Back on the frontline the damage caused by 'letting it rip' is all too apparent. "Broken" seems to be the word of the day - both for staff and NHS.
As the battle for the Omicron narrative begins, hearing the word 'coping' now stings a bit too much...'success' a swell of anger...
Lots of Covid today. New outpatient treatments (someone has to administer them); loads of patients not well, but with some effort can be managed at home; the inpatients, and the odd escalation to Level 2 care..
It's a lot of work in the middle of our usual brutal winter caseloads
Being on the senior medical team is tough. Lots of compromising, and spreading too little way too thinly. Sleepless nights and little left to give for the family. I feel for the patients more...although many don't realise. I feel also for the juniors and med students...
..a look of horror "did I choose the right path?". Not the environment to teach high quality care nor for retention of our brightest to the UK's health service. So many have one eye on the door...NZ, Auz, Canada, M.East...so many places where HCWs are respected, protected.
There is now little desire in asking the paramedics, GP, ED or Medical Teams what it's like. On our shoulders you walk to your 'freedom', and on the backs of the grieving families you dance...freedom taken from the disabled victims of poorly timed illness. Someone has to pay.
Hearing our voices or the voices of those affected will be inconvenient now. It need not matter that history has already recorded the countries who choose the suffering of others as a fair levy for profit and some form of ill-defined sense of liberty. Our voices too sore now.
The strength of character of so many patients, nurses (particularly nurses) and so many others lifts me...
But our voices need to be heard...we CANNOT allow the cunning story-tellers in their ivory towers to warp the truth to a more popular, soothing, fake narrative...
So, can I ask you to speak up? Can we hear your stories over the last month? Your long waits, your challenge in accessing care, your losses, your sacrifices...Let us hear it and share it and bookmark it so we remember, what it felt like, dying in a leadership vacuum...
END
RT

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More from @danielgoyal

9 Jan
How will the pandemic end?

To appreciate the magnitude of lunacy behind the UK, US, and some other nations pandemic strategy, it is helpful to try and “game out” how the pandemic will “end”.

Here are some scenarios…
1. Waves of new variants with increasing immune tolerance to SARS-CoV-2.

Only someone very brave or very foolish would bet against more variants. As the population develops immunity to one variant the conditions become favourable for another to take hold.
We don’t know what such variants may look like. They may be more severe or less severe, they may cause more illness in the young or less, they may be more responsive to vaccines or less. No doubt, on this path uncertainty remains high.
Read 18 tweets
7 Jan
Here is the UK’s national ICU report. Published today.
Only one point I would like to draw your attention to:

The ICU burden of Covid in comparison to pneumonia and to Flu.

Page 23/24

icnarc.org/Our-Audit/Audi…
Firstly, pneumonia.

The orange lines are Covid ICU admissions. The grey are pneumonia (non-Covid).

Our post-freedom baseline ICU use from Covid was 2K to 3K per month [Peaked at 12k Jan ‘21.]

Pneumonia baseline 2019 was 1K to 1.7K per month. With peak at 2K.
Here is Flu (Influenza).

2019. For around 6 months there were almost no Flu admissions to ICU. Then, between 100 to 650 admissions per month.

2,600 Flu ICU admissions in 2019.
42,000 Covid ICU admissions in 2021.
Read 4 tweets
6 Jan
"Living with Covid" means different things in different countries.

Lets look at Singapore...

@chrischirp @ChrisCEOHopson @Kit_Yates_Maths @jburnmurdoch @DrGregorSmith @devisridhar @theAliceRoberts @doctor_oxford @DrEricDing @Dr2NisreenAlwan
Singapore has performed well.
About the size of Scotland (pop 5m.), they have suffered 800 deaths.
They began with a 3 month Lockdown, which they used to significantly increase care capacity.
They have 5000 additional Covid Care Beds and opened 900 Public Health Clinics (GP-led).
Apart from brief periods, routine care has continued relatively unaffected by Covid. GP's and private hospitals have been financially supported to provide routine care, while GP's and government hospitals tackled Covid.
This is reflected in their low excess mortality rate:
Read 12 tweets
6 Jan
NHS Confederation steps up!

Some good news this morning. NHS chiefs have called for more resources to the frontline and called out Johnson’s rhetoric of “riding it out”.

Concerns grow that millions of patients will suffer unless action is taken…

[Reported in the Guardian]
While still not publicly requesting proper PPE for front-facing staff nor directly asking for an immediate pay rise, @NHSConfed have openly challenged the PM’s reassurance that the NHS is not overwhelmed.
States:

“The government now needs to do all it can to mobilise more staff and other resources for the NHS to get through this extremely challenging period.”

Calling for reducing staff isolation to 5 days is IMO desperate and possibly counterproductive measure to staff frontline
Read 6 tweets
5 Jan
How wrong is Johnson’s (and other leadership’s) inaction?

Almost beyond comprehension.

They have abandoned the public and frontline staff. AND make absolutely no mistake about it, they have accepted avoidable deaths and disability of thousands.

1/n
Johnson’s view that we can ride out the next few weeks is based on a complete disconnect from reality.

Firstly, we have not even reached the peak in the UK. The pressures will only worsen.
The two years of profound healthcare rationing that we have endured will only worsen

thelancet.com/journals/lanep…
Read 11 tweets
1 Jan
Can 2022 be the year we learn from our mistakes?

We are entitled to make mistakes, given how new Covid is.

But stubbornness and ego have no place in pandemic management.

On that note: Covid admissions rising in many places.

Here’s New York: Image
And here is London:

@chrischirp Image
Denmark, France and the wider US… Image
Read 9 tweets

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