Powerful and important stories from healthcare

Josef Järhult receives us in his office at Uppsala University Hospital. Nowadays, he is not only an infectious disease physician and professor but also the Head of the Department of Medical Sciences at Uppsala University. However, our conversation today, much like this year’s Olof Rudbeck Day, will focus on a time when the first two roles were in the spotlight, namely, the time of the coronavirus pandemic.

“This year’s theme for the Olof Rudbeck Day is significant because it offers an opportunity to reflect on what really happened and how we managed the situation. There has been extensive research, discussions, and writings during the years when the pandemic was most active and immediately afterwards. However, it’s understandable that a certain saturation occurred. Now, I believe the time is right to revisit the subject, partly to discuss lessons learned and partly to initiate some form of collective processing,” says Josef Järhult.

Focus on healthcare and patient stories

In his daily life, he divides his time evenly between clinical work in patient environments on the one hand, and research and teaching on infectious diseases on the other. During the Olof Rudbeck Day, all aspects of Josef’s professional life will be highlighted. His lecture, “Viruses that transmit between animals and humans – What might have happened in Wuhan?”, will delve into what occurs when viruses spread between animal species and between animals and humans, and what the virus needs to cross species barriers. In the program, “Severely ill with COVID-19 – narratives from patients and staff at Uppsala University Hospital,” Josef will serve as the moderator.

“I believe there is a general interest and curiosity about how everything was experienced from within healthcare, both from the patients and from us as the staff. Here, there will be a more practical insight into what worked, what the challenges were, and what the experience was like for the patients. Is there something we can take with us to other challenging situations that arise or to our daily work? These are the topics that will be raised during the discussion,” says Josef Järhult.

Assisting from the other side of the world

Josef has plenty of stories from within healthcare. However, they do not begin at the same time as for the rest of the staff at the Clinic for Infectious Diseases at Uppsala University Hospital.

“The start was a bit different for me. In 2019, my family and I moved to Australia for a research exchange. I was temporarily in Sweden shortly after the turn of the year in 2020 when reports began to emerge that the virus might have spread beyond China, and then the questions started coming: Where are we heading now? Should I really fly internationally, or maybe focus on getting the family back instead?”

Josef chose to fly back to his family. The virus subsequently spread globally, and Australia imposed much stricter lockdown measures than Sweden did. He began to feel frustrated about not being able to assist his colleagues at Uppsala University Hospital, who were working tirelessly. But it turned out that there was a way to help from the other side of the world.

“It was my wife who came up with the fantastic idea: ‘Can't you answer the phone?’ It turned out that I could. When it was midnight in Sweden, the exhausted on-call doctors at the clinic of infectious diseases called me and handed over so I could manage their duties for a few hours when it was daytime for me in Australia. It turned out to be a very good solution so that those back in Sweden could rest, and I could help from a distance,” Josef explains.

New ways of working

In June 2020, he and his family cut short their stay in Australia by a few months and flew back to Sweden, getting closer to the virus “for real”.

“That’s when I entered clinical work at the hospital and experienced something entirely new. Normally, our ward has 20-29 beds. Suddenly, there were hundreds of patients admitted, many of whom were severely ill. This meant that we had to start working in completely new ways, and new specialised COVID-19 units were established. As infectious disease physicians, we were given more of a consultative role, answering questions from different parts of the hospital. We procured more high-flow oxygen machines, and the infectious diseases ward became a sort of intermediate unit for the most seriously ill patients who still did not need intensive care,” recalls Josef Järhult.

While the work was strenuous, there was still a silver lining in that it was possible to create an entirely new system for an entirely new and acute situation.

“Of course, it was very challenging, perhaps especially for the nurses and nursing assistants. There was suddenly so much focus on logistics and space, but it was fascinating that we could create a system that allowed us to meet the healthcare needs that arose. Personally, I never felt that we were in a situation where we had to choose which of two patients would receive certain care.”

Predominant feeling of pride

Even though healthcare needs were met, there were also many instances where healthcare simply was not enough. Until 14 September this year, 653 people had died from Covid-19 in Uppsala County since the pandemic began, according to statistics from the National Board of Health and Welfare. Josef Järhult looks back on the intense period with mixed feelings.

“As professionals in healthcare, we are affected by many different human fates, and naturally, we are affected by that. In hindsight, I can feel that it was a pity that, for example, we didn’t know from the start that treatment with corticosteroids was effective because it could have saved more lives. Despite this, the predominant feeling is one of pride that we helped so many, even though we navigated the unknown. We learned and improved for our patients all the time, and I am proud of that,” concludes Josef Järhult.

Robin Widing