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12 Dec, 7 tweets, 3 min read
Spoke too soon. Two weeks ago I was hopeful that the second COVID tide was starting to turn. Things weren’t easy but had stabilised and national numbers were down. Now we're seeing rising numbers at national level in and several regions, including where I work in east London. 1/7
The number of people testing positive for SARS Cov-2 is definitely up in the last 7 days, while the number of patients admitted to hospital with COVID-19 is beginning to rise, and the number of deaths (which lags behind admissions) was falling but has now levelled off. 2/7 https://coronavirus.data.gov.uk/
Government data fit with the independent data from @ICNARC describing intensive care admissions. The number of patients in ICU with COVID-19 appeared to be falling 7 days ago but not any more. 3/7 https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
Sadly these national data fit with local experiences of doctors. Hospitals are very busy in hotspots in various areas such as south Wales, east London and north Kent. Some good news: numbers are falling in the north of England and Northern Ireland. 4/7 https://coronavirus.data.gov.uk/
NHS hospitals are still looking after a lot of patients with ‘usual’ medical problems (strokes, heart attacks, surgery, etc) but these services are being increasingly squeezed by the need to deliver COVID care. Some elective work will have to stop soon. 5/7 https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
The coronavirus will be with us for a long time to come, even if not at pandemic levels. Years even. Vaccines will really help but it will be spring before we have achieved population levels of immunity through vaccination. Our main defence is STILL #HandsFaceSpace 6/7
Sorry there isn't new or better news. NHS staff are really grateful for all you are doing but please keep up the good work. Think carefully about your Christmas plans. Get vaccinated if you can (I definitely will) and stay safe. #DocsForVax 7/7 Photo @jometsonscott

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Rupert Pearse Profile picture
8 Dec
I’m not a vaccine expert so it’s reasonable to ask why I am confident that I want to be vaccinated for COVID-19. I will have the jab for myself, my family, friends, my work colleagues and even for people I don't know. A few reflections... #DocsForVax 1/9
First of all, I have seen first-hand too many times what COVID can do to people. It’s a truly horrible disease. It damages the lungs, the kidneys, the heart. It causes blood clots. It kills people and those who survive can take a long time to recover. #DocsForVax 2/9 Photo @jometsonscott
As an ICU doctor, I know that every treatment I give can bring benefit or harm to my patient. I routinely balance these risks in my mind. Like all drugs, vaccines can have side-effects, but they will likely be rare compared to the harms of COVID-19. #DocsForVax 3/9
Read 9 tweets
Rupert Pearse Profile picture
5 Dec
Themes of the week: vaccine roll-out, the COVID tide turning, and the lockdown ending. This is where I think we’re at, having talked again with friends across the UK and compared this all with the national data. 1/9
Friends in many (not all) badly hit hospitals tell me the second COVID tide is beginning to turn. BUT the NHS is still really busy keeping surgery services going, as well as winter pressures of acute medical admissions, and then COVID on top of all that. 2/9
News from ground level fits with the national data which show a consistent decrease in numbers of people testing positive for SARS CoV-2, a decrease in patients being admitted to hospital with COVID-19, and in subsequent deaths. 3/9
Read 9 tweets
Rupert Pearse Profile picture
2 Dec
Fantastic news that the first COVID-19 vaccine has been approved for routine use so quickly. Here is why I am happy to be vaccinated and why I want my family and friends to have a vaccine too... 1/10 #InjectionforProtection #DocsforVax
bbc.co.uk/news/health-55…
Widespread vaccination was always our best and only route out of the pandemic. The fewer people who carry the virus, the slower it can spread. By being vaccinated, we protect not only ourselves but our family, friends, work colleagues and so on, even strangers on the bus.... 2/10
The UK has one of the best and strictest drug regulatory processes in the world. Testing new drugs is a thing we are really good at. Anyone who has worked on a clinical trial will vouch for the rigour and safety of @MHRAgovuk and @HRA_Latest processes. 3/10
Read 10 tweets
Rupert Pearse Profile picture
21 Nov
An update from ground level across the UK NHS. Things are very different to March. UK COVID-19 projections continue to look more like a ‘slow burn’ than a second wave. But the NHS is under very definite and increasing strain. We are going to have a long hard winter…… 1/12 Photo from @jometsonscott
COVID-19 hospital admissions continue to rise. Now 1750 new patients/day. Much less than the mid-April peak of 3100/day but we will reach that same rate in 8 weeks unless the rise slows. It takes at least four weeks for the lockdown to take effect. Perhaps it will soon? 2/12 https://coronavirus.data.gov.uk/details/healthcare
The same pattern is reflected in @ICNARC (independent) data describing COVID-19 admissions to intensive care units: 140 new patients/day and rising with >1500 COVID patients currently in ICU… 3/12 https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
Read 12 tweets
Rupert Pearse Profile picture
19 Nov
Some interesting news here from @remap_cap that #Tocilizumab may improve patient outcomes for COVID-19. Understandable that the team are eager to announce this but given the limited detail and small sample of 303 patients, a few notes of caution are needed.... 1/7
The researchers have declared #Tocilizumab has 'efficacy' for a combination of patient outcomes which include survival and how long patients spend on organ support eg a ventilator. Efficacy means the drug can work in specific (usually well controlled) circumstances. 2/7
It looks like there is a big treatment effect (odds ratio: 1.87) in this trial. That's great but results like this are sometimes too good to be true. Treatment benefits are generally smaller in large trials which account for the real-world problems of delivering patient care. 3/7
Read 8 tweets
Rupert Pearse Profile picture
8 Nov
As the NHS enters what will likely be our hardest ever winter, what about the Nightingales….? is a common question, and for some a retort to news that hospitals are struggling to deliver routine patient care in the face of a rapidly rising patient admissions for COVID-19. 1/10
The speed with which the Nightingale Hospitals were established, and our need to believe in them, has left us with the impression that building a major NHS hospital within a few weeks is a thing we can easily do. It isn’t. 2/10
The old Nightingale style wards had rows of beds down each wall. A few nurses could have sight of many patients, and easily communicate with each other. If a patient has a problem (e.g. cardiac arrest) it is easy to spot and help arrives faster. Photo: Wellcome Collection. 3/10
Read 10 tweets

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