling with things at different times so we will keep that between ourselves."

As well as juggling being a GP and a mother, she is still maintaining her lacrosse training.

Wales were meant to be playing home internationals on April 4-5 against England and Scotland but they were cancelled. The team's next big tournament is the World Cup next summer.

"There is a training programme and there have been a few running things. Lots of the mums [in the team] are used to not being able to access the gym and have got solutions like using children as weights! 

"The team did a Zoom training session all together the other day.

"Focus of training has changed a little bit as we were counting down to the home internationals, so now the next thing is the World Cup. 

"I think it is really helpful to have a target to train for. A lot of us have that in our heads, to get through the next six, nine, 12 months, which will be difficult. 

"Although there's no guarantee this will all be sorted by summer 2021, it feels distant enough away to be a tangible, to have as your goal post."

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