From: slider@anashram.com

Across the country, even before Omicron admissions have started to rise,
the bed occupancy in our hospitals is 94%.

That seems a luxury to me; it is quite a while since I saw an empty bed in mine. Our bed occupancy hovers around 100% and has done so for some weeks.

There is nothing unusual in this, however. Successive decades and serial
A&E closures, combined with rising healthcare demands from an elderly and growing population, have meant our bed provision is far too small for our
area. Even in a normal winter, critical bed crises are a common problem,
with operations cancelled and patient care often compromised as a result.
The whole system has been slowly gutted to the point that there is not
even enough capacity to deal with routine fluctuations in demand.

This, however, is not shaping up to be a normal winter. The Omicron
variant is spreading with a speed that is terrifying to me, even after all
I have seen and done over the past months.

https://www.theguardian.com/society/2021/dec/20/omicron-is-terrifying-so-why-wont-we-learn-from-past-mistakes

I don’t even need to look at the figures to know this; the evidence is all around me. Friends and family, even the careful ones, have started testing positive and having to isolate. There are multiple outbreaks in schools
again. Football matches are being cancelled. And there are already many colleagues unable to attend work, leaving rota gaps that we are already struggling to cover.

And the worst of it is yet to come.

Extrapolating from the current figures, it looks like within our local
area we will have infections in the tens of thousands by the middle of
next week. And here comes the biggest unknown.

Is this variant really, as we all hope, less virulent than its
predecessors? Will our vaccines and immunity be enough to keep people out
of hospital? Even with a hopelessly optimistic low rate of
hospitalisations, it still looks like there will be far too many patients
for us to look after.

A steady stream of patients arriving at The Royal London Hospital in Whitechapel. The NHS is under severe pressure with a big backlog of
patients as well waiting for routine operations.

A small proportion of a very large number is still a large number.
Remembering also that there is a lag of a week or two between infection
rates rising and people becoming unwell enough to present to hospital,
this means the potential point of maximum pressure comes around Christmas
and New Year, when many of us were hoping, finally, to take a few days
off, and many more will be sick or isolating with Covid.

And we have significant other pressures working against us. GPs are
scaling back the routine care they offer in favour of vaccinations. Some hospitals are also cancelling elective care so that their consultants can
join in the jabbing.

Despite this, the new variant has some power to evade the vaccine, meaning
that even the current heroic effort may not put the requisite protections
in place in time. Vaccinated patients are unlikely to get critically ill,
but even relatively well patients coming into hospital could overwhelm us.

The reduction in usual care is likely to result in more patients seeking
help in hospitals, despite best efforts.

One glimmer of hope is the new treatments for Covid now available for
patients who are particularly vulnerable, with the aim of stopping the
disease progressing and reducing the need for hospitalisations.

The first centres for this went live this week, using staff redeployed
from other vital work. The problem is, however, that these were set up and resourced based on numbers calculated from the Delta variant. Within the
first 24 hours of opening it became clear that the numbers now identified
for treatment already exceeded capacity fivefold and are rising
exponentially.

So even this hope must be tempered with realism: how much will these
really be able to hold back the tide?

I find myself grudgingly admiring the Covid-19 virus, that with all our
modern medicine and incredible science, it is still managing to confound
us even 20 months on. It is a fearsome opponent.

So why, yet again, do we seem to be underestimating it? Why do we not
learn from our mistakes?

For a healthcare system already strained beyond capacity the potential
threat that Omicron poses is obvious, even though its virulence is yet
unknown.

Why not therefore take at least some sensible precautions to try to hold
back the spread, to buy us time to vaccinate some more and make sure we
are set up to give all the therapies at our disposal?

Plan B will make very little difference to a strain this infectious. In
any case, these measures take time to work.

By the time that hospitalisations start to rise, it will be too late.
Surely it would be better to make the mistake of introducing early
restrictions unnecessarily than to make the mistake of not doing so and
causing unnecessary deaths?

Boris Johnson “know[s] the pressures on everyone in our NHS”. But does he really? Has he got any idea of the exhaustion, burnout and low morale that
I see and feel every day? The dread that my colleagues and I express as we
talk about what this winter holds in store, again? How it feels to be potentially facing yet another wave?

And yet still we sit on the fence, pretending we can vaccinate our way out
of this while carrying on with life as normal. Talk of shielding the NHS
rings hollow in the face of this inaction.

And while we have been working on throughout to keep people safe, it seems
that in Downing Street they found the time to have unmasked quizzes and after-hours gatherings. How nice.

It really is hard to put into words exactly how shameful, deceitful, and hypocritical this is.

In medicine we sign up to a “duty of candour” that we all owe to our patients, whereby if mistakes are made we admit them, apologise, do our
best to make amends. It is a basic thing that even the most junior medical student knows about. Too basic, it seems, for some important people to be concerned with.

What we have achieved in the NHS over the past year is little short of
amazing. And now we are being asked to make another “extraordinary effort” by leaders who show themselves to be above such things yet too cowardly to admit it.

### - but we DO learn from our mistakes! that's HOW we learn!

so it's obvious then that some pretty piss-poor 'political' decisions have
been directly interfering with what we've LEARNED we NEED to do, versus
going in-favour of compromising what needs to done in order to keep a
bunch of fat-cats: fat??


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* Origin: you cannot sedate... all the things you hate (1:229/2)