Freedom Day

20th July 2021

UK COVID Deaths – Daily 96 / 7-Day average 49

Total UK COVID Deaths within 28 days – 128,823

Total UK Deaths with COVID-19 on the death certificate – 153,070 (up to 09 Jul)

All COVID cases within South Tees Hospitals Trust – 94

James Cook Critical Care

COVID cases – 12 (10 ventilated)

Non-COVID cases – 33 (15 ventilated)

Freedom Day came and went yesterday with surprisingly little fanfare. I spent most of the day cutting my garden hedge and getting repeatedly stung by wasps. By the time I put away the hedge trimmer it was already quite late in the evening and I was good for very little other than opening a cold beer and flopping in front of the television. It was a shame, as the end of almost all legal restrictions designed to minimise the spread of COVID-19 should really have been something to celebrate. But, with the third wave still in ascendance, the end of the pandemic continues to remain out of sight. Where we will be in a month’s time is anyone’s guess. Some are predicting that we might see as many as 200,000 COVID cases a day. Of course, the number that really matters is the number of hospital admissions that occur each day. Once again, it is the health service’s ability to cope that will determine whether we might see the return of restrictions at some point in the future.

All of us in Critical Care have been surprised by the amount of patients we have seen over the past fortnight. Whilst the number of new admissions has slowed down over the weekend, there are still more patients in the hospital that we were expecting. Vaccination was never going to be a silver bullet but we were hoping that it would result in fewer admissions to ICU than we are currently witnessing. The arrival of the Delta variant has laid waste to the sense of optimism that we all felt back in the spring. There is no doubt that fully vaccinated patients are significantly protected from the serious complications of COVID-19. However, after spending the morning on the COVID wards, I can testify that there are still an awful lot of unvaccinated people who are becoming worryingly unwell.

What’s concerning us the most is the effect that a large number of COVID admissions would have on the hospital’s operational capability. At the peak of the second wave the country saw about 4200 patients a day admitted to hospital. Even if we see half as many as this, there would be major disruption to the NHS. Lots of routine operations and appointments would end up being cancelled and an already huge NHS backlog would become even larger. Unfortunately, we are not as prepared for round three as we could be. The number of hospital beds in the United Kingdom has halved over the past 30 years. This is an ongoing trend amongst all developed nations but the UK has been left with far fewer beds relative to its population than many of its neighbours. This is especially true of Intensive Care Beds. We also have fewer doctors and nurses per head of population than almost any other developed country. We are simply not equipped to soak up a large, sustained increase in acutely ill patients.

However, the NHS is really rather good at doing a lot with a little. It’s how we have coped as well as we have with the first and second waves. I have no doubt that we will be able to cope with the third. I’m just worried about what state the NHS will be in when the dust finally settles.

But enough consternation and worry. In order to find something we can all celebrate, I would like to tell you about Brett’s Hamster. At the beginning of the pandemic, my Consultant colleague, Brett, was breaking up with his girlfriend. As part of the separation settlement, Brett got to keep the hamster which he duly renamed ‘Covid’. If truth be told, little Covid was always trying to bite the ex-girlfriend and so Brett felt a certain kinship toward the poor thing. I’m delighted to say that Covid has thrived in her new home and has just recently reached the ripe old age of two years. In order to mark this hamster-related-milestone, Brett has decided to rename her ‘Long Covid’.

Long Covid