Normally, January is the month to count the cost of Christmas. The credit card bills are coming. New Year’s resolutions are made. We must face the consequences of the recent indulgence.
This year, however, the cost of celebrating Christmas with loved ones could be much higher – and counted in lives. NHS doctors and nurses report they are seeing a record number of admissions of people with Covid-19.
In recent days, the daily death toll has passed 1,000. “The last time we hit that number, we were still 22 days from the peak,” said Zudin Puthucheary, respiratory and intensive care consultant at Royal London Hospital, speaking on behalf of the Intensive Care Society. The daily death toll hit a new high on Friday of 1,325.
NHS staff and the public are increasingly concerned that the worst will happen before things improve. The new strain of the virus, which spreads more easily, coupled with the effects of party gatherings, has put rocket boosters below infection rates. Ministers have always said that without strict measures the service could be overwhelmed. The truth is, however, that even after the most drastic restrictions, this can still be the result. Three locks, the moment of truth is approaching.
“The workforce is the key, but we’ve got everyone in there – everyone who can,” Puthucheary says. “The next step is: will we have enough equipment? Probably. Will we have enough medicine? We believe so. But it’s a logistical nightmare and we don’t yet know the answers.
“We are proud to be able to help other hospitals. This is one of the things we’re good at. What’s really scary is that we now think maybe we can’t. How are we going to continue to accelerate for another three weeks? “
London mayor Sadiq Khan said on Friday he was in the grip of an emergency. A day earlier, the capital’s medical director, Vin Diwakar, said in a briefing, leaked to the Health Services Journal, that London hospitals were within two weeks of being overwhelmed.
Ganesh Suntharalingam, London-based intensive care consultant and former president of the Intensive Care Society, said: “We are seeing big numbers through the front door, which has very worrying implications for what will happen in care. intensive in a week.
The next week at 10 days is seen as critical – the test of whether the system could flex under the pressure of the growing number of cases, the growing shortage of staff and the challenge of administering vaccines. “There are all these races against time going on that could decide whether the NHS holds up, or imply it can’t handle,” said a senior consultant at a London hospital.
Jon Bennett, respiratory consultant at Glenfield Hospital in Leicester and president of the British Thoracic Society, said the staff workload had been relentless, beyond anything seen before. Doctors and nurses had been “under winter pressure since November last winter” – 14 months without any relief. As the number of cases grows, staffing levels in wards and general practitioner practices decline as new tension hits those trying to cope with its terrifying consequences.
Last week, BMA Chairman Chaand Nagpaul wrote to its members to tell him that in total more than 46,000 healthcare workers were on leave with Covid-19 across the UK. He said the need to immunize frontline staff was acute.
Staff absences across the NHS last April reached 6%. Sources within the service believe the actual figure may now be over 12%.
Brexit has also played its part – some international collaborators have left the country. “We have lost a lot of trained employees very, very quickly over the last six months,” Puthucheary says.
“The intensive care units were staffed with Portuguese nurses, Spanish nurses, Italian nurses, left, right and center, and they left. 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 ICU, said the increase in cases and absences made planning particularly difficult .
“The number of sick people will change from hour to hour, so when you walk into a shift you don’t know how many employees you’re going to have, how many patients you’re going to have, how sick the patients are. are going to be, or what department you’re going to be in, ”she said. “This is the level of intensive care flow across the UK. And you could have people with 10 years of intensive care experience, 10 weeks, or even 10 minutes.
“The South East is the newer place, because of the new variant, but Wales and the North West have had it for months and I think people have forgotten about it. Regional centers are overwhelmed. “
There are other pressures, she said. “We are seeing across the UK that there are higher rates of verbally abused nurses, because people are so angry that Covid is killing their loved ones, and they don’t believe their parent won’t see each other withdrawing their oxygen, another invented rumor.
Staffing issues plague the NHS at all levels and in all of its tasks – including, now, its ability to deliver urgently needed vaccinations. In Kent, which has been one of the hardest hit areas in southern England, around 25% of clinical and administrative staff are said to be absent. John Allingham, medical director of the Kent Local General Practitioners Committee, which represents general practice in the county, said some practices saw up to half of the staff absent.
This impairs the practices’ ability to administer the vaccines, he said, in part because the injections are done in person, but also because the logistics of arranging the appointments are handled by the administrative staff. .
“A large practice that could have eight or nine receptionists on duty could be reduced to three, and they have to answer 300 phone calls on a Monday morning,” Allingham said. “One of them has to open the door because surgeries are usually done with a locked door. And there are repeat prescriptions and hundreds of pieces of mail every day as well. “
Martin Marshall, president of the Royal College of General Practitioners, said that even without staff falling victim to Covid, there aren’t enough people in local surgeries to meet the ambitious goal of two million vaccinations per week.
“There are currently enough to deliver the limited supplies we have,” he said. “But we certainly don’t have enough staff to run a much larger program in two or three weeks, while still delivering the influenza vaccination program and performing normal general practice activities.”
Social protection, including for the elderly, has also been hit hard. The National Care Forum, a nonprofit association of social care providers, said some care services have seen more than half of their staff fall ill.
Vic Rayner, Executive Director of NCF, said: “If people can’t be supported to leave the hospital, whether it’s moving into a nursing home or having home care, then the whole system will fail.