Black Wednesday

5th August 2020

UK COVID Deaths - Daily 65 / Total 46,364

James Cook Hospital – Total COVID deaths – 255

All COVID cases within South Tees Hospitals Trust – 4

James Cook Critical Care COVID cases – 0

Don’t worry, the title of today’s post doesn’t indicate a day full of unspeakable medical horrors or a catastrophic stock market crash but rather the day when newly qualified Junior Doctors start work in the NHS and when other Junior Doctors rotate to new training posts.

The term became ‘popular’ after a study in 2009 showed that the mortality rate in hospitals was allegedly up to 6% higher on Black Wednesday when compared to the previous Wednesday over an 8 year period in 170 UK hospitals. A similar effect has been reported in the USA where it is known as the ‘July Effect’, reflecting their slightly earlier changeover date.

To be honest, because the death rate in hospitals is traditionally low in August, the number of excess deaths was only 45 amongst a total of 300,000 emergency admissions over the nine year period. This is statistically significant, but only just. However, steps have been taken since then to mitigate any risk. New doctors now shadow outgoing doctors for a few days before taking over and more senior medical staff are now more available to supervise. It’s not something the general public should really lose much sleep over, despite proclamations by the Daily Mail to the contrary.

Intensive Care is not allocated brand new baby doctors so this is not much of a concern for us but we have had to say goodbye to all the trainees that we have worked with during the initial surge of the pandemic. This has saddened all of us; we have all worked closely together during this difficult time and we came to know this last intake of trainees very well. We have nothing but praise for them and I am proud to have worked alongside each and every one of them.

We have had a relatively calm day compared to the rest of the hospital which is continuing to get busier and busier. We have admitted a couple of patients with neurological and cardiac problems respectively and attended a Helicopter Trauma Call in A&E following a roller-coaster accident of which you can read more about in the local press.

COVID patient numbers remain low although the hospital has seen a few patients admitted for other reasons who have tested positive for COVID-19 when swabbed. These patients were originally infected with confirmed COVID-19 infections weeks ago and have recovered before being re-admitted to hospital with unrelated conditions.

A positive COVID-19 swab test under these circumstances does not mean that the patient is ill and infectious. The test only detects fragments of viral genetic material, known as RNA, rather than the live virus itself. I know of patients who have continued to test positive for over 80 days after they developed their initial infection. Research studies have attempted to isolate the live virus in tissue culture from such patients and have all failed, confirming that the patients are no longer infected.

One thing that brightened my day today was a picture that is one of many that can be found adorning the main hospital corridors. It’s part of a collection of pictures that have been drawn by local children. Unsurprisingly, they feature lots of rainbows, expressions of thanks to NHS and key-workers, advice on social distancing and optimistic messages of hope. You’ll have seen many of them displayed in the front windows of houses up and down the country. I must confess that it is often quite easy to walk right past them without paying them too much attention. However, one of them caught my eye today and made me laugh. I thought I ought to share it with you:

Taste the Rainbow…