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Rupert Pearse Profile picture
@rupert_pearse
Dec 24, 2021 • 12 tweets • 5 min read • Read on X
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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
The omicron wave hit London first. Hospital admissions have increased three-fold since the start of December. These are patients are coming into hospital with covid disease.

Good news is we now expect a worst case peak of half the number of admissions we saw in January 21. 4/12
Another bit of good news is that covid admissions to intensive care in London have not really started to rise. A little early to expect this but maybe just maybe fewer covid patients in this wave are developing life-threatening critical illness... 5/12
...so an early clue that may fit with research out this week suggesting covid due to the omicron variant may be less severe. BUT remember that huge number of infections so we shouldn’t get carried away. The main impact on NHS hospitals is yet to come. 6/12
bbc.co.uk/news/health-59…
The main increase in hospital admissions in London is expected between Christmas and New Year with a peak in the first half of January. The rest of the UK can expect a similar pattern a week or so later. So across the UK, hospital admissions have yet to rise. 7/12
Quick reminder: When do a PCR test for a COVID patient, we only get a positive or negative. The genotyping tests which tell us which variant take longer, so we don’t know in real time whether we are treating omicron or delta, and cannot tell if they behave differently. 8/12
Also on the plus side, we now understand covid really well. We have lots of effective treatments. NHS escalation plans are a tried and tested routine. Staff are well drilled, patient care more efficient. We have good supplies of drugs, PPE and ventilators. 9/12
The biggest reasons to be positive are the huge number of people who have got themselves vaccinated (nine out of ten people) and the care people are taking to keep everyone safe. @ONS data suggest really good compliance with public health guidance. 10/12
But we cannot relax yet. The NHS pressure may not be as bad as last winter, but it’s still REALLY bad. We have lots of staff sickness and we're struggling to deliver ‘routine’ work such as surgery and cancer care. GP surgeries are busy vaccinating us alongside usual work. 11/12
Covid data wont be available over Christmas so don’t expect any major news for a few days. The NHS situation will be difficult but not as bad as last winter. Our individual actions are what keep COVID under control, so please keep up your amazing efforts. #StaySafe 💙 12/12

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More from @rupert_pearse

Rupert Pearse Profile picture
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
Rupert Pearse Profile picture
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
Rupert Pearse Profile picture
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
Rupert Pearse Profile picture
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
Rupert Pearse Profile picture
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
Rupert Pearse Profile picture
Dec 18, 2021
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/
Read 14 tweets

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