UK covid cases to top 100,000 a day .

[BrianV]

Yes I agree genetics will affect how you react to anything but how does your reaction to a novel type of vaccine prove one virus is more or less harmful than another?

What is it they say “non so blind as those who will not see!”

 

[essex man]

What is it they say “non so blind as those who will not see!”

You could explain how?

 

[Charlie Gill]

The reaction to covid has caused more deaths than the would otherwise have been the case imo for reasons I have outlined previously.
Waiting lists would not have increased at all.

There's a nurse that works in a London hospital on digital spy whose posts you may find interesting. They give an insight as to why the virus has had such an impact on the running of hospitals and why they are in the situation now regarding backlogs. Her username is marellak if you want to Google her.

Yes. The lockdowns were to protect the NHS.

Of course, it was more about stopping the intensive care units from being completely overwhelmed rather than the NHS per se. Patients with covid on general wards usually only need oxygen, they get given oral dexamethasone and IV remdesivir for 10 and 5 days respectively. They either get better and go home after a few days - or they deteriorate. Most of these ward covid patients are/were relatively straightforward and able to manage their own basic care needs and didn't need much 'nursing'. Those who deteriorated were usually, in the first instance, given CPAP which is an AGP that is usually done in a high dependency ward (but can be ICU in some smaller hospitals). Others deteriorated so dramatically that intubation was the only option. My London hospital is part of one of the largest NHS trusts (in terms of population it covers) yet we only had 6 HDU beds at the start of the pandemic and under 30 ICU beds, plus a few others in the other smaller sites that are also part of the trust. We had plenty of ward beds once routine elective work was stopped but the ICUs (we opened several) always struggled to match the demand as patients deteriorated.

At the start of the pandemic the NHS had a total of around 5K adult critical care beds. It's difficult to establish an exact figure because of the set up in smaller hospitals where HDUs are incorporated into ICUs, also some hospitals specialise in certain types of intensive care such as neuro-surgery or cardiothoracics. However, a figure of 4.5-5.5K ICU beds for the whole country is generally what was accepted as the total NHS ICU bed base (one of the lowest per head of population in the developed world) - and that's what the ICUs were staffed for. ICU is extremely technical, involving the management of many complex, sophisticated machines - ventilators, renal dialysis/filtration, cardiac output monitoring, also multiple drug infusions to manage sedation, muscle relaxing, blood pressure etc. Every ICU must meet certain specified standards, with a stipulation that a proportion of the nursing staff (think it's around 50%) must have completed an approved post graduate intensive care nursing course. The other staff will be in developmental roles in the expectation that they will also do the ICU course. https://www.ficm.ac.uk/sites/default/files/Core Standards for ICUs Ed.1 (2013).pdf The CQC (pre pandemic) has been known to issue notices to units where some of these requirements are not met and some units have been temporarily closed down until they can satisfy the minimum ICU standards/requirements.

These requirements were most definitely not met during the pandemic. The ICU bed base more than doubled nationally (trebled where I work, in the first wave). The intensive care nursing staff, instead of delivering 1:1 care, were responsible for at least 3 patients each and sometimes more (up to 6), supported by re-deployed staff from elsewhere in the hospital, who were on a sharp learning curve. Remember that we had huge amounts of staff off sick at any one time and, during the second wave, where I work about 25 of our ICU nurses received shielding letters.

The average age of patients admitted to all NHS ICUs was 58 during the first wave and just over 59 during the second (which ICNARC classes as from 1st September to the present). ICNARC is the Intensive Care Audit and Research Centre which collates data from all participating ICUs in England, Wales and Northern Ireland. I think that it's only smaller hospitals who don't contribute their data because a full time staff member is employed to do this work and we can justify this expense in larger units. According to ICNARC 88% of all ICU covid admissions did not have what is classed as a 'serious' health condition, although many, if not most, had conditions such as diabetes and obesity so, yes, most had 'underlying health conditions' but these were not conditions that would normally be considered as serious or life limiting.

Only patients who have been assessed as having a good chance of surviving the aggressive nature of ICU interventions ever get admitted there. This is applicable in normal times too so we weren't rationing care, although I believe we came close to doing that during the first wave in some places. We were well organised for the second wave and had a robust transfer system in place, moving critical covid patients from units that were near or at capacity to units that were quieter.

Most ICU covid patients were/are therefore younger with non serious underlying health conditions. Where I work we had patients in their twenties upwards and even now, when we're no longer seeing new covid admissions and only have around 2-3 still testing positive, the vast majority of the 15 or so 'ex' covid patients who are still on ventilators are under 60, there are a couple in their 40s. I don't think the ex covid patients get counted in the official figures as still occupying ICU beds.

I know the overall statistics suggest that covid is a disease that primarily affects the elderly and those with serious underling health conditions - but what we saw in our intensive care units were mainly younger patients, previously well (if a bit overweight) who were so seriously, critically ill that many did not survive and those who did have a lot of rehabilitation ahead of them.

I know the NHS has now got to look at the ICU bed base in this country. It's clear that it's not sufficient, even in normal times. This pandemic may be drawing to a close but there will be future pandemics and we need to be better prepared next time. Operation Cygnus which was the report on our preparedness for a pandemic revealed that we had nowhere near enough critical care beds. Yes, we were flexible, we expanded and accommodated everyone who needed ICU in the end but only at the expense of closing down normal NHS work so we could move staff to the critical care areas, staff who weren't experienced or trained in managing critically ill patients.

Intensive care units are phenomenally expensive. It's not just the incredibly expensive equipment but the need for 1:1 nursing, with additional staff on top. The NHS budget will most definitely have to be increased to allow for this re-structuring but nursing staff are also in short supply so it's not going to be easy, even with increased funding. The NHS is in for a tough few years as it deals with the aftermath of the past year and also prepares for the future.

 

[Muck Spreader]

I would be pretty sure there would have been an underlying possibly undetected condition. My 81 year old father picked it up in hospital and whilst unable to leave for two months because he was continually testing positive at no time did he display any symptoms. It's a bit luck of the draw..ish.

Around a third of the population has underlying health problem that could affect their ability to fight off the covid virus.

 

[Lowland1]

Around a third of the population has underlying health problem that could affect their ability to fight off the covid virus.

If you’d asked Christian Erikson a month ago if he had any underlying health issues i’m pretty sure he’d have said he was pretty fit. So i’m sure there are many others thinking they are fine and healthy.

 

[Muck Spreader]

If you’d asked Christian Erikson a month ago if he had any underlying health issues i’m pretty sure he’d have said he was pretty fit. So i’m sure there are many others thinking they are fine and healthy.

Exactly. Many of us would be unaware of these conditions until we contracted covid.

 

[essex man]

If you’d asked Christian Erikson a month ago if he had any underlying health issues i’m pretty sure he’d have said he was pretty fit. So i’m sure there are many others thinking they are fine and healthy.

That was before he had the vaccine?

 

[Trutti]

That was before he had the vaccine?

Very good discussion on this point on radio 4 at the moment, referring to an article in Nature magazine. Seems there is a direct link to individuals genomes and the severity of Covid.

 

[Charlie Gill]

That was before he had the vaccine?

I know you love a good conspiracy, but it's reported he hadn't actually had a Covid vaccine as he wasn't eligible.

 

[Sonoftheheir]

They’re going to turn down the test and trace app sensitivity-

NHS Covid-19 app sensitivity to be reviewed https://www.bbc.co.uk/news/uk-57772515

Makes sense

 

[Pasty]

I have no idea why anyone would allow this surveillance app to be on their phone. Smartphones are bad enough already.

 

[essex man]

I know you love a good conspiracy, but it's reported he hadn't actually had a Covid vaccine as he wasn't eligible.

I imagine it is.

 

[essex man]

They had pics of this lot having it though so couldn't really deny it

 

[BrianV]

They had pics of this lot having it though so couldn't really deny itView attachment 972723

You have to consider the possibility that if they have collapsed because of an adverse reaction to the vaccine what would be the likelihood of them actually dying if they became infected with the real thing?

 

[essex man]

You have to consider the possibility that if they have collapsed because of an adverse reaction to the vaccine what would be the likelihood of them actually dying if they became infected with the real thing?

Indeed, that's the point really

 

[Pasty]

I wonder how many people there on this planet who have not yet been exposed to this virus. I reckon it's a very small number, at least in developed countries.

 

[essex man]

I wonder how many people there on this planet who have not yet been exposed to this virus. I reckon it's a very small number, at least in developed countries.

I guess it depends how you define exposure.
If you are interested in effectiveness of restrictions then I guess is interesting to ponder how many have been within 1m unmasked of someone with the virus.
Given 20 million in uk have had it, how many extra people who didn't catch it have been exposed under this definition?
could make a case for average of one each?
So 20 million more

 

[Johnnyboxer]

I guess it depends how you define exposure.
If you are interested in effectiveness of restrictions then I guess is interesting to ponder how many have been within 1m unmasked of someone with the virus.
Given 20 million in uk have had it, how many extra people who didn't catch it have been exposed under this definition?
could make a case for average of one each?
So 20 million more

Don’t you ever give it a rest?

 

[Lowland1]

Don’t you ever give it a rest?

Of course not because we are all paid by the word by the Kremlin.

 

[kiwi pom]

I wonder how many people there on this planet who have not yet been exposed to this virus. I reckon it's a very small number, at least in developed countries.

Not many here so far.
Not over yet though.