On the intensive care unit today covering a colleague who is unwell, so only time for a brief update this week. You may have seen a lot of coverage that London hospitals are very badly affected by COVID-19 right now. This is all pretty accurate I’m afraid. 1/10

Hospitals in the north of England seem to be stabilising now which is a relief, but the situation in south Wales, east London and the north Kent remains very difficult. COVID patient numbers have doubled where I work in the last week. 2/10

Compared to the first wave, we are looking after a much larger number of patients with ‘usual’ illnesses. Heart attacks, strokes, trauma, cancer surgery etc. NHS staff are getting pulled in lots of directions. 3/10

Hospital staff are spread very thinly. We cannot shut down other patient services and re-deploy staff to intensive care or respiratory wards as we did in the spring. Nursing staff in particular, are under a lot of pressure as they work to maintain good quality patient care. 4/10

Nightingale Hospitals won't help because the main problem is the availability of trained staff. We are already 'diluting' our skilled ICU nursing staff with less well trained volunteers from other parts of the hospital. 5/10

In the first wave we enjoyed a wonderful sense of cohesion. Everyone in society seemed to understand and accept the crisis. NHS staff felt genuinely moved by the weekly clap for carers and felt absolutely appreciated for the personal risks they were taking. 6/10

Now we see people in positions of responsibility (e.g. MPs) routinely question public health policy. Social distancing efforts amongst the public are a lot more variable. NHS staff see this making their work even harder, and it’s hitting morale hard. No-one is clapping now. 7/10

People debate impacts on the economy versus public health as if it’s a straight trade-off. It’s not. Poor health leads to poor wealth. A simple fact. It’s not credible that anyone would claim to care about economic impact on the little guy, but not worry if they live or die. 8/10

This is very much the long hard winter that NHS leaders feared. We can also expect a further rise in hospital admissions in January. This will affect everyone’s healthcare for every illness. Society expects the NHS to deal with all of this and will criticise us if we fail. 9/10

So please take care over the next few days and weeks, if only for your own sake. I have seen what COVID-19 can do to you. Get vaccinated as soon as you are invited. We are proud to be your NHS but please take care of us this Christmas. #HandsFaceSpace 10/10