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Rupert Pearse

10 Jul, 10 tweets, 4 min read

COVID sitrep: The latest UK wave continues to grow. The good news is (compared to previous waves) there are definitely fewer hospital admissions in relation to the number of infections. But the number of infections is now very large. TLDR: The link is weaker but not broken. 1/10

We are still seeing a significant number of people who need hospital care for COVID. They are mostly people who have not yet been vaccinated. A few have medical problems that leave them at greater risk of infection. Others are young and previously fit & well. 2/10

The daily number of new COVID cases in the UK continues to rise (now more than 35,000/day) and is bigger than the November peak. We expected a peak of infections in late July but as we are relaxing not tightening public health measures, the timing is now harder to predict. 3/10

The number of patients admitted to hospital with COVID also continues to rise and is currently around 500/day. The rate of patient admissions per infection is much lower than the winter wave but still a significant number. The link is weaker but not broken. 4/10

Just over 400 COVID patients are being treated in intensive care. This is 15% of all COVID patients in hospital, and a slightly larger proportion than the winter wave. This probably reflects the fact that most ICU’s have capacity to admit patients when referred. 5/10

The current major hotspots for infection are parts of Scotland, the north-west and north-east of England. However, the rates of hospital admissions seem slightly different between areas. It looks like the NHS in NW England is worst affected. 6/10

Again, most COVID patients are not vaccinated, or have an illness which affects their immune system. But vaccination rates have right down. Please get vaccinated if you can. The benefits far outweigh any risks. People are dying from COVID every day. 7/10

The NHS is being pulled in several directions. We have extremely busy Emergency Depts, an epidemic of viral infections in children and a huge backlog of surgery, while we care for patients with ‘usual’ illnesses and once again those with COVID. 8/10 bbc.co.uk/news/uk-577860…

The extraordinary events of the past two years have changed our perceptions. The current level of COVID admissions to hospital may seem small but this is still a major epidemic. There will inevitably be many deaths in the coming weeks. 9/10

We are relaxing nearly all our public health rules at the very moment we expect this wave of COVID infections to peak. The virus is all around us right now. Please think how you can protect others. #HandsFaceSpace and fresh air. Because the link is not yet broken. 10/10

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More from @rupert_pearse

Rupert Pearse

@rupert_pearse

3 Jul

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

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

Read 13 tweets

Rupert Pearse

@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

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

Read 8 tweets

Rupert Pearse

@rupert_pearse

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:

@DHSCgovuk

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.

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

Read 12 tweets

Rupert Pearse

@rupert_pearse

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

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

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

Rupert Pearse

@rupert_pearse

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

Rupert Pearse

@rupert_pearse

6 Mar

@teamaccu

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

@NHSBartsHealth

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

@teamaccu

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

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