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Rupert Pearse Profile picture
@rupert_pearse
Oct 3, 2020 • 8 tweets • 2 min read • Read on X
Brief update from the front lines: The second wave is definitely here and NHS hospitals are putting the finishing touches to their escalation plans. Time to make the difficult call on how many COVID-19 patients to prepare for. 1/8
Shooting for a very large COVID capacity means planning to shut down some or all of our routine NHS work. Many doctors are concerned about protecting services for cancer, stroke, heart disease etc. 2/8
Plan A for a lot of hospitals will be preparing for a peak of around two thirds of the COVID numbers we saw in the spring. We can keep many routine services going at that level albeit at reduced capacity. 3/8
Right now that seems the right approach. Hospital admissions with COVID-19 (not just positive swabs) definitely rising but not as steeply as March. Also, possible that fewer patients are needing ventilation in ICU. Looking more like a slow burn than a second wave. 4/8
This time we will see hospitals work together much more. Patients will often be transferred between hospitals to maximise COVID free 'green zones' keeping usual services going. This will also protect smaller hospitals which cannot expand capacity. Families should expect this. 5/8
Meanwhile, there are relatively few concerns about supplies. Last time we ran with a one-day supply of PPE. Stocks now much more resilient. Drug supplies also better except perhaps remdesivir (not the most important drug to be honest). Plenty of ventilators too. 6/8
Staff morale currently pretty good. A very calm routine on @teamaccu this week. We feel safe but still worry about our resilience on what for us is a second tour of duty. Lives are on hold. Many staff are missing close family who live abroad. 7/8
Hopefully the deniers will calm down and note what has happened to their icon Donald Trump. #HandsFaceSpace works! Thank you to everyone for doing your bit. I will leave you with a pic from this week's ward round. Stay safe 🤗 8/8

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More from @rupert_pearse

Rupert Pearse Profile picture
Jan 29, 2022
COVID Sitrep: Only a short update as on call this weekend with this amazing team covering covid ICU. TLDR: Things may be settling but the work is far from over. 1/8 Image
Lots of talk this week about new covid infections hitting a plateau. This is probably driven by children going back to school. So not ideal, but better than the rebound peak we feared would happen after New Year. 2/8 https://coronavirus.data.go...
New hospital admissions continue to fall but slowly. A large proportion of these are those 'incidental' covid patients admitted for other 'usual' medical problems not covid disease. 3/8 https://coronavirus.data.go...
Read 9 tweets
Rupert Pearse Profile picture
Jan 22, 2022
COVID sitrep: Some positive news to report this week. We are definitely feeling a fall in NHS hospital and ICU admissions with covid in London this week. The rest of the UK should see a similar pattern in the coming days. This below appeared on our ICU board this week! 1/10
As mentioned in previous weeks, being confident we are past the peak is a big deal for the NHS. Every day things get a little easier, a little simpler. We can do more ‘usual’ NHS work. We can get back to clearing the backlog of surgery and other patient care. 2/10
The colours on the national map are getting lighter every week which reassures us that the number of new infections continues to fall in most areas of the UK. 3/10 https://coronavirus.data.gov.uk/
Read 10 tweets
Rupert Pearse Profile picture
Jan 15, 2022
COVID sitrep: Lots of topics to choose from this week. Good news is we have probably passed the peak in new COVID-19 infections in several UK regions. This week’s map (right) is not so dark. But what will happen next is not so clear. A thread from the NHS perspective. 1/12 https://coronavirus.data.gov.uk/https://coronavirus.data.gov.uk/
All eyes have been on London as the first UK region to get hit by the omicron variant. Cases seem to have peaked both in younger and older people (light blue line=<60yrs, dark blue line=60+ yrs). But we aren’t sure whether new case rates will fall quickly or plateau out. 2/12 https://coronavirus.data.gov.uk/
Why so cautious when others seem confident cases are falling? Well, passing the peak defines the NHS response. When we know we are past the worst we stop planning extra covid capacity, re-focus on the patients we have, and plan more routine NHS work. A big shift in strategy. 3/12
Read 12 tweets
Rupert Pearse Profile picture
Jan 8, 2022
First COVID sitrep of the New Year: The number of omicron variant COVID-19 infections remains extremely high in the UK and still far higher than anything we have seen up until last month. Here’s what’s happening in the NHS… 1/14 https://coronavirus.data.gov.uk/
London was the first UK region to get hit by the omicron variant before spreading across the country. This week’s million dollar question is whether new infections have peaked in London. Many say yes, but it seems too early to be sure…. 2/14 https://coronavirus.data.gov.uk/
…and being sure we are past the peak is a key moment in the NHS response to each wave. Once we *know* we are past the worst, we can stop planning extra covid capacity, we can re-focus on the patients we have, and all the other routine NHS work. This makes a big difference. 3/14
Read 14 tweets
Rupert Pearse Profile picture
Dec 31, 2021
COVID sitrep for New Year’s Eve: The wave of omicron variant COVID-19 infections continues to spread around the world. Hospital admissions are rising across the UK but there are important differences to earlier waves…. 1/12
This omicron variant seems to spread much more easily. Infection rates are smashing all previous records. 189,000 ‘cases’ yesterday. Yes, we are testing a lot more people, but the proportion who test positive is also going up (blue line in graph). 2/12 https://coronavirus.data.gov.uk/
The big discussion now is how harmful the omicron variant might be. Lots of reports of high rates of ‘incidental’ infections in hospital - patients testing positive for coronavirus who were admitted to hospital for a different illness. So what’s happening on the ground? 3/12
Read 14 tweets
Rupert Pearse Profile picture
Dec 24, 2021
COVID sitrep for Christmas Eve: The huge wave of COVID-19 infections, driven by the new omicron variant, is spreading across the country. Hospital admissions are now rising in London but the good news is we think things won’t be as bad as last winter. 1/12 bbc.co.uk/news/uk-597587…
The wave of infections with SARS CoV-2 is simply huge, passing 100,000 ‘cases’ two days in a row and way in excess of the previous record peak of 81,000 in January 2021. Yesterday 119,000 people tested positive 2/12
Before anyone suggests it, this is NOT simply because we are doing more tests. Firstly, the proportion of tests done which are positive has increased too (blue line in graph). Secondly, people get tested for a reason - symptoms or a covid contact – it’s not random behaviour. 3/12
Read 12 tweets

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