Saturday, May 15

NHS calculates the cost of Christmas in lives and warns that the worst is yet to come | Coronavirus


In normal times, January is the month to count the cost of Christmas. Credit card bills arrive. New Years resolutions are made. The consequences of the recent indulgence must be faced.

This year, however, the price of having celebrated Christmas with loved ones could be much higher and counted in lives. NHS doctors and nurses report that they are seeing a record number of admissions of people with Covid-19.

In recent days, the daily death toll has exceeded 1,000. “The last time we hit this number, we were still 22 days off the peak,” said Zudin Puthucheary, a respiratory and intensive care consultant at the Royal London Hospital, speaking on behalf of the Intensive care society. The daily death toll reached a new record Friday of 1,325.

NHS staff and the public are increasingly afraid that something worse will happen before things get better. The newest strain of the virus, which spreads more easily, coupled with the effects of festive gatherings, has put rocket boosters on infection rates. Ministers have always said that without strict measures, the service could be overwhelmed. However, the truth is that even after the most draconian restrictions, that may be the result. Three running of the bulls, the moment of truth is approaching.

“Manpower is the key, but we have everyone, everyone who can be,” says Puthucheary. “The next stage is: will we have enough equipment? Probably. Will we have enough drugs? We think so. But it’s a logistical nightmare and we don’t know the answers yet.

“We are proud to be able to help other hospitals. It’s one of the things we’re good at. The really scary thing is that now we are thinking that maybe we can’t. How are we going to keep accelerating for another three weeks? “

On Friday, Sadiq Khan, the mayor of London, declared that he was in an emergency situation. A day earlier, the capital’s medical director Vin Diwakar said in a briefing that it was leaked to the Health Services Journal, that London hospitals were less than two weeks away from being overwhelmed.

Ganesh Suntharalingam, a London-based critical care consultant and former president of the Society for Intensive Care, said: “We are seeing large numbers through the front door, which has very worrying implications for what is going to be in the room. ICU in a week. “

The next 10-day week is seen as critical: the test of whether the system could fail under pressure from the increasing number of cases, growing staff shortages, and the challenge of administering vaccines. “There are all these races going on against time that could decide whether the NHS holds up or whether it means it can’t handle it,” said a senior consultant at a major London hospital.

Jon Bennett, a respiratory consultant at Glenfield Hospital in Leicester and president of the British Thoracic Society, said the staff’s workload had been relentless, beyond anything seen before. Doctors and nurses had been “under winter pressure since November last winter,” 14 months with no relief. As the number of cases increases, staffing levels in GP wards and surgeries are declining as the new strain hits those trying to deal with its terrifying consequences.

Last week, BMA President Chaand Nagpaul wrote to its members saying that a total of more than 46,000 healthcare staff were out of work with Covid-19 across the UK. He said the need to vaccinate front-line personnel was acute.

Staff absences across the NHS last April reached 6%. Sources within the service believe the true figure may now be above 12%.

Brexit has played its part too: many the international staff is gone the country. “We lost a lot of trained personnel very, very quickly in the last six months,” Puthucheary says.

“The intensive care units have been cared for by Portuguese nurses, Spanish nurses, Italian nurses, left, right and center, and they are gone. Those who stayed are those with personal ties to the country. “

Kate Tantam, a sister intensive care specialist in the South West of England, speaking on behalf of the Society for Intensive Care, said the increasing number of cases and absences makes planning especially difficult.

“The number of people who are not sick will change per hour, so when you enter a shift, you don’t know how many employees you are going to have, how many patients you are going to have, how sick the patients are going to be, or in which department it’s going to be, ”he said. That’s the level of flow in intensive care in the UK. And you could have people with 10 years of ICU experience, 10 weeks, or even 10 minutes.

“The South East is the newest place, because of the new variant, but Wales and the North West have had it for months and I think people have forgotten it. The regional centers are overwhelmed. “

There are other pressures, she says. “We are seeing across the UK that there are higher rates of nurses being verbally abused, because people are very angry that Covid is killing their relatives and they don’t trust that their relative is not going to have their oxygen withdrawn, or some other invented rumor. “

Staffing problems are affecting the NHS at all levels and in all its tasks, including, now, its ability to deliver urgently needed vaccines. In Kent, which has been one of the hardest hit areas in the south of England, around 25% of clinical and administrative staff are believed to be absent. John Allingham, medical director for Kent’s local general practitioners committee, which represents the county’s general practice, said that in some practices half the staff were absent.

That is affecting the practices’ ability to administer vaccines, he said, in part because the injections are done in person, but also because the logistics for making appointments are handled by administrative staff.

“A large practice that could have eight or nine receptionists on duty could be reduced to three, and they have to take 300 phone calls on a Monday morning,” Allingham said. “One of them has to open the door because surgeries generally operate with a closed door. And there are also repeat prescriptions and hundreds of mailings every day. “

Martin Marshall, president of the Royal College of General Practitioners, said that even without staff falling victim to Covid, there are not enough people in local surgeries to reach the ambitious goal of two million vaccinations a week.

“There are enough right now to deliver the limited supplies that we have,” he said. “But we certainly don’t have enough staff to carry out a much larger program in two or three weeks, while at the same time continuing to implement the influenza vaccination program and going about normal business in general practice.”

Social assistance, including that of the elderly, has also been severely affected. The National Care Forum, a nonprofit association of social care providers, said some care services had left more than half of its staff sick.

Vic Rayner, NCF Executive Director, said: “If you can’t help people get out of the hospital, whether it’s moving into a nursing home or getting care at home, the whole system will fail.”


www.theguardian.com

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