COVID sitrep: On call for ICU this weekend. We definitely have another wave of COVID hospital admissions in the UK. As we did in Nov ’20, we are projecting a ‘slow burn’ of hospital admissions rather than a third wave. Let’s hope our forecast is more accurate this time….. 1/13
The number of COVID cases diagnosed each day in the UK rose more than 10-fold from ~2000 at the start of May to almost 30,000/day now. Meanwhile COVID-19 admissions to NHS hospitals have doubled to ~250 patients/day in the same period (January ’21 peak was over 4000/day). 2/13 https://coronavirus.data.gov.uk/
We have nearly 2,000 hospital in-patients with COVID-19 across the NHS and rising. Of these, nearly ~300 patients are in intensive care beds. This compares to the January peak of nearly 40,000 in-patients with 4,000 in ICU. Small by comparison but still a major epidemic. 3/13 https://coronavirus.data.gov.uk/
The north-west of England is the worse affected area with NHS hospitals here treating a quarter of all UK COVID hospital in-patients, and one third of the ICU patients. Scotland has more infections than the second wave but hospital admissions are rising more slowly. 4/13 https://coronavirus.data.gov.uk/
Friends working in NHS hospitals across the UK tell me most COVID in-patients are not vaccinated, or have an illness which affects their immune system. But some are young fit (unvaccinated) patients in their 20’s and 30’s. We may be seeing more pregnant patients than before. 5/13
Happily, it does seem that fewer ICU patients are needing a ventilator. Many of those admitted to ICU are coping with extra oxygen, or mid-level breathing support such as ‘CPAP’ which involves wearing a tight-fitting oxygen mask. 6/13
We think (and hope) that vaccination is making the difference. Despite large numbers of new cases, fewer patients are coming to hospital and fewer are getting seriously ill. Please accept the vaccine if offered. The benefits far outweigh any risks. COVID is a nasty disease. 7/13 https://coronavirus.data.gov.uk/
Remember, it's still early in this latest wave. Hospital admissions peak 2-3 weeks after infections. Patient numbers could still rise steeply. We are planning for a peak of hospital admissions around early August. Plans for ‘surge’ ICU beds are in place in NHS hospitals. 8/13
NHS hospitals are also dealing with other big problems. Emergency Departments are reporting extremely high numbers of patient attendances, while children’s services are coping with an epidemic of viral infections more commonly seen in Winter. 9/13
bbc.co.uk/news/health-57…
We are also working very hard to maintain routine services for ‘usual’ diseases such as heart disease, stroke and cancer. We must clear a backlog of more than 2 million patients who saw their surgery delayed or cancelled in the past 18 months. 10/13
Meanwhile many hospitals are beginning to struggle with staffing as NHS Track & Trace asks our staff to isolate following COVID contacts in the community. Most are double vaccinated and we may find we need to make pragmatic decisions if staffing gets any worse. 11/13 bbc.co.uk/news
There are similar stories in many countries. Low-income countries in Africa are at particular risk while the World Health Organisation (WHO) has warned of a major wave of COVID-19 infections across Europe. 12/13
bbc.co.uk/news/world-eur…
NHS staff will continue to care for every patient with every illness. COVID numbers are manageable in most areas but numbers are rising. Sadly, people continue to die from this disease. Please stick to government guidelines and #staysafe. Thanks for all you are doing. 13/13

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More from @rupert_pearse

26 Jun
COVID sitrep: We are definitely now entering another wave of hospital admissions in the UK. In the NHS Trust where I work, we are admitting more COVID-19 patients to hospital and more to intensive care, although the pattern seems different to the winter.... 1/8
What we are seeing locally in east London fits with the national pattern of infection rates. The number of patients coming to our hospital group who test positive for COVID had dwindled to single figures but is now back up to 40+ each day and rising. 2/8 https://coronavirus.data.gov.uk/
Hospital admissions are rising too. Both older patients yet to take up the invitation to be vaccinated, and young fit patients in their 20’s and 30’s who have not yet had the chance. There are ~1500 COVID patients in NHS hospitals. The January peak was just under 40,000. 3/8 https://coronavirus.data.gov.uk/
Read 8 tweets
19 Jun
Covid sitrep: Was not planning on doing another one but things are definitely changing on the ground in some NHS hospitals. Vaccination has been a huge help but we are seeing more patients admitted to hospital and to ICU. Frustrating but there are reasons to be hopeful 1/11:
First thing to explain is that although there has definitely been an increase in new admissions to hospital, the numbers are very small. We are reassured by @DHSCgovuk reports that vaccination is reducing the number of severe cases of Covid 2/11. https://coronavirus.data.gov.uk/details/healthcare
The flow of patients with covid needing intensive care had almost stopped for a few weeks but is rising again. ICU staff are seeing a change. Again, the numbers are very small but we also know they start small. 3/11 https://coronavirus.data.gov.uk/details/healthcare
Read 12 tweets
13 Mar
COVID sitrep: The situation in NHS hospitals continues to improve as new infections reach the lowest level since mid-September. Lots of green on the map now. Many patients now well enough to be cared for at home. Still lots going on though. 1/9 coronavirus.data.gov.uk
We now have fewer than 10,000 COVID patients in NHS hospitals, and the lowest number since 24th October. A great milestone but still a vast number for a single infectious disease. The NHS is a long way from business as usual. 2/9 coronavirus.data.gov.uk
National patterns can often hide regional variations but it’s great to see both hospital admissions and deaths from COVID now falling in every region of England. 3/9
Read 9 tweets
7 Mar
A family member asked me to explain why I wasn’t convinced by a clinical trial of ivermectin. Yet again (apologies) it’s complicated. But here’s ten things for the non-expert can look for to help them understand how much a clinical trial should influence patient care.
1. Beware the tabloid headline: We all want a nice simple message but science just isn’t like that. Clinical trials need careful nuanced interpretation. But media, politicians, and often researchers themselves, want a snappy success story. These are generally misleading.
2. Evidence before eminence: your first impressions should be made by the trial and the data, NOT the researcher(s), however brilliant they may be. In particular, if the reputation of one individual is used strongly in support of the trial findings, then be careful.
Read 13 tweets
6 Mar
Sitrep: Yesterday marked a year since the first COVID-19 patient was admitted to @teamaccu @royallondonhosp. A year like no other. East London was badly hit by both the first and second waves. Many stories to tell. Here’s mine (long thread but easy read!). 1/22 Photo: @jometsonscott
The four hospitals in @NHSBartsHealth has treated more than 8000 patients with COVID-19. This was beyond our wildest imagination a year ago. Even the worst winter ‘flu epidemic was tiny by comparison. The entire organisation forced to configure around a single disease. 2/22
Our expanded @teamaccu has admitted 648 COVID patients in 12 months to an ICU which expanded three and a half times our original size to 150 beds. For ICU staff this is just mind boggling. An incredible logistical effort from staff of all grades from across @NHSBartsHealth. 3/22
Read 22 tweets
3 Mar
Not the first time in the past year that a non-expert has offered a simple narrative on a complex healthcare problem...
Let's gloss over the use of percentages without explanation of what they mean, and the failure to quote a data source, and look at some facts....
Firstly, many NHS staff are not clinically trained eg porters, cleaners, managers, admin staff, etc. They don't have any more reason to understand vaccination than any other members of the public.
Read 9 tweets

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