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 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

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

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 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

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 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

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

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

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

COVID sitrep: The situation in NHS hospitals hasn’t changed much since last week. A worry in itself. The number of patients admitted to hospital with COVID-19 continues to rise slowly. The current COVID wave now seems certain to combine with winter pressures in November. 1/10 The daily number of COVID infections continues to trend steadily upwards, as does the number of patients admitted to hospital. This means the NHS COVID workload is building. 2/10

COVID sitrep: On call this weekend and the pandemic grumbles on. Where I work in east London we are seeing lots of unvaccinated patients, many needing intensive care. Locally and nationally, hospital patient numbers are rising but slowly. The NHS COVID workload remains high. 1/10 The daily number of COVID infections continues to trend steadily upwards, but the number of patients admitted to hospital is rising more slowly. 2/10

COVID sitrep: Last week I reported the news that we feel we’ve passed the high water-mark for this wave in the UK. But this week expert epidemiologists have been discussing how infections are rising once more. So what’s happening on the ground? 1/10 .....this graph helps to explain. The number of COVID infections chatters up and down but the number of patients in hospital (our COVID-19 workload) is currently holding steady. Nothing like the winter peak of nearly 40,000 patients but still a lot of patients to look after. 2/10

COVID sitrep: We are now fairly confident we have passed the high water-mark for this latest wave in the UK. Both infection rates and hospital admissions in decline. Good news but the NHS faces several competing major challenges as we look towards another difficult winter. 1/8 The daily number of COVID infections is consistently falling, and now the number of patients admitted to hospital each day with COVID-19 is on a downward trend as well. 2/8

COVID sitrep: Lots of discussion this week about whether UK COVID infections are falling. The answer is maybe, but this misses the point. We must accept that these waves will come and go. The pandemic is not over, nor is the impact on individuals, the NHS and society. 1/10 If we look at the national COVID positive tests, we might see the suggestion of a downward trend, but the most recent (and so incomplete) data in the grey columns suggest the infection rate is fluctuating. It is just too early to draw any definitive conclusions. 2/10

COVID sitrep: Have been off this week so something slightly different. News stories like this one suggest the number of new infections may be beginning to stabilise. Experience tells us it is far too early to know. 1/10
bbc.co.uk/news/health-57… When cases passed 60,000 a few days ago we were starting to worry, so it’s good news if this was a one-day spike. If we look back, we can see these are spikes common. It’s too early to know whether this is a genuine fall. The numbers jump up and down for lots of reasons. 2/10

COVID sitrep: As infections rise exponentially the NHS is again reconfiguring for COVID hospital admissions. This week in the hospital where I work we re-opened our temporary ‘surge’ intensive care unit. The link between infection and serious illness is weaker but not broken 1/10 This from a one my nursing colleagues. It is heart-breaking to think we will again see significant numbers of patients in Intensive Care, and more deaths from COVID-19. 2/10

https://twitter.com/Rud_NJ/status/1415771734108692480?s=20

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

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

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

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: 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.

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

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.

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 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