Rupert Pearse Profile picture
Dec 18, 2021 14 tweets 5 min read Read on X
COVID sitrep: It’s clear to anyone following the news that we are expecting a very large wave of COVID-19 infections, driven by the new omicron variant. Very unwelcome news and we aren’t certain how well vaccination will protect us. Here’s what’s happening in NHS hospitals… 1/14
The first thing to say is that when do a PCR test for COVID, we only get a positive or negative. The genotyping tests which tell us which variant take longer, and we aren't routinely sent them. So we don’t know in real time whether we are treating omicron or delta. 2/14
We are all looking at the graphs of new SARS CoV-2 ‘cases’. Like it or not, we face a huge wave of infections. Yesterday 93,000 people tested positive which is already well past the January 2020 peak of 81,000. 3/14 https://coronavirus.data.gov.uk/
Sceptics and non-sceptics alike, will ask whether this rise in infections is translating into rising admissions to NHS hospitals. We think so. Infections are rising fastest in London and we are beginning to see a very early rise in admissions.… 4/14 https://coronavirus.data.gov.uk/
….but in general, we are not yet seeing a wave of increased hospital admissions across the UK. Hospital admissions increase around 7-10 days after infections. So we know the wave is coming but it hasn’t hit us yet. The next two weeks will reveal a lot more. 5/14 https://coronavirus.data.gov.uk/
Looking just at Intensive Care, the number of COVID patients in ICU beds is currently around 900: almost one fifth of our national capacity - healthcare which is not available for other services such as major surgery. We don’t yet know how much these numbers will rise. 6/14 https://coronavirus.data.gov.uk/
Since July, NHS hospitals have been dealing with a lots of challenges: Very busy Emergency Departments, out of season epidemics of childhood infections, a huge backlog of patients waiting for surgery, and a moderate number of COVID patients as well…. 7/14
bbc.co.uk/news/health-59…
.…on top of these challenges we now know we will face a huge wave of omicron infections but we simply don’t yet know how many people will be sick enough to need hospital or ICU admission. We can hope for the best but we must plan for the worst. 8/14
The UK has one of the most vaccinated populations in the world. 812,000 people were vaccinated on Thursday alone. Good to see this report today suggesting vaccination will perform reasonably well against omicron but we still don’t know for sure. 9/14
bbc.co.uk/news/health-59…
Also on the plus side, we understand the disease really well. Clinical trials have delivered a range of new treatments. NHS escalation plans are tried and tested. Staff are well drilled, patient care more efficient. We have good supplies of drugs, PPE and ventilators. 10/14
We also have reasons to worry. Existing staff shortages will get worse. Like everyone, NHS staff are tired of the pandemic. We are struggling to deliver ‘routine’ work such as surgery and cancer care. GP surgeries are very busy vaccinating us on top of their usual work. 11/14
This week’s @WHO map reminds us that COVID is a global problem. 545,000 new infections per day. Sharing drugs and vaccines with other countries is vital because none of us are safe until we’re all safe. 12/14 @WHO
Several doctor colleagues having difficult interactions with families who don't believe their loved one has COVID. This makes good patient care much harder. Please get your info from trusted sources eg @BBCNews. For doctors in the media, do they actually treat NHS patients? 13/14
The current NHS situation is difficult and will get worse. We’re not sure how much worse. All of our healthcare will be affected. Our individual actions are what keep COVID under control. So please stay vaccinated and keep up your good work with #HandsFaceSpace & fresh air💙14/14

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More from @rupert_pearse

Jan 29, 2022
COVID Sitrep: Only a short update as on call this weekend with this amazing team covering covid ICU. TLDR: Things may be settling but the work is far from over. 1/8 Image
Lots of talk this week about new covid infections hitting a plateau. This is probably driven by children going back to school. So not ideal, but better than the rebound peak we feared would happen after New Year. 2/8 https://coronavirus.data.go...
New hospital admissions continue to fall but slowly. A large proportion of these are those 'incidental' covid patients admitted for other 'usual' medical problems not covid disease. 3/8 https://coronavirus.data.go...
Read 9 tweets
Jan 22, 2022
COVID sitrep: Some positive news to report this week. We are definitely feeling a fall in NHS hospital and ICU admissions with covid in London this week. The rest of the UK should see a similar pattern in the coming days. This below appeared on our ICU board this week! 1/10
As mentioned in previous weeks, being confident we are past the peak is a big deal for the NHS. Every day things get a little easier, a little simpler. We can do more ‘usual’ NHS work. We can get back to clearing the backlog of surgery and other patient care. 2/10
The colours on the national map are getting lighter every week which reassures us that the number of new infections continues to fall in most areas of the UK. 3/10 https://coronavirus.data.gov.uk/
Read 10 tweets
Jan 15, 2022
COVID sitrep: Lots of topics to choose from this week. Good news is we have probably passed the peak in new COVID-19 infections in several UK regions. This week’s map (right) is not so dark. But what will happen next is not so clear. A thread from the NHS perspective. 1/12 https://coronavirus.data.gov.uk/https://coronavirus.data.gov.uk/
All eyes have been on London as the first UK region to get hit by the omicron variant. Cases seem to have peaked both in younger and older people (light blue line=<60yrs, dark blue line=60+ yrs). But we aren’t sure whether new case rates will fall quickly or plateau out. 2/12 https://coronavirus.data.gov.uk/
Why so cautious when others seem confident cases are falling? Well, passing the peak defines the NHS response. When we know we are past the worst we stop planning extra covid capacity, re-focus on the patients we have, and plan more routine NHS work. A big shift in strategy. 3/12
Read 12 tweets
Jan 8, 2022
First COVID sitrep of the New Year: The number of omicron variant COVID-19 infections remains extremely high in the UK and still far higher than anything we have seen up until last month. Here’s what’s happening in the NHS… 1/14 https://coronavirus.data.gov.uk/
London was the first UK region to get hit by the omicron variant before spreading across the country. This week’s million dollar question is whether new infections have peaked in London. Many say yes, but it seems too early to be sure…. 2/14 https://coronavirus.data.gov.uk/
…and being sure we are past the peak is a key moment in the NHS response to each wave. Once we *know* we are past the worst, we can stop planning extra covid capacity, we can re-focus on the patients we have, and all the other routine NHS work. This makes a big difference. 3/14
Read 14 tweets
Dec 31, 2021
COVID sitrep for New Year’s Eve: The wave of omicron variant COVID-19 infections continues to spread around the world. Hospital admissions are rising across the UK but there are important differences to earlier waves…. 1/12
This omicron variant seems to spread much more easily. Infection rates are smashing all previous records. 189,000 ‘cases’ yesterday. Yes, we are testing a lot more people, but the proportion who test positive is also going up (blue line in graph). 2/12 https://coronavirus.data.gov.uk/
The big discussion now is how harmful the omicron variant might be. Lots of reports of high rates of ‘incidental’ infections in hospital - patients testing positive for coronavirus who were admitted to hospital for a different illness. So what’s happening on the ground? 3/12
Read 14 tweets
Dec 24, 2021
COVID sitrep for Christmas Eve: The huge wave of COVID-19 infections, driven by the new omicron variant, is spreading across the country. Hospital admissions are now rising in London but the good news is we think things won’t be as bad as last winter. 1/12 bbc.co.uk/news/uk-597587…
The wave of infections with SARS CoV-2 is simply huge, passing 100,000 ‘cases’ two days in a row and way in excess of the previous record peak of 81,000 in January 2021. Yesterday 119,000 people tested positive 2/12
Before anyone suggests it, this is NOT simply because we are doing more tests. Firstly, the proportion of tests done which are positive has increased too (blue line in graph). Secondly, people get tested for a reason - symptoms or a covid contact – it’s not random behaviour. 3/12
Read 12 tweets

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