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  • Richard Cree

Aftermath

26th October 2022


Total UK Deaths with COVID-19 on the death certificate – 205,843 (up to 20 May)

James Cook Hospital – Total COVID deaths – 976

All COVID cases within South Tees Hospitals Trust – 71

James Cook Critical Care

COVID cases – 1 (1 ventilated)

Non-COVID cases – 46 (21 ventilated)


This will be my last post.


I began writing this blog in March 2020 just as the first wave of the pandemic began. Back then I didn’t think that after two and a half years, COVID-19 would still be causing trouble. Of course, the virus of today is very different from the virus that caused the first three waves of the pandemic. By February this year, it was obvious that most Omicron infections were much less severe. Omicron was far less likely to cause severe lung inflammation and intensive care units had almost stopped admitting patients with COVID pneumonitis.

I commented at the time, that for those of us in Intensive Care, it felt like the pandemic was over, and I wondered whether it was time for me to stop writing. After all, most restrictions had been lifted and the requirement to isolate after a positive test was soon expected to end.

However, I was sure that infections would soon be on the rise again and I decided to carry on for a while longer. By the time the Queen’s Platinum Jubilee rolled around, my enthusiasm had started to wane and I had been posting rather infrequently. Cases, admissions and deaths had all been falling for months and even the most ardent COVID hermits had begun to live more normal lives.


Looking back, this would have been a perfect opportunity to decide to stop writing. But, by the time the Jubilee had finished, cases were already rising again. I decided to carry on, certain that Omicron had almost run out of steam and that this wave would be short lived. Unfortunately, I hadn’t counted on the ability of new variants to cause reinfections so quickly and, once again, hospital admissions and deaths began to climb.


By September, things were settling down again and I again thought that it was time to wrap things up but then the Queen died and it all started to go wrong. One of the Queen’s last acts was to invite Liz Truss to become the nation’s new Prime Minister. The PM went out of her way to reassure her that the country was in safe hands. I’m sure Her Majesty found this very comforting.


Days after the Queen’s funeral, the Government decided to hurl the economy over a cliff. As the value of the pound began to fall, COVID cases started to rise again. But we can’t blame Trussonomics; rather it is the fault of yet more pesky variants, waning immunity and the return of schools and universities.


Fortunately, there are signs that this latest wave may have already have peaked. This is good news because each successive Omicron wave has resulted in fewer cases, fewer admissions and fewer deaths than the one before it. Long may this trend continue.


So why stop writing now? Well, I’ve been waiting for the WHO to announce that the pandemic is officially over but there’s still no sign of that happening yet. They claim that the end is in sight but don’t say what will constitute the ‘end’. It’s clear that the emergency phase of the pandemic has been over for some time and that COVID is here to stay. We now need to ensure that our health service can cope with ‘endemic’ COVID.


For most of us, serious illness following an Omicron infection remains extremely unlikely. For the very elderly, frail or immunosuppressed, Omicron continues to be a palpable threat. Another round of booster vaccinations this autumn will help to ensure that these people are as protected as they can be. For the rest of us, the danger from Omicron comes from the pressure it continues to exert on the NHS.


The Health Service has been creaking at the seams for some time now but the pandemic has exposed its many shortcomings. Every winter seems to push the service closer and closer to its limits. Many are fearful that we will be hit by a ‘flu and COVID double-whammy this year. If that happens, then this winter might turn out to be ‘the big one’. I’m talking about the winter that many of us have been fearing for some time; the one that finally brings the NHS to its knees and reveals just how bad things have got.


Over the past few years, the number of hospital beds across the UK has been steadily declining. When you look at the number of hospital beds compared to the population, our bed count is one of the lowest in Europe. If you look at Intensive Care beds, the situation is even worse. Much like our traditional performance in the Eurovision Song Contest, the UK consistently scores ‘nul points’.


It's not only that we don’t have as many beds as our European neighbours, the few beds that we do have are always full. Things are especially bad at the moment. Ambulances are queuing to unload patients, Accident and Emergency departments are overflowing, patients are stuck on trolleys waiting for a bed and hospitals can’t discharge anyone because the social care system is in tatters. It’s an utter shambles.


Things are no better on the ICU. Every day brings a steady stream of critically ill patients that require our attention. Every day brings a struggle to find a beds to put them in and nurses to look after them. I worry about what will happen if, this winter, the stream becomes a torrent.


Many of our problems are due to a shortage of staff. This is not a new development. We have fewer doctors per head of population than almost anywhere else in Europe and the situation is getting worse. We aren’t training enough doctors and many that we do train end up leaving the profession. At the other end of the spectrum, seasoned Consultants like myself are retiring early and we are losing a worrying number of experienced people. The nursing profession is facing the same problems; we don’t have enough nurses and those we do have are tired, fed-up and are thinking of leaving. Morale is at an all-time low.


One of my Consultant colleagues committed suicide this summer. This tragedy has had a profound impact on the department and we are all struggling to come to terms with what has happened. Other colleagues have left as a result of illness or have chosen to work elsewhere. It seems that there is no happy ending to this story; none of us are sailing off into the sunset.


It doesn’t have to be like this. Everyone deserves better. The pandemic showed just what we can achieve. We saved many lives and I’m very proud of what we accomplished. This was the NHS at its finest and it breaks my heart now to see it in such a sorry state. It’s why I have to stop writing.



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