On the intensive care unit today covering a colleague who is unwell, so only time for a brief update this week. You may have seen a lot of coverage that London hospitals are very badly affected by COVID-19 right now. This is all pretty accurate I’m afraid. 1/10 Photo: @jometsonscott
Hospitals in the north of England seem to be stabilising now which is a relief, but the situation in south Wales, east London and the north Kent remains very difficult. COVID patient numbers have doubled where I work in the last week. 2/10 https://coronavirus.data.gov.uk/details/interactive-map
Compared to the first wave, we are looking after a much larger number of patients with ‘usual’ illnesses. Heart attacks, strokes, trauma, cancer surgery etc. NHS staff are getting pulled in lots of directions. 3/10
Hospital staff are spread very thinly. We cannot shut down other patient services and re-deploy staff to intensive care or respiratory wards as we did in the spring. Nursing staff in particular, are under a lot of pressure as they work to maintain good quality patient care. 4/10 Photo: @jometsonscott
Nightingale Hospitals won't help because the main problem is the availability of trained staff. We are already 'diluting' our skilled ICU nursing staff with less well trained volunteers from other parts of the hospital. 5/10
In the first wave we enjoyed a wonderful sense of cohesion. Everyone in society seemed to understand and accept the crisis. NHS staff felt genuinely moved by the weekly clap for carers and felt absolutely appreciated for the personal risks they were taking. 6/10
Now we see people in positions of responsibility (e.g. MPs) routinely question public health policy. Social distancing efforts amongst the public are a lot more variable. NHS staff see this making their work even harder, and it’s hitting morale hard. No-one is clapping now. 7/10
People debate impacts on the economy versus public health as if it’s a straight trade-off. It’s not. Poor health leads to poor wealth. A simple fact. It’s not credible that anyone would claim to care about economic impact on the little guy, but not worry if they live or die. 8/10
This is very much the long hard winter that NHS leaders feared. We can also expect a further rise in hospital admissions in January. This will affect everyone’s healthcare for every illness. Society expects the NHS to deal with all of this and will criticise us if we fail. 9/10
So please take care over the next few days and weeks, if only for your own sake. I have seen what COVID-19 can do to you. Get vaccinated as soon as you are invited. We are proud to be your NHS but please take care of us this Christmas. #HandsFaceSpace 10/10 View from the 15th floor COVID ICU at the Royal London Hospi

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Rupert Pearse

Rupert Pearse Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @rupert_pearse

12 Dec
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
Read 7 tweets
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
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
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
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
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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!