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Writer's pictureRichard Cree

Fourth Wave

Updated: Dec 30, 2021

29th December 2021

UK COVID Deaths – Daily 57 / 7-Day average 100

Total UK COVID Deaths within 28 days – 148,089

Total UK Deaths with COVID-19 on the death certificate – 171,801 (up to 10 Dec)

James Cook Hospital – Total COVID deaths – 724

All COVID cases within South Tees Hospitals Trust – 67

James Cook Critical Care

COVID cases – 7 (4 ventilated)

Non-COVID cases – 39 (23 ventilated)


Christmas at the hospital was mercifully quiet for once. My colleagues who were working over Christmas saw fewer Critical Care patients than usual and, by the time I returned to work on 27th December, we had a handful of empty beds for a change. There were only four patients on the COVID ICU and I was struck by how much calmer things seemed.


Unfortunately, this festive tranquillity doesn’t look like it’s going to last. The hospital has been admitting increasing numbers of COVID patients over the past 72 hours and the total number of such patients in the hospital is almost double what it was a week ago.


This is not unexpected. Omicron is now responsible for well over 90% of English COVID-19 infections. Case numbers within the Tees Valley have increased significantly over the Christmas holiday and an increase in hospital admissions was bound to follow. We have been told we can expect less severe illness in the Omicron patients and there are some signs that this is true. None of the recent admissions to hospital have required ventilation. However, there are still a significant number who have required CPAP to treat their respiratory failure and we have admitted three of the most unwell CPAP patients to the ICU for close observation.


Currently, over two-thirds of the patients admitted to our ICU are unvaccinated. They are all relatively young and nearly all of them have the usual risk factors for severe COVID pneumonitis; they tend to be male, overweight and have type 2 diabetes. Some of these patients are fundamentally opposed to vaccination but many more seem to have simply not appreciated that they might be more at risk of severe illness. When offered vaccination, they have simply told their GP that they would rather ‘take their chances’.


Just like last year, the intergenerational mixing that tends to take place over the holiday period has led to severe illness striking different members of the same family. We recently admitted a father and son to the COVID ICU within days of each other and, as I’m sure you can appreciate, this makes for a very emotionally charged situation. It’s hard to imagine the worry and distress that comes from having two members of your family in the same Intensive Care Unit at the same time.


The rest of our COVID ICU patients are all fully vaccinated and boosted. Unfortunately, they have significant underlying health problems and are all on potent immunosuppressive treatments. A number of them are kidney transplant patients who are very much at risk of severe illness should they become infected with COVID-19.


As bad as all this might sound, it’s worth keeping a sense of perspective; the current number of COVID patients within the hospital is still relatively low. We have been dealing with similar or higher numbers of patients on-and-off since July and so there’s no cause for alarm just yet. Indeed, some would argue that all we are seeing is a continuation of the third wave. A rise in cases after Christmas was always to be expected. However, the recent decline in hospital admissions has been much better than any of us anticipated and we have been allowed an all-too-brief respite. As a result, the current increase in hospital admissions feels very much like the unhappy beginning of a fourth wave.



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18 Comments


paul
Jan 02, 2022

evening richard, i have been following since you started but not commented for a while, please never underestimate the help youve given to me and many others by your blogs, especially at a time when im sure you could of done without them, fantastic effort sir !!


heres some feedback for you regarding vaccination, the dreaded cv19 has manged to clip me mainly due to me deciding to put my trust in the vaccination programme, i tested positive via LTF on tuesday, i attended the match on sunday(boxing day) and im pretty sure thats where it took me out via a friend of my son who doesnt go to the match with us but we gave a lift home to…


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Richard Cree
Richard Cree
Jan 03, 2022
Replying to

Hi Paul Sorry to hear you have been infected but pleased to hear you have not been that unwell with it. We could argue for days about the moral and ethical issues surrounding vaccination but given my role, I take a rather fatalistic view. I believe everything should be done to encourage vaccine uptake and prevent disinformation. People should be free to make informed choices. However, most of my patients have made unwise health decisions – smoking, drinking alcohol, over-eating, drug taking, violent behaviour and reckless driving to name but a few. Many of these choices ultimately have an impact on others, not least of all, their immediate families as well as consuming increasingly precious health resources. I don’t expect this…

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claire.druery
Dec 31, 2021

Thank you for the blog, I find your balanced view really helpful. I really wish that the government would get some marketing/PR experts involved in the vaccination campaign. People need educating not instructing. Just some simple data and stats about why the vaccine is effective rather than threats about not being able to go on holiday/to nightclubs etc would really be beneficial in my view.

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Richard Cree
Richard Cree
Jan 01, 2022
Replying to

Hi Claire. I think the problem with a lot of the people who decline vaccination is that they don’t believe or attach importance to what they are being told. You can take a horse to water…etc… Anyway - all the best for 2022. Cheers, Richard

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janet
Dec 31, 2021

Good morning Richard,

thank you for your fantastic reporting on your hospitals covid journey over these last two years. I find them very reassuring and calm and they have helped me deal in my own head how things are going. It would of been really great if every hospital dealing with this horrible pandemic could of had someone like yourself writing there own hospitals journey . I hope you carry on with this blog long after it’s all over ( i do know it’ll never be completely over).

All the best for 2022 and to a better working more normal life.


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Richard Cree
Richard Cree
Jan 01, 2022
Replying to

Thank you Janet. I have to hope that things will be better come the spring! Cheers, Richard

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peter.nms
Dec 31, 2021

Thanks for the update and time taken to fill us in on the local situation.


I have been following the admissions, England is now seeing over 2k a day, we are many weeks from the peak.


Admissions are surging ...



and so are the numbers of people in hospital ...



Admissions are likely to surpass last winter but people in hospital should be fewer. It seems like average time in hospital with Covid is much reduced.


This continuing mismanagement will have far reaching consequences for those left with Long Covid.


What a sad situation we find ourselves in again!


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peter.nms
Dec 31, 2021
Replying to

🤣🤣🤣

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rick.rwbarnes
Dec 30, 2021

Hoping that things stay calm into the new year. It seems as though the vaccination message isn't getting through to some. They see the adverts and then ignore them as they don't see the issues. I think there needs to be more done on highlighting the changes in the admissions you are seeing and further work to show that the vaccines are safe compared to long covid etc which seems to still being overlooked.

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Richard Cree
Richard Cree
Dec 31, 2021
Replying to

Hi Rick. Yes, I was thinking the other day that we don’t hear very much about long covid anymore. I hope that it will be much less likely with Omicron as it appears that the host inflammatory reaction is less. If covid continues to become less severe then the long covid suffers may feel more and more marginalised as society ‘forgets’ about them. With regard to vaccine uptake - there are a lot of communities where being obese and having diabetes is not unusual. As a result, some probably don’t give them much thought and underestimate the risk they pose. Cheers, Rich

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