Northern Ireland

Shielder doctor involved in landmark Covid vaccine trial reveals 'jubilation' of breakthrough after struggles in lockdown isolation

Dr Johnny Stewart took part in the landamark Novavax vaccine trial, the only one if its kind in Northern Ireland, with its research base at Belfast City Hospital Picture by Mal McCann.
Dr Johnny Stewart took part in the landamark Novavax vaccine trial, the only one if its kind in Northern Ireland, with its research base at Belfast City Hospital Picture by Mal McCann. Dr Johnny Stewart took part in the landamark Novavax vaccine trial, the only one if its kind in Northern Ireland, with its research base at Belfast City Hospital Picture by Mal McCann.

Shielding, taking part in breakthrough vaccine trials and having a baby....One junior doctor lifts the lid on on his lockdown experience one year on. Health Correspondent Seanín Graham reports

REMOTE working as a GP became a struggle for Dr Johnny Stewart six months into the pandemic - with him ending up feeling like a "call handler".

At just 31-years-old, the medic shielded from the beginning of last March due to underlying health problems which resulted in him triaging patients by phone or video consultation.

His twin sisters are also junior doctors and were based on Covid wards in Belfast's Mater hospital during the first surge, who he had to shut off from and worried about at a time of severe PPE shortages.

Separated from his patients and colleagues in a busy west Belfast GP practice took its toll on the trainee from Castlerock, Co Derry, who had come to love his job after four years in general practice alongside academic research work into asthma.

He and his wife Meghan were also expecting their second child and home-schooling their five-year-old daughter, Anna.

"Even before shielding was introduced, a decision was taken by the practice for me to work at home. I have underlying health issues so it was thought I would be at higher risk," Dr Stewart, a member of the British Medical Association's (BMA) junior doctor committee, said.

"As a GP I can do a lot phone triage type work and was able to work from home, so I could still make a contribution. But there's no joy in remote working.

"I’ve said this many times but I didn’t sign up to medicine to be a call handler. The joy of the job for me is relationships with patients and looking people in the whites of their eyes.

"It’s very difficult to build a rapport remotely over the phone in the same way as you would face-to face. You can’t build relationships over Zoom.

"It’s not just patients you’re separated from but your colleagues also and the enjoyment you get from working alongside them.

"All the bits I enjoyed most about general practice in terms of relationships, using the examination room and your vital skills – all of that went out the window.

"So I did find that really challenging and continued to find that very challenging until I stepped across to do the research post."

The 'post' was no ordinary one, as last August Dr Stewart was offered the chance to take part in ground-breaking research into a new Covid vaccine.

Led by Queen's University Belfast, the Novavax clinical trial was the first of kind in Northern Ireland and involved almost 500 participants as a part of UK-wide study totalling 15,000 people.

Hundreds of doctors, nurses and academics from across the north were assembled within weeks, with their base at the north's regional clinical research centre at Belfast City Hospital.

Such was the success that Novavax is currently being assessed by the medical regulator for approval, with 60 millions dose already purchased by the British Government.

For Dr Stewart, the timing of him being asked to oversee the GP element of the trial meant he could return to the frontline.

"The trial bent over backwards to make it compatible for me and meant I could come in, albeit social distancing and wearing PPE. It was the first time since the beginning of March that I ventured out," he said.

"Because of my research and GP background, my role was to recruit 25 local GPs. Some had very little research background but they had very good clinical skills.

"Another big part of my role was to find out somewhere safe to assess patients.

"We developed a relationship with the Belfast Covid centre and that was the location. We worked along them and assessed patients who may or may not have had Covid. Primary care played a pretty big role.

"The interesting thing about this study is that we particularly focussed on older participants, with more than a quarter aged over-65. We wanted to focus on that age group because other trials hadn’t such a heavy focus.

"My son, Christopher, was born in September and we started recruiting in October - we were blown away by the response. Even the recruitment was a huge logistical challenge in the pandemic."

The trial results were published in January in a week which saw one of the pandemic's highest death tolls.

Dr Stewart said it was a stressful time as they weren't entirely certain about the strength of the vaccine's efficacy.

"The pre-clinical data was excellent but we were still in limbo for a month or two beforehand," he added.

"Ultimately we are clinicians and wanted to do the best for our participants who we thought of as patients. The evening the results came through, I think every single one of us breathed the biggest sigh of relief you can imagine.

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"Our trial was the also the first to come out to test against the Kent variant. There was concern that the efficacy would drop off, but it had an overall efficacy of 90 per cent."

The BMA member said the moment marked the professional 'high point' of his year.

"At that point in the pandemic, it was winter and everyone was exhausted, people were looking for good news. It was overwhelming relief and jubilation that we got the results we’d hoped for - you felt you felt you were doing the right thing," he said.

The vaccine rollout had a massive impact personally as it meant his family were protected, while his elderly parents got to meet their new grandson only recently.

"We were all so worried about the twins during the first wave as they were seeing Covid positive patients all day," he added.

"We also couldn’t see my parents as they were elderly and at risk so we were facing challenges all the people in Northern Ireland were facing at that time. There was so much uncertainty and isolation."

As the health service emerges from the third wave and vaccinations continue at pace, plans are underway to rebuild non-Covid services.

Dr Stewart expressed concerns about the long term impact of Covid-19 on care as well as the workforce.

"I think there is going to be a massive fallout from the pandemic," he said.

"One of the things we’re going to see is patients who haven’t come forward for months with serious conditions - there’s going to be a deluge of chronic disease in the context of an exhausted healthcare profession.

"I also worry we haven’t seen the worst of the fallout from a psychological perspective in our profession. The hope is that staff will have a bit more downtime and chance to rest - as they haven’t had that in quite a long time."