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  • Richard Cree

Blue Monday

19th April 2021


UK COVID Deaths – Daily 4 / 7-Day average 25

Total UK COVID Deaths within 28 days – 127,274

Total UK Deaths with COVID-19 on the death certificate – 150,419 (up to 2 Apr)

James Cook Hospital – Total COVID deaths – 611

All COVID cases within South Tees Hospitals Trust – 18

James Cook Critical Care

COVID cases – 5 (5 ventilated)

Non-COVID cases – 42 (26 ventilated)



The number of coronavirus cases in the community continues to fall. The Office of National Statistics estimates that about 1 in 500 of the UK population was infected in the week ending 10th April. This level of infection is ten times lower than that seen in early January and is similar to that seen back in September last year. Reassuringly, there has been no significant rise in infections amongst school children since the schools opened in March.


The ONS estimates that there are still about 11,000 new cases occurring every day which means that there is still the potential for cases to rise following the reopening of non-essential shops, gyms, hairdressers and outdoor pubs last week. We will have to wait another two or three weeks to see if any such rise in cases might postpone the plan to relax restrictions further on 17th May.


It was announced today that India has been added to the UK’s travel ‘red list’ due to concerns that an Indian coronavirus variant could turn out to be a ‘variant of concern’. A variant of concern could be more infectious, produce more severe illness, be resistant to existing vaccines or a combination of all three. In the UK there have been a small number of cases of people who have become infected with the South African variant despite receiving a single vaccine dose. However, there is still a hope that our existing vaccines will offer reasonable protection against serious illness and we are yet to see anyone who has been protected by a vaccine require Critical Care admission.


At the hospital, things continue to improve. Almost no COVID patients have been admitted over the past week and most of our COVID ICU patients are now recovering from their illness. The prevalence of COVID-19 within the local community continues to fall and, as a result, we have made a change to the COVID ‘pathway’ system at James Cook. The longstanding red, amber and green pathways have been replaced by two, simpler, red and blue pathways.


The red pathway, for those patients who have been diagnosed with COVID-19, continues as before but the new blue, non-COVID pathway replaces the amber (medium-risk of COVID) and green (low-risk of COVID) pathways. All blue patients will still be routinely screened and tested upon arrival and at regular points during their stay in order to prevent asymptomatic infection. There are now only three red areas remaining – the single COVID ICU, one COVID ward and a small COVID area within A&E; all other areas are now blue.


This announcement has been met with jubilation by ICU staff. Because of the current low risk of a blue pathway patient inadvertently having COVID-19, there is no longer a requirement to wear full PPE in these areas. Instead staff can opt to wear just a regular facemask, with the addition of a standard disposable apron and a pair of gloves if interacting with a patient. Gone is the requirement to ‘suit-up’ with an uncomfortable FFP3 mask or ventilated hood system, a surgical gown or boiler suit, taped-up gloves and a visor before even setting foot on the ICU. It makes everything so much easier and much, much more comfortable. Anyone who doesn’t appreciate how happy this makes us clearly hasn’t spent enough time in full PPE.


The last few days have been much quieter than I have been used to. I haven’t seen a COVID patient in days and have been getting back to looking after ‘regular’ ICU patients. Even the really sick patients don’t compare to desperately ill COVID patients. I haven’t had to prone anybody, worry about hideously low oxygen saturations and relentlessly fiddle with ventilators for days. That’s not to say that we haven’t seen some very unwell patients, some of whom have not escaped tragedy but, for the time-being, it still feels surprisingly calm. We are all very much hoping it stays this way.


Celebrating Blue Monday



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