THREAD: we need start planning for the recovery of NHS staff right now.

NHS staff are working beyond their limits – have been for weeks and will continue to for weeks. They've been at the limit for a year. What will be the consequences? What can be done?

Please do read. 1/12
NHS workers are already at higher risk of mental health problems & suicide than general population. Studies pre- pandemic showed that UK nurses & docs were 2-5 times more likely to take their own lives than the general pop.
metro.co.uk/2018/09/03/sui…
independentnurse.co.uk/professional-a… 2/12
The British Medical Association did a survey after the 1st covid wave. 45% of ICU staff showed signs of mental ill-health, 40% with signs of PTSD, more than 2x recent combat veterans. 1 in 5 nurses & 1 in 7 docs had thoughts of self-harm or suicide.
bmj.com/content/372/bm… 3/12
In wave 1, hospitals had more than 10K patients for 40 days. So far it’s been 80 days at over 10,000 & we are only just reaching peak (at 34K!). At *best* it will take 50 more days to return to 10K (still v high!). So wave 2 at least 3x long as wave 1 - and more intense. 4/12
The mental and physical health burden is huge. The massive increase in stress, no leave for months, fewer breaks or respite from front line care. So many patients dying. Many staff will have had Covid & some long covid. Many have lost relatives and friends to Covid. 5/12
It is not just coming to terms with what happened during the peak of wave 2, but, for many, the stress of working outside their expertise, away from their team and not being able to provide care to their “usual” patients 6/12
For junior staff, there is the additional stress of missing months of training, falling behind in their exams. Don't underestimate this. There will be pressure to dive back into study (often self-imposed pressure). 7/12
As well as coping with “normal work” and the enormous backlog of care, there will also be extra follow-ups for the up to 10% of people who develop long covid – tens of thousands of new patients to care for. 8/12
We need to plan NOW for how to support NHS staff over the coming months and years. How can we make sure everyone can take the leave they’ve abandoned, to rest and recuperate? How can we provide mental health support? How can we support their wellbeing? 9/12
The existing practitioner health programme for doctors & dentists needs to be extended to ALL NHS staff with access to talking therapies in a way that fits in with shift work. 10/12
The NHS has worked with health & wellness apps to give free access to support to staff during pandemic – this needs to be continued and scaled up for the long term. Mental health needs to be openly discussed by leaders to avoid stigma. 11/12
This isn’t optional. We can’t just “go back to normal”. It’s NOT “clear backlog” OR “help staff”. If we burn out staff, we damage them & their families, we lose valuable expertise from the NHS and we lose compassionate, high quality care. And we owe it to them. 12/12
PS this article in the Guardian makes many of the same points and is worth reading
theguardian.com/society/2021/j…
One more thing: the govt needs to properly fund the NHS now and urgently address the understaffing and staff leaving - particularly nurses. And yes, Brexit has made this much worse. sueryder.org/news/fears-of-…

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More from @chrischirp

17 Jan
THREAD: for anyone working with those or living with long term conditions whose care is being disrupted by Covid.

We asked parents of kids with Congenital Heart Disease (CHD) and adults living with CHD about their 1st wave experience...

Important lessons emerged! 1/6
Firstly, a lot depended on how well someone felt - people coping well with their CHD or those who were seen just before March lockdown were less worried. People with more complex disease were more likely to be worried and some had had no contact at all from specialists. 2/6
Many people spoke about getting different messages from different people - particularly about shielding and whether they shoud be at work / school.
People who had access to someone they could call for advice really valued it.
Some GP experiences were better than others... 3/6
Read 6 tweets
16 Jan
THREAD: quick overview of where we are with Covid in the UK.

TLDR: some optimism but a long way to go. NHS will struggle for a bit yet :-( 1/11
First, cases have come down over last week which is good BUT they have climbed over this week.

Is this a blip? or is this is the impact of people going back to work after Xmas, more stuff open & more kids in school than March lockdown? This week should tell us more. 2/11
The proportion of people tested who have Covid is coming down in ALL nations - esp in NI and Wales. Good news!

BUT this misses data from later part of week which had higher case numbers & rates are still v high everywhere (we were at 1-2% over summer!) 3/11
Read 11 tweets
16 Jan
THREAD: on the connection between age, infection, hospitalisation, death and vaccination...

TLDR: it matters! so read 7 tweets :-)

Each bar in the charts shows the proportion of people in each of the coloured age categories. 1/7
Confirmed cases are more likely to be working age adults & older teenagers. Young kids (esp pre-school) less likely to show symptoms (& get tested) & poss less likely to get infected. Over 65s less likely to be exposed.

Vaccinating >70s is *not* going to stop Covid cases. 2/7
But although relatively few people over 65 get infected, they are the majority of people in *hospital* with Covid - they're much more likely to get really sick.

Vaccinating >70s WILL relieve a lot of pressure on hospitals (by March).

We still need to drive cases down NOW. 3/7
Read 9 tweets
11 Jan
THREAD: good news / bad news / good new on covid with data up to 5/6th Jan by date of test.

Thanks to Bob Hawkins who did the charts for me :-)
First, both Wales and N. Ireland now seeing sustained decreases in case positivity rates. Long may this continue.

Scotland is definitely flattenning and England looks like it is too. WIth any luck, both will start trending down over the next few days.
Looking at English regions, places that have been tier 4 equiv restrictions for longest (inc Christmas) are seeing little or no increase (SE, East, London). This is GOOD.

Bad news is that West Mids & NW saw big increase week after Christmas. Birmingham & Liverpool struggling.
Read 6 tweets
8 Jan
LONG THREAD: Digging into UK Covid numbers & what they mean & what's in store...

TLDR: everything is bad and getting worse.

Except vaccines. They are a shining light - we just need to give a LOT more of them.

Read on (25 tweets!)...
CASES: Cases are climbing very fast - over 735K cases in last 2 weeks, compared to 413K the 2 weeks before that. These increases *will* mean more hospital admissions and more deaths over the coming weeks.

I'm afraid that is inevitable. Image
Drops in testing over Christmas & New Year, and longer times to get tests mean that most recent 5 or 6 days is a bit unreliable.

Cases & +vity show massive increases in England & NI & also steep from Scotland. Wales is mixed. Don't trust v recent plateau - could be lag. ImageImage
Read 26 tweets
7 Jan
THREAD: Will lockdown work?

We're starting several weeks of lockdown in England while we try to vaccinate as many vulnerable people as possible.

Every day more stories drop about the terrible situation in hospitals.

The thing is, I'm not sure lockdown will be enough...
Last spring, we got R down to 0.6-0.7, cases & hospital admissions dropped steadily. Hospital occupancy peaked 3 weeks after lockdown. Even that will place unbearable strain on NHS.

But this isn't March's virus and this isn't (despite what govt is saying) March's lockdown. Image
Different virus: The new strain (B117) is estimated to increase R by between 0.4-0.7. Even a March lockdown will struggle then to bring R below 1 where B117 is widespread. Some regions might get lucky & stamp out B117 before it takes hold. With Xmas & NYE, seems unlikely.
Read 15 tweets

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