@JohnsHopkinsIH dashboard of current worldwide cases. 
@FT graph showcasing the cumulative confirmed cases in various countries/areas. Raw numbers log, then per million linear. The steepness of the increase in NI is obviously a worrying trend.
In NI we have had 5475 positive cases in the last seven days. In this new era of increased testing, with a younger demographic of positive cases, it is hard to know the % of this total that will require hospital or ICU-level care.
There is still a spectrum of numbers associated with projected ICU admissions per positive cases. This will differ across the world. journals.plos.org/plosone/articl… Makes it difficult to plan for.
April's literature predicted that positive tests accounted for 7-10% of the true infection numbers in the UK. Due to higher testing capacity, it is difficult to know what the % is now - but the current increase is worrying. bmj.com/content/370/bm…
#COVID19 The reason it's worrying is that even a small % of the total number of COVID positive tests likely contributes to increased hospital admissions, and thus critical care burden. This is on top of long-standing winter pressures: nhsproviders.org/topics/deliver…
Critical care relies on specialist nurses, doctors and AHP's to provide 24/7 care to its patients. We don't have enough ICU nurses/staff to provide extended cover to growing numbers of #COVID19 and non-COVID patients. nursingtimes.net/news/hospital/…
During the last surge, ICU staff worked alongside amazing individuals, outside of their own realms of practice. As their practice areas have been restored, we don't currently have ICU staffing numbers to match our initial response and cover the extended role of ICM in the UK.
Full-PPE has essentially made COVID-ICUs zones that require increased staff numbers. Each member of staff has to be periodically relieved: cas.mhra.gov.uk/ViewandAcknowl…
RCN position statement after the first COVID surge about ICU nurse staffing levels: rcn.org.uk/covid-19/rcn-p…
Staffing the NHS is a major issue. Before COVID, in 2019 - there were almost 44,000 nursing vacancies across the NHS (12% of the nursing workforce), but this could hit 100,000 in a decade. This is now critically exacerbated further with #COVID19 surges theguardian.com/society/2019/n…
Further issues are burnout and exhaustion amongst all staff groups, in relation to COVID, on top of diminishing staff numbers and recruitment/retention issues: bma.org.uk/news-and-opini…
The same medical staff that work in ICU are also the staff that run and are in charge of a vast spectrum of other medical services in the hospital, such as operations (anaesthetics), outpatients, medical wards, pre-assessment, HDU, pain services and more. #COVID19
As true in March as it is now in October... There is NO point in having a great ventilator-making drive or building vast 'ICU hospitals' without the staff to support this. nursingtimes.net/news/coronavir…
Ongoing trials notwithstanding, there have been few major medical 'breakthroughs'. Steroids, homogenization of management and remdesivir have been the first major recommendations. This is obviously an evolving area. Unsurprisingly, a panacea has not been discovered.
CPAP on respiratory wards has become a mainstay of progression therapy of #COVID19 respiratory failure: sign.ac.uk/media/1757/sg_…
ECMO during #COVID19 is an evolving area of research, with more data coming soon. thelancet.com/journals/lance…
Duration of ICU stay is approximately 12 days (as a sensible average). Our patients do not quickly recover, and so the patient turnover in ICU is slow. With positive cases increasing, ICU resource-consumption and bed-occupation are further amplified. bmcmedicine.biomedcentral.com/articles/10.11…
The reported ICU mortality has fallen (WRT COVID-19) as the pandemic unfolded. SR's estimate ~41% mortality in ICU. acc.org/latest-in-card…
Collateral damage will be significant. Despite ongoing efforts to restabilise, there will be substantial increases in the number of avoidable cancer deaths as a result of diagnostic delays due to the #COVID19 pandemic in the UK + delayed surgeries. thelancet.com/action/showPdf…
It is clear that ICU capacity across the world is somewhat fragile and under serious strain. The numbers of hospital admissions do not even need to reach 'record heights' for serious issues to develop within the NHS. Many aspects of Public Health policy are based on this.
@NickTriggle comments here about NHS capacity. Capacity, is not homogenous - and different types of capacity require different staff groups in order to function. More published data on staff numbers and beds would indeed help the public understand the NHS's predicament.
@iceman_ex @Wilkinsonjonny We published a letter in March stating 'COVID is not just another flu" - outlining possible, distinct differences between Influenza A/B and #COVID19. A group have since confirmed key symptom, lab and radiological differences: pubmed.ncbi.nlm.nih.gov/33035373/
Concerns raised over the fact that UK mitigation strategies are unlikely to reduce total death toll due to a highly skewed distribution of mortality to older age groups. pubmed.ncbi.nlm.nih.gov/33028597/ #COVID19
BCG Vaccination has been mooted as a vaccine that could attenuate the risks of #COVID19, but increasing evidence says this hypothesis must be treated with caution: pubmed.ncbi.nlm.nih.gov/33027297/
Hopes have been raised with a Russian COVID vaccine being approved, with criticism across other nations for 'bypassing' standard vaccine development protocols - namely Phase 3 Trial. thelancet.com/journals/lanre…
Many novel therapies have been explored and 'trials'/reviews published across the world - but what is the global opinion? Can/should we homogenise treatment regimes - and when? #COVID19 ncbi.nlm.nih.gov/pmc/articles/P…
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