The new variant #Omicron reminds us that we MUST be pandemic ready.
The clinical basics:
1⃣ Find the sick.
2⃣ Treat the sick.
3⃣ Stop others getting sick.
Some nations have failed on all three.
Short thread.
If you want good care, you must demand it!
RT pls.
1/9
#Covid_19
The clinical basics:
1⃣ Find the sick.
2⃣ Treat the sick.
3⃣ Stop others getting sick.
Some nations have failed on all three.
Short thread.
If you want good care, you must demand it!
RT pls.
1/9
#Covid_19
It is worrying that some nations - 20 months in - still have not got the clinical basics down:
1. TRIAGE.
Triage is the initial clinical assessment when someone is expected or confirmed to have Covid. It determines if someone needs further medical care.
1. TRIAGE.
Triage is the initial clinical assessment when someone is expected or confirmed to have Covid. It determines if someone needs further medical care.
We know that identifying those needing care earlier reduces the need for ICU, the length of hospital stay, and the rates of Long COVID. #LongCovid
Being clinically proactive saves resources, keeps hospitals open, and crucially, diminishes the level of pandemic THREAT.
Being clinically proactive saves resources, keeps hospitals open, and crucially, diminishes the level of pandemic THREAT.
2. FOLLOW-UP
Ideally all patients should be followed-up. But certainly all high risk patients should be followed-up.
Waiting for patients to present with severe Covid-19 (e.g. UK and US) before offering assessment will lead to more deaths and will overburden hospitals.
Ideally all patients should be followed-up. But certainly all high risk patients should be followed-up.
Waiting for patients to present with severe Covid-19 (e.g. UK and US) before offering assessment will lead to more deaths and will overburden hospitals.
We must catch the deteriorating patient as soon as they become hypoxic (or before). This can make the difference between a few days of hospital admission versus a few weeks; short recovery versus long recovery.
[From preprint: identifying hypoxia early saves lives and resources]
[From preprint: identifying hypoxia early saves lives and resources]
Finally we must:
3. INCREASE BASIC HEALTHCARE CAPACITY
To many this would sound very obvious. There are going to be a lot of extra, additional sick people needing medical care. So we need more capacity to treat them. And basic care is easier to staff than ICUs.
3. INCREASE BASIC HEALTHCARE CAPACITY
To many this would sound very obvious. There are going to be a lot of extra, additional sick people needing medical care. So we need more capacity to treat them. And basic care is easier to staff than ICUs.
It is however, CRUCIAL that capacity is created earlier. With Covid-19 or any unknown pathogen/variant we must have a lower (not higher) threshold for admission. We learned this with silent hypoxia and blood clots. We MUST have the space to admit patients we are concerned about.
If we don't provide additional capacity, then either those with Covid don't get the care they need OR other patients don't. And probably both. If we can't admit Covid patients early, they present later and sicker and take up the high intensity care space for other conditions.
THESE ARE THE BASICS.
▪️Triage
▪️Follow-up
▪️Capacity
It really is not complicated.
A proactive clinical approach saves resources.
Keep the mortality low and reduce the threat posed by Covid.
And we can do it!
But is there the will?
RT pls.
▪️Triage
▪️Follow-up
▪️Capacity
It really is not complicated.
A proactive clinical approach saves resources.
Keep the mortality low and reduce the threat posed by Covid.
And we can do it!
But is there the will?
RT pls.
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