Thread by @drraghibali

This series on COVID tries to analyse data objectively and aims to avoid the twin dangers of fear & complacency; prevent a large second wave & a second lockdown.

No 7. Is the NHS in the same position now as it was on March 23rd? And does that mean we need another lockdown?

Over the last few days, much has been said and written about the fact that there are now more patients in hospital with COVID than there were on ‘lockdown day,’ March 23rd, and some are claiming this justifies a second national lockdown to prevent the NHS being overwhelmed. .

While it is true that that there are more patients in hospital with COVID now (3332) than there were on March 23 (3160), the trajectory is very different (as I explained it would be 4 weeks ago - due to social distancing, isolation, masks, etc.)

In March, the no. of COVID patients in hospital was doubling every 3-4 days whereas now it is 14 days.
The no. of cases in the week before lockdown (which predicts future admissions) was about 1.5 million (& doubling every 3 days) whereas last week

we had about 200,000 cases and a doubling time of 10-12 days. Also, looking at daily admissions, they are currently half of what they were on March 23rd (527 vs 1119) – then, they were doubling every 5 days, now it’s every 14 days.

Therefore, while the first lockdown was justified on the basis that admissions were rising so fast that the NHS would have been overwhelmed without one (leading to even higher numbers of both direct and indirect than we suffered), the same does not apply this time.

The NHS overall should be able to cope with the current level of admissions/inpatients, particularly with the additional capacity we now have with the Nightingales and private sector. This judgement is also based on my own experience:

the reason I volunteered to go back to the frontline in March was because admissions were rising so quickly & we had seen what had happened in Italy and feared the same would happen here. Thankfully, although April was like nothing I had seen before, even in the worst flu seasons

it wasn’t as bad as we feared – partly because many of our usual patients stopped coming to hospital – with tragic consequences. (If you are interested in reading my experience of the first wave, the link is below– many of the issues I raised then are equally relevant now.)

This week, locally we have had far fewer COVID admissions than we did at the end of March. However, I do recognise that admissions are much higher in some areas than others (which is why measures should be locally targeted)

and it is also true that the NHS can’t cope with the same level that we reached at the peak in April while keeping all other services running (which we must do this time - particularly with the huge backlog we now have) - there are simply not enough staff or beds.

Therefore, we must keep levels lower this time – both so that we can continue treating all of our patients and so that our patients are not scared of coming to hospital.
This will save the most lives from all causes, not just COVID - which should be our aim.

In conclusion, although this is not a repeat of the first wave & we are not where we were on 'lockdown day', this is because most of us are following the current measures to control the virus and the situation can change quickly if we don't.

And I hope those who are not doing so will realise that by making these smaller sacrifices now, we can avoid the much greater harms of a second lockdown.

References below:
coronavirus.data.gov.uk/healthcare
mrc-bsu.cam.ac.uk/now-casting/
conservativehome.com/platform/2020/…

conservativehome.com/platform/2020/…

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