NHS staff are suffering from ‘moral injury’, a distress usually associated with war zones | Mariam Alexander

Adequate support now could head off a post-pandemic exodus of health workers who feel broken by their experiences

• Coronavirus - latest updates
• See all our coronavirus coverage
• Mariam Alexander is an NHS consultant liaison psychiatrist

I remember the exact moment when the enormity of the Covid-19 crisis dawned on me. In the days before the pandemic was even called a pandemic, I was sitting in a hastily organised meeting of senior hospital colleagues. We were thrashing out how we might respond if the terrifying scenes emerging from northern Italy were to be replicated in our hospital. A critical care consultant stood up and said: People have to understand that we are entering a war zone - we have to adapt accordingly." There was a moment of stunned silence in the room. From somebody else these words might have seemed melodramatic, but from this wise, well-respected doctor, they struck a sobering chord.

With the latest UK government figures showing that there have been nearly 150,000 deaths where Covid-19 was mentioned on the death certificate, it's understandable why some people compare the pandemic with a war. Indeed, daily life in the NHS is now peppered with military language: the frontline, gold command calls, redeployment, buddy systems. As a psychiatrist, the term that has resonated with me the most is moral injury".