« NHS staff have a sense of dread about what is going on around the corner. While we understand that things have to open up for a while, the timing feels like total madness as we’re so close to successfully vaccinating the population, and a more contagious variant is circulating. “
This view, expressed by a frontline respiratory consultant, is widely shared across the NHS. The doctor concerned has already struggled with the first two waves of Covid. She is now preparing for the next one which, despite being in its early stages, has already led a large hospital trust, in Leeds, to cancel scheduled surgery, including several cancer operations.
Among a tired NHS workforce after 16 months of battling the pandemic there is a mixture of apprehension, nervousness, fear, a resignation here on the return of a familiar foe, a stoic will to do his best again, and also the anger they will have to endure.
The same doctor adds: “We have seen a constant increase in [Covid] numbers over the past few weeks and are back to having full Covid service and intensive care patients. Although they are overall much younger, unfortunately, deaths are slowly increasing despite this.
“Healthcare professionals are deeply concerned about the impact of easing restrictions further given the current increase in Covid cases. Removing risk mitigation measures like social distancing and wearing masks is incomprehensible to many of us. I feel anxious and frustrated.
“The terror and anxiety is because we’ve been here before, we’ve been through the first two – or three depending on where you are – the waves. We don’t want to be back in this place where we are on ‘escalating’ rotations, routine work is canceled and we face deaths that we believe could have been preventable with a better health strategy. public. “
Dr Nick Scriven, the former president of the Society for Acute Medicine, who works at a Yorkshire hospital, said: ‘We in the north are experiencing a fourth wave of community cases, with a slight increase in hospital cases. While the numbers aren’t huge, it’s both frightening and upsetting for staff as intensive care cases increase with unvaccinated people, whether young or by choice or both. There is a growing feeling to me that vaccination makes this almost preventable. “
Doctors and hospital leaders are a bit more relaxed about the next increase in cases, however, as they expect it to be different from the first two intensely demanding: smaller, less dramatic, and less susceptible. to cripple the NHS. London intensive care consultant Dr Rupert Pearse tweeted sardonically last weekend say: “As we did in November 2020, we anticipate a ‘slow burn’ of hospital admissions rather than a third wave. Hopefully our forecast is more accurate this time around.
Covid admissions to hospitals in general and intensive care units in particular are on the rise again, reflecting the recent strong growth in infections. But the numbers involved remain low compared to last year’s spring and last winter, and the trajectory, while undeniably upward, is by no means as vertical as it was then.
Chris Hopson, chief executive of the NHS Providers hospital group, said: “For this set of variants, vaccines have broken the link between infections and previously high hospitalization / death rates. So there is great confidence among the trusted leaders that increasing infection rates in the community, even to the levels that we saw in January, will not translate into the levels of hospitalization and mortality that we have. saw during this pic; a spike that put extreme pressure on the NHS. “
But Hopson said in a file the tweets this week on the NHS ‘willingness to resist the next wave that an even smaller increase in Covid cases posed a threat to a health service that is already – and official figures confirm – the busiest it is he never was.
He highlighted the NHS ‘efforts to tackle the huge backlog of people in need of hospital treatment and deal with the record number of people coming to A&E, while trying to give tired and stressed staff time off well deserved and to operate with fewer beds than before. -pandemic because social distancing in hospitals means that an eight-bed room only contains six. He is also increasingly concerned about the burden the growing number of ‘long Covid’ cases now places on hospitals – a much less common problem in waves one and two.
Scriven says, “It’s very busy even without another wave of Covid. In the future, the increase forecast by the government [in infections to 100,000 a day] due to unlocking is a concern. Even though the number of hospitals does not reach the same levels, the NHS is in a really difficult situation. Any rise of the Covid will seriously call into question the electives [surgery] urgent and emergency recovery and care already struggling under demand. “
Hopson and his NHS Confederation counterpart Matthew Taylor have warned in recent days that a new influx of Covid-positive patients arriving as an overloaded and understaffed ward faces a demand for care similar to the he winter in July would inevitably force hospitals to limit the amount of surgery they can perform. “Any significant increase in Covid this summer will put even more pressure on a system that is struggling to cope,” Taylor said.
As ministers press the NHS to give the 5.3 million people on the waiting list in England the treatment they need as soon as possible, the service’s inability to do so – and the prospect of a further suspension of normal care – could become a key political issue.
Hopson points out that this time around, the risk to the NHS is not “the probable absolute level of hospital admissions from Covid-19”, which, thanks to the vaccination program, is expected to be much lower than before. It’s more about the timing of the next wave and the underlying fragility of the service after a decade of austerity funding and chronic staff shortages.
Surgery delays can have consequences, he says worryingly, suggesting that they may turn out to be inevitable, depending on events beyond the control of the health services, particularly what happens in England after the ” freedom day ”on July 19. “Trusted leaders obviously have a mission to avoid unnecessary harm. They are therefore instinctively worried about the potential harm to any patient. But they also recognize broader issues at play here. “