New coronavirus infections are decreasing and 14 million people in the UK have received one vaccine dose. But the sitrep is that hospitals are still caring for 24,352 COVID patients – more than at the peak of the first wave. NHS staff cannot rest yet. 1/8 bbc.co.uk/news/health-56…
Despite the absurd claims of COVID sceptics, we have seen a huge number of excess deaths in the past 12 months, and well above the five-year average mortality rate. COVID remains the leading cause of death right now – many amongst working age people. 2/8
The pressure on the NHS remains extremely high and will be for months to come. This by @Zudin_P and @stevemathieu75 for @ICS_updates describing the vast effort needed to create extra Intensive Care beds across the UK. We still have more ICU patients than the first wave. 3/8
Of 5450 ICU beds in the UK, 3275 are occupied by a patient with COVID. The pandemic affects the healthcare any of us might need, at any moment, whether we are healthy or ill. Happily, most of us understand this. Compliance with public health measures remains high. 4/8
Lockdown has impacts on us all. As the situation drags on, we are increasingly unhappy. But the more the virus spreads, the stricter the rules needed to control it. Consistent low case numbers can only be achieved through consistent public health measures. 5/8
Coronavirus won’t go away just because we ignore it. Like the flu virus, SARS-CoV-2 develops mutations. New variants can be more contagious and more virulent (harmful). We have a different flu vaccine each autumn to tackle this, and we will likely need the same for COVID. 6/8
Doctors are worried that some MPs are pushing back hard on government public health measures, despite the situation in NHS hospitals. We’ve seen this many times in the past year, and not once did it work out well. Control of virus spread is the only path back to our freedoms. 7/8
Even as infection rates ease, we must respect public health advice as much as ever. I'm not sure NHS staff could cope with another big pandemic wave. Keep up the great work with #HandsFaceSpace. Tell your MP why. We can’t simply ignore the virus and expect all to be well. 8/8

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More from @rupert_pearse

30 Jan
Sitrep: situation report. This is what we call our daily briefings right now. Here’s mine. We are now fairly confident we have reached the high water-mark for the second wave of COVID-19 NHS hospital admissions across the UK. Good news but.... 1/10
....we still have nearly 40,000 patients in hospitals with COVID-19. Despite huge increases in staffing, we are very short-handed. In many hospitals, admissions have stabilised but not all. Some differences across the UK. Things still getting worse in the Midlands and North. 2/10
4000 of these patients (10%) need intensive care. This is huge: in January 2020 the UK had only 4100 adult ‘critical care’ beds including both ‘intensive care’ ventilated beds for the sickest patients and 'high dependency' beds for less sick patients. 3/10
kingsfund.org.uk/publications/c…
Read 10 tweets
23 Jan
Oxygen supply in hospitals is getting a lot of media coverage. Some hospitals are using five times more oxygen than usual triggering low pressure alarms. Media reporting oxygen supplies ‘running out’ and ‘not enough to go round’. The problem is not quite what it sounds… 1/12
We don't usually think about oxygen supply. It isn't something we notice until the oxygen pressure alarms go off. That used to be rare. The unfamiliar and emotive problem can seem frightening for NHS staff and public alike. This from @ChrisCEOHopson 2/12

Oxygen supplies don’t run out like an electricity power cut. Instead the pressure drops like it can with the hot water system in your home. Your shower doesn’t run dry but the water pressure is not what you need. You may need to turn some other taps off to solve this. 3/12
Read 12 tweets
20 Jan
A bit of controversy at the moment about medical students redeploying in Healthcare Assistant (HCA) roles. Some unfortunate language which I’m sure is regretted. I’m very involved in the @QMULBartsTheLon @QMUL med student redeployment and would like to point a few things out. 1/8
In the first wave (March), med student studies were suspended. Ours had just finished final exams and *volunteered* to join us to support patient care. They did not expect to get paid. They were incredibly professional and made me very proud to be a @QMUL prof. 2/8
In the second wave (January) our students’ studies have NOT been suspended. We (@QMULBartsTheLon) have *sent* them to help. While many would choose this, not all would. Our final years have major exams looming and must also complete educational log books, attend teaching etc. 3/8
Read 8 tweets
19 Jan
Optimistic news: National data on new coronavirus infections data do now show we have passed the peak. Good news but really this is just the end of the beginning for the NHS response. 1/7 https://coronavirus.data.gov.uk/
Firstly, the national data hide regional differences. New infections are still increasing in many parts of the UK. NHS hospitals in different areas will need to support each other for some time to come. 2/7
This map illustrates this much more clearly. Many areas of the country still very badly affected by new infections. This affects NHS healthcare in pretty much every part of the UK. 3/7 https://coronavirus.data.gov.uk/
Read 7 tweets
17 Jan
What reaching the peak means for the NHS: We're increasingly confident we have hit *a* peak and hopefully *the* peak of the second wave of coronavirus infections. Hospital admissions lag behind and will carry on rising for another week or so, but this is still a key moment… 1/10 Photo @jometsonscott
I have talked before about how and why the healthcare the NHS provides right now is simply not as good as usual. We have protected emergency care but routine care for cancer, cardiac disease and so many other illnesses has been badly affected. Especially surgical treatments. 2/10
The surge in COVID patient admissions has a huge impact on other parts of the NHS. We see this pattern often in the winter flu season but it is far worse right now. The shortage of normal hospital beds and ICU beds makes in-patient work very difficult. 3/10
Read 10 tweets
14 Jan
The number of new coronavirus infections may be levelling off, but patient admissions to NHS hospitals for COVID-19 will increase for another 7-10 days. The question of how we choose which patient gets an ICU bed is now a routine one in media interviews. Doctors are worried. 1/11
The burden of decision making around ICU admission traditionally falls on senior ICU doctors. Most of us are privately very worried about what will happen if we run out of resources. The false suggestion that we rationed ICU beds in the first wave has upset a lot of people. 2/11
To be clear, I am not aware of ANY patient who was not admitted to intensive care during the pandemic when the ICU consultants responsible believed that they should be. But we would be failing in our duty if we do not plan for this situation. 3/11
Read 11 tweets

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