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Some reflections after a weekend on ICU
Most importantly, despite distractions like Brexit, COVID-19 remains our most pressing matter......and vaccination our most pressing priority.
There are major threats & real opportunities
Most importantly, despite distractions like Brexit, COVID-19 remains our most pressing matter......and vaccination our most pressing priority.
There are major threats & real opportunities
The number of patients in hospital with COVID is now essentially the same as at the peak of surge 1: but the duration of the height of the surge is already longer
.... & we're also trying to manage winter pressures & routine care so the hospitals and ICUs are bulging
.... & we're also trying to manage winter pressures & routine care so the hospitals and ICUs are bulging
Our ability to continue routine hospital care is now being overwhelmed by emergency admissions
London - as in March - under extreme pressure https://www.theguardian.com/society/2020/dec/27/hospitals-in-england-told-to-free-up-all-possible-beds-for-surging-covid-cases
London - as in March - under extreme pressure https://www.theguardian.com/society/2020/dec/27/hospitals-in-england-told-to-free-up-all-possible-beds-for-surging-covid-cases
Wales too - putting out a call to ICU professionals in the public to help https://www.bbc.co.uk/news/uk-wales-55454280
Hospitals overrun and having to transfer patients between hospitals: from hospitals with full ICUs to those who still have some space - known as 'mutual aid'
Calls every day this weekend about this.
Calls every day this weekend about this.
Even in October there was a major challenge to normal hospital activity - despite use of private hospitals to increase surgical capacity
There is no doubt this will worsen in December and into the new year
https://twitter.com/doctimcook/status/1334216562660806658?s=20
There is no doubt this will worsen in December and into the new year
https://twitter.com/doctimcook/status/1334216562660806658?s=20
There is no doubt that this surge will continue for several weeks
The new variant will dramatically increase the numbers of cases https://twitter.com/doctimcook/status/1341887715088998406?s=20
The new variant will dramatically increase the numbers of cases https://twitter.com/doctimcook/status/1341887715088998406?s=20
New variant described in more detail here
https://www.medrxiv.org/content/10.1101/2020.12.24.20248822v1
https://www.medrxiv.org/content/10.1101/2020.12.24.20248822v1
Important to understand due to the higher transmissibility
- surge will be bigger
- surge will last longer
- there will be greater impact on hospitals
- lockdowns will need to be stricter to have any effect & will take several weeks to have any effect https://twitter.com/JeremyFarrar/status/1341883800104673282?s=20
- surge will be bigger
- surge will last longer
- there will be greater impact on hospitals
- lockdowns will need to be stricter to have any effect & will take several weeks to have any effect https://twitter.com/JeremyFarrar/status/1341883800104673282?s=20
The impact on healthcare services and on staff is shown in this thread
-more staff sickness
-staff absences meaning services are closed
-transmission of COVID from staff to patients & other staff
-harm to patients and staff https://twitter.com/doctimcook/status/1341065224078635009?s=20
-more staff sickness
-staff absences meaning services are closed
-transmission of COVID from staff to patients & other staff
-harm to patients and staff https://twitter.com/doctimcook/status/1341065224078635009?s=20
1 in 10 anaesthetists not available for work in October
1 in 10 healthcare staff off in December (in some cases 1 in 5)
>1 in 10 of all (higher risk) COVID cases in hospital acquired it there
1 in 5 surgical and medical patients who acquired COVID in hospital at risk of dying
1 in 10 healthcare staff off in December (in some cases 1 in 5)
>1 in 10 of all (higher risk) COVID cases in hospital acquired it there
1 in 5 surgical and medical patients who acquired COVID in hospital at risk of dying
The opportunity is VACCINES
VACCINES
VACCINES
VACCINES
Vaccines really are an opportunity to find our way out of this pandemic https://twitter.com/Anaes_Journal/status/1338786910722985984?s=20
VACCINES
VACCINES
VACCINES
Vaccines really are an opportunity to find our way out of this pandemic https://twitter.com/Anaes_Journal/status/1338786910722985984?s=20
Vaccine urgency cannot be overstated
It needs to be done very very soon to manage the surge
The new variant has increased this urgency significantly
It needs to be done very very soon to manage the surge
The new variant has increased this urgency significantly
Vaccine equity is also vital
No point in vaccinating the UK & not the rest of the world. Apart from the ethics, if virus continues to circulate it will return & will evolve so vaccines no longer effective.
Vaccines can turn the pandemic around but only if
-rapidly
-globally
No point in vaccinating the UK & not the rest of the world. Apart from the ethics, if virus continues to circulate it will return & will evolve so vaccines no longer effective.
Vaccines can turn the pandemic around but only if
-rapidly
-globally
Reports the government plan to vaccinate at a million per week.....its not enough.
That will take 2 years to vaccinate the country (by which time well need boosters)
A million a day would be a great goal https://www.dailymail.co.uk/news/article-9092123/SAGE-expert-warns-hitting-one-million-vaccines-week-wont-curb-Covid-crisis-months.html
That will take 2 years to vaccinate the country (by which time well need boosters)
A million a day would be a great goal https://www.dailymail.co.uk/news/article-9092123/SAGE-expert-warns-hitting-one-million-vaccines-week-wont-curb-Covid-crisis-months.html
