‘I felt like the pandemic was being censored.’ Photographing the fight for life – and grief of death – in COVID-19 Britain

This photojournalist documented two little-seen front lines in the UK's war against coronavirus. Her images reveal intensive care of every kind – amidst a pandemic close to every home.

Thursday, July 23, 2020,
By Lynsey Addario
50 year-old COVID-19 patient William Ferguson receives care at the Royal Papworth Hospital, near Cambridge, June 2020. ...

50 year-old COVID-19 patient William Ferguson receives care at the Royal Papworth Hospital, near Cambridge, June 2020. Since the coronavirus pandemic began, the UK's death toll has risen to be amongst the highest in the world. Papworth houses one of the specialist units that care for the sickest victims.  

Photograph by Lynsey Addario

Lynsey Addario is a Pulitzer Prize-winning photojournalist who has worked in over 70 countries and covered conflict and humanitarian catastrophe over a 20-year career. Born in Connecticut, she has lived in the UK for 9 years. 

As the COVID-19 pandemic unfolded, Addario began to cover its effects from two sides of the fight: within the high-dependency wards of NHS hospitals, and the funeral workers struggling to keep up with the number of dead arriving at their door. You can read her report here – and below, she describes photographing her first assignment on home soil.   


I’ve never been confronted with a huge story unfolding where I live. All of my work has been overseas – and I’m usually the first on a plane to go off and cover some world event, or war. Once I was confident my family was in a good place and everyone was safe, I started thinking about how I could cover the pandemic. 

It’s important for photographers, even if they’re not covering the ‘frontline’, that they are covering life right now. This is such a unique time, and we need a collection of images to look back upon. In villages, in cities, around the world - what did the pandemic look like? 

On March 21, I wrote my first email to an NHS Hospital. I had been watching the many images of overwhelmed medical facilities coming out of Italy and the United States, but from the end of march to the beginning of May, I was seeing almost no still photographs of the COVID-19 wards in the United Kingdom. The statistics of high rates of infection and rising number of dead – coupled with NHS workers leaking stories of hospitals inundated across London and other major cities, and the lack of adequate PPE – spoke volumes. But, despite trying relentlessly for months to get into hospitals to cover the pandemic, I was repeatedly denied access. This was frustrating to me as a journalist. I felt like the pandemic was being censored here. 

My go-to instinct is always suspicion. If you tell me as a photographer that I’m not allowed in to six different hospitals to cover a global pandemic, then I’m going to be suspicious about what is happening inside those hospitals. But there are so many unknowns with coronavirus. Obviously people are really nervous about journalists being in these wards and the intensive care units (ICUs) – and for good reason, in terms of the spread and the risk. Family and loved ones weren't being allowed in to hospitals and care homes to visit their gravely ill and dying, so it was on some level justified to keep all non-medical staff out. But documenting a crisis first-hand, witnessing success and shortcomings, is essential to inform policy, and hold leaders accountable. This felt largely absent to me.

(Related: 'It has become our sanctuary': The calming power of nature in a pandemic.)

“If you want people to respect the lockdown, if you want people to understand just how bad it can be with coronavirus, they should see the images.”

Lynsey Addario

Left: ICU Doctor, Jim Buckley, pastes a photograph of himself onto his PPE to help other doctors and nurses easily identify him through his masks and face shield, while making rounds in the ICU section of London's Royal Free Hospital, June 2020. Right: Ranghbir Hayer being fitted for non-invasive ventilation (NIV) at University Hospital Coventry, May 2020.

Photograph by Lynsey Addario

I do think there was some degree of the UK being unprepared for the pandemic. Not having enough PPE for the medical staff, for instance. And I think [the government] didn’t want the population to panic by seeing so many people infected with COVID-19. Which to me is counter-intuitive, because if you want people to respect the lockdown, if you want people to understand just how bad it can be with coronavirus, then they should see the images. So I kept asking and asking, and writing to all these different hospitals. 

I wasn’t allowed in until it was very quiet. Most of the wards had emptied out. And the irony was, every single hospital I went in to, from end of May, the first question the medical staff asked was ‘where were you at the height of the pandemic? Why weren’t you here mid-April?’ They wanted the press to cover what was going on and what they were going through, how inundated they were. But very few people were granted access.

Laura Bowden, 41, ECMO Specialist Nurse with staff inside the ICU of the Royal Papworth Hospital, near Cambridge, June 15, 2020. Royal Papworth is one of 5 hospitals in the UK with ECMO machines, which serve the sickest COVID-19 patients. 

Photograph by Lynsey Addario

Anaesthesiologist Caroline Borkett-Jones leads a team turning a suspected COVID-19 patient from their back onto their stomach—a treatment called proning—at the Royal Free Hospital in London. 

Photograph by Lynsey Addario

COVID-19 Patient, Foysal Ahmad, 51, speaks with his wife Nipa Begum from the Intensive Care unit of the Royal Papworth Hospital in Cambridge, England, June 15, 2020. Foysal was among some of the most severe COVID-19 patients in the country, though after 55 days in the ICU, is making great strides with his recovery. 

Photograph by Lynsey Addario

So much of my work over the years has been about being on the brink of death. The aftermath, the rituals, how different cultures approach not only tragedy and trauma, but also war and humanitarian crises. I’ve covered basically every war of the past 20 years, but I have not covered a global pandemic. And I had to learn very quickly.  

The toughest thing about covering coronavirus is not knowing where the frontline is. Where the danger is. There are so many people who are asymptomatic. You don’t really know where you can catch it, who might be higher risk. So I just went into full-on preparation-for-war mode in the beginning, learning from doctors who specialised in infectious diseases about PPE requirements, how to don and doff gear, and what situations were higher risk compared to others.  

Domestic caretaker Jim Johnson, 32, takes a breath of air outside the paramedic's entrance of the A&E, Blackpool Victoria Hospital, June 17, 2020. While the peak of COVID-19 patients in the UK was in April, there are still patients being treated at hospitals across the country. 

Photograph by Lynsey Addario

It's always astonished me how doctors, nurses and healthcare workers really put themselves out there. They’re exhausted, it’s emotionally and physically draining – their lives are also at risk – but they’re always thinking about the patient. It’s incredible to see that.

I saw one nurse leaning over a patient. He couldn't speak because, like many of the other critical COVID-19 patients in the ICUs he was on a ventilator, and she was leaning in close and kind of reading his lips. I quickly took a photo and I said, ‘what were you saying to him?’ and she said: ‘I noticed he was a little down today and I just wanted to make sure he was OK.’ It was so beautiful because on top of everything else – on top of making sure that they have patients' medicines in order, that they have everything they need, keeping them clean, keeping everyone alive – they're caring for their emotional state. 

At the Royal Papworth Hospital, William Ferguson has been on ECMO for over 100 days – one of the longest patients to be connected to the machine. Standing for Extra Corporeal Membrane Oxygenation, ECMO does the job of the lungs, allowing the organs to rest and recover. It may also prevent recognised complications associated with conventional ventilation. 

Photograph by Lynsey Addario

Staff in the the triage section of the A&E for suspected and confirmed COVID-19 patients; Blackpool Victoria Hospital, June 17, 2020. 

Photograph by Lynsey Addario

Dr. Andrew Fahey, center, wipes his eyes while speaking with the family of a COVID-19 patient in intensive care, giving them an update on her condition while on duty at the Royal Free Hospital in London, June 2020. Lynsey Addario: “I always wondered what those conversations sounded like when the prognosis wasn’t great.” 

Photograph by Lynsey Addario

What we all tell ourselves is, ‘we’re not the vulnerable ones. We’re young enough. It only hits people who are over X.’ But I think the reality is, there are the outliers. There are young and healthy people who are hit very very hard. The surprising thing in a few of the ICUs that I visited was that some people were young. They were 50, 51. To see the patients who are not much older than me – I'm 46 – is scary. There are people who fall out of the categories that we’ve been told. 

People asked me if it was hard to shoot through a visor. I’ve worn a burkha, a flack jacket, helmets – I’ve shot fully veiled when I met with the Taliban in 2008, I’ve shot in any kind of imaginable outfit you can think of. Is it comfortable? No! But it’s necessary, and if it helps keep me alive, and keep  the patients safe from whatever I might have, that’s the important thing. It’s inconvenient and it’s hot – but the doctors have to spend all day, every day wearing that.            

Care for the living, and the dead: a doctor at the Royal Free Hospital makes notes (left) on medications, diagnoses and exisiting conditions on the file of a COVID patient, London, England, June 2020. Right: an employee of Taunton Funeral Services attach a name tag to the wrist of a patient who died that morning in a nursing home; Somerset, April 2020.

Photograph by Lynsey Addario

Most funeral homes had double the amount of deceased that they were handling normally. I started working with one that had 40 COVID positive, or suspected COVID positive, bodies in a garage – where they normally kept the hearses – because they were so inundated. Many places kept suspected and COVID bodies separate; but these were just an overflow of bodies because there were so many people dying, and funerals were taking so long to take place. There was a huge backlog. 

Every single person I worked with was putting their life on the line. Funeral workers were dressing the deceased, people who died from COVID-19, doing embalmings. And it didn’t seem that there was any mention of the fundamental work that they were doing. They were providing a service to everyone who needed it. It's very important to cover these key workers who have put their lives at risk. 

I photographed a pallbearer called Jake Kill, working at a funeral services at Surrey throughout the pandemic. One of his children was vulnerable, and quite young. So he stayed away from his family. He would see them socially distanced. There was a moment when his son made a drawing for him, and he broke down. He knew that as a key worker, as someone who was handling deceased people who had died of COVID-19 or with COVID-19, he had to be careful for his family. He would get tested regularly, and then he would isolate – and if the test came back negative, he would be able to hug his kids.

Islamic funeral director Mohammed Tariq, 60, centre, and his assistant, Zain Muhammed bin Farooq, 20, centre right, prepare to place the body of Muslim man who passed away with suspected COVID-19 into a coffin after doing a traditional preparation at Muslim Funeral Services in South London, June 3, 2020. Across the UK, funeral directors of all different faiths and background are working to maintain tradition and adhere to religious instructions for burial – despite the increased risk inherent in handling infected bodies after death.

Photograph by Lynsey Addario

Zak Rolfe, a pallbearer at Stoneman Funeral Services in Surrey prepares to remove a pacemaker from the body of a COVID-19 victim. Due to the potential infectiousness of the body of any person thought to have died with the coronavirus, protective precautions must be taken by funeral workers, too. Suspected and confirmed COVID-19 bodies are frequently stored separately.     

Photograph by Lynsey Addario

Jake Kill, a pallbearer for Stoneman Funeral Services in Surrey, greets his family at social distance. As a key worker in regular contact with COVID or COVID-suspected deceased, he has spent much of the pandemic isolated from his wife and children. 

Photograph by Lynsey Addario

Access to this story in the UK has been some of the hardest I’ve tried to get in my career. From going to the hospitals to asking to photograph a funeral is really asking to access one of the most intimate moments in someone’s life – especially for a family in mourning. It’s tough and uncomfortable to ask, but there were families who understood the value of documenting this. Of looking back at it in 20 or 30 years and knowing what this period in time looked like. It's critical to be honest, transparent, and very clear about what I’m working on and why I think it’s necessary to tell a particular story. Then people make their own decisions whether they want to be involved or not. 

The UK is so diverse. And I think whether you’re Buddhist or Hindu or Muslim or Catholic, it’s important to show the different traditions that come along with burial and death. There was a Buddhist teacher, Rob Burbea, who passed away from pancreatic cancer. He didn't want to be in a hospital or hospice during coronavirus because of the increased risk of exposure to others, and because his loved ones wouldn't be able to visit. He made the decision to pass away gently in his own home; he was cared for by six women who tended to his every need in the months leading up to his death. They did what a hospice worker would have done, with no previous experience. After he passed away, they held an online vigil via Zoom, where around 300 people came and sat silently with his body, remotely. And then before delivering Rob to the undertakers in Devon, his caregivers meditated and chanted over him at dusk by candlelight. This sort of beautiful care only with friends probably wouldn't have happened before coronavirus. The world slowed down, and had become more intimate within peoples’ respective bubbles.

Six women caretakers and loved ones share in a moment of meditation as they surround the body of Jacob Robert Burbea, 54, who passed away from Pancreatic cancer 48 hours prior, before carrying him out (below) and passing him over to the undertakers in Staverton, South West England, May 9, 2020.

Photograph by Lynsey Addario

Because of COVID-19, Burbea chose to live out his final 6 weeks at home, rather than in a hospital. None of the women were professionally trained caregivers, but they were advised by nurses and hospice workers and were able to care for him until the end. 

Photograph by Lynsey Addario

Nearly a hundred graves are prepared at the Taunton Deane Crematorium, located in rural Somerset county, in preparation for the projected numbers of COVID-19 deaths. The graves will be backfilled if they are not used. 

Photograph by Lynsey Addario

In the UK I’ve found people are really, really stoic in terms of their emotions. I’m used to working in countries where people are throwing themselves at the grave, throwing their hands in the air crying – being very expressly emotional. And here it was hard, because people are very contained. And it’s hard to show sadness if you don’t see it, especially with a still photo. 

Zoom has played a part in so many funerals. Everyone now has a phone up, to either the casket or the body of the deceased to show relatives and loved ones who can’t make it. That is really unique, and something I’ve never seen before the pandemic. It seems like every funeral I go to now is being Zoomed. 

(Related: read about a new phenomenon – Zoom fatigue.)

Rakesh Parekh, centre, stands before his father's coffin minutes before cremation at the Golders Green Crematorium. His wife, as Parekh's sister and wife zoom in around one hundred other family members and loved ones for the rituals surrounding the funeral in London, May 28, 2020. Due to the COVID-19 pandemic, rituals surrounding funerals and deaths for both COVID-19 and those who passed away from other causes, have been altered due to social distancing and other restrictions imposed for the safety of mourners and funeral directors. Rakesh said, “I am indebted to our head priest who made himself available to conduct the sacred last rites for my father. This is a great honour for myself and my family.” 

Photograph by Lynsey Addario

Relatives and loved ones await the arrival of the coffins of 104 year-old mother Alexteen Alvira Roberts and her son Brandis Metcalf Roberts at Tottenham cemetery in London, June 5, 2020. Alexteen arrived in the UK from Jamaica, arriving in the UK on the SS Windrush in 1948. Her son Brandis passed away with COVID-19 in a nursing home after catching it in a hospital in London. The mother and son passed away within days of each other, though they were living separately. Statistics reveal that people of colour are disproportionately impacted from COVID-19 – with black people four times more likely to die from the disease, according to the UK's Office for National Statistics. 


 

Photograph by Lynsey Addario

Hundreds of friends, family, and supporters of the NHS line the streets as the coffin of long-time paramedic, Peter James Hart, who died on his 52nd birthday after testing positive for COVID-19, makes its way through Smallfield Village before heading to the crematorium for a private family funeral, June 18, 2020.  Hart worked for years at the South East Coast Ambulance Service before joining the Surrey and Sussex NHS trust in 2017.  


 

Photograph by Lynsey Addario

What ties these two bodies of work together is the proximity to death – and death itself. And, I think, people’s approach to the family members, the workers, the people affected from these deaths.

This is a terrifying virus. There’s a degree of complacency amongst young and fit people because they think, well, it’s not going to hit me. But that’s proving not the case all the time. To see someone being kept alive on an ECMO (Extra Corporeal Membrane Oxygenation) machine, their body completely ravaged by COVID-19, it’s terrifying. I attended the funeral of a paramedic named Peter Hart. There were dozens if not hundreds of people on the hospital lawn when I was following the hearse. And I saw his photograph taped to the back and I just thought, ‘my god – he was so young.’ 

Mourners and family members gather while maintaining social distance during a funeral for Joan Fudge at the Church of St. Bartholomew, in Bathealton, April 15, 2020. Fudge died at 84 years old, from pneumonia and dementia in a nursing home in Wellington. The United Kingdom was one of the last in Europe to call for a nationwide lockdown to prevent large-scale deaths and illness from COVID-19. As of 12 July it has the highest death toll at 44,830 of patients who tested positive for coronavirus. Joan Fudge, like many who died in UK care homes at the beginning of the pandemic, was not tested.

Photograph by Lynsey Addario

Mohammed Tariq and Zain Muhammed bin Farooq help bury Ali Ilhan Kinay, a 91-year-old man who died on May 21. Kinay developed COVID-19 symptoms after recovering from a fall in a hospital in London. He died soon after. Though the virus wasn’t listed as his cause of death, his sons suspect that it killed him.

Rebekah Anderson, 26, stands with her son, Elisha, 3, as they look down into the grave of Elisha’s grandmother, Esther Akinsanya, 55, in a special new section of the Woolwich cemetery dedicated to COVID-19 victims in south London, June 22, 2020.  The young boy repeatedly asked: “why is she so far down?”

Photograph by Lynsey Addario

There are a lot of things that seem to have changed forever in the lockdown. I’ve seen that people have really learned to appreciate the freedom that we had that we now may never get back. Freedom in terms of socialising, in terms of how we shop, how we have funerals. Having dozens of people crammed into an office, or thousands in a high rise. These things may never go back to normal. 

Tragically, what I’ve been covering for 20 years, is life and death. It’s not something I’m unfamiliar with. But like with every story I’ve done I’ve found myself crying sometimes, or really sort of entering these beautiful moments of celebration of a life that ended too soon. There were funerals where I was crying really hard for people I never knew and had no connection to. But you can’t help as a human being to feel other people’s emotions when you are that close to them, and documenting them. At least, I can’t. 

As told to Simon Ingram.

Find out more about Lynsey Addario's work for National Geographic here. Follow her on Instagram @Lynseyaddario

This work was supported in part by the National Geographic Society's COVID-19 Emergency Fund for Journalists.

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