23rd December 2021
UK COVID Deaths – Daily 147 / 7-Day average 112
Total UK COVID Deaths within 28 days – 147,720
Total UK Deaths with COVID-19 on the death certificate – 171,801 (up to 10 Dec)
James Cook Hospital – Total COVID deaths – 724
All COVID cases within South Tees Hospitals Trust – 41
James Cook Critical Care
COVID cases – 4 (4 ventilated)
Non-COVID cases – 49 (28 ventilated)
Yesterday, the Prime Minister confirmed that Christmas will go ahead without any new restrictions. There are to be no curbs on socialising over the next few days but the announcement came with a warning that extra measures may be needed before the New Year if the rate of hospital admissions rises unacceptably.
The booster campaign has been gathering pace, with close to one million doses being administered every day over the past week. To date, over 55% of the UK population who are above the age of twelve have received a third dose and this will, undoubtedly result in far fewer people becoming seriously ill over the next month. Unfortunately, there is already evidence that protection from infection with Omicron following a booster dose begins to wane after 10 weeks. Protection from serious illness should last much longer but Israel and Germany are already planning to administer a fourth dose to the over-60s in the New Year. Here in Britain only those who are immunosuppressed are eligible for a fourth dose but this is likely to change soon.
Much hope has been pinned on the expectation that Omicron is milder than its predecessors. I’m pleased to report that there is now an increasing amount of evidence to suggest that this is no longer just wishful thinking. A major study from South Africa and preliminary studies from the UK suggest that those infected with Omicron are significantly less likely to be admitted to hospital.
Some of this reduction in severity is thought to be due to the increasing level of immunity that is present within the population as a result of previous infection and vaccination. However, it seems that some of the reduction in severity is a result of changes to the virus itself. A laboratory study from Hong Kong suggests that, whilst Omicron is much better at multiplying within the larger airways of the lung than Delta, it is less efficient at multiplying within the deep lung tissue. This may go some way to explain why the virus is less likely to cause primary respiratory failure.
The growing amount of evidence that points to Omicron being less pathogenic is undoubtedly good news. However, a milder virus doesn’t mean we’re off the hook. COVID hospital admissions have risen significantly in London and the capital’s health service is finding itself under increasing pressure. It’s still not clear just how many patients we can expect to see next month.
The situation here at James Cook is still very different. The total number of COVID patients in the hospital is the lowest it’s been since the summer. The number of COVID patients within Critical Care has also fallen but, sadly, this is because two of our patients died earlier this week. Deaths from COVID-19 are far less common than they used to be but there are times when it’s easy to forget this. Both these patients were likely to have survived an Intensive Care stay had they been admitted with other, less serious, illnesses. One of them was young, healthy and unvaccinated and we are continuing to see similar patients regularly. The potential for the fourth wave to cut through the great-unvaccinated is high and I suspect a significant number of them will end up in hospital.
Unfortunately, as the number of COVID patients has gone down, the number of non-COVID patients within ICU has gone up. We still have significantly more ventilated patients than usual and we are frequently running out of beds. Still, it’s Christmas Eve tomorrow and I believe it’s traditional for there to be no room at the inn.
Nicky and I are now not back at work until after Boxing Day. There is the inevitable last-minute shopping and frantic present wrapping to deal with but, come tomorrow evening, we should be done and be able to enjoy dinner and a Christmas movie with the kids. This year it’s a toss-up between The Muppet’s Christmas Carol and It’s a Wonderful Life. It’s not a bad choice to have to make.
A year ago today, Nicky’s father was admitted to hospital with severe COVID pneumonitis. This year, he and Nicky’s Mum are spending Christmas Day with us. So, even with Omicron looming in the background, it’s worth remembering that this is a far, far better Christmas than last year. I hope the same is true for all of you.
Merry Christmas.
Ho...Ho...Ho...
"The great unvaccinated"? That is very derogatory Dr Cree. I don't think you should be using phrases like this!!!
Thank you to everyone for your kind comments. I hope you are all continuing to enjoy the festive season and I wish you all the best for 2022. Richard
Thankyou for the update, nice to read a little positivity among the doom and gloom, Merry Christmas to you and your family and all your team at JCUH.
Thank you so much Richard fro all your blogs, and for the wonderful way you deal clearly with difficult and often complex issues. Maybe that is part of the role of the intensivist. God bless you and your loved ones, and all your staff over Christmas and into 2022.
Thank you Richard, as always, for your common sense and factual view of life on the front line. I wish you, your family and your wonderful work colleagues the merriest of Christmases (when you get the chance) and a happy, healthy New Year. Thank you for all that you do. 🫂👏👏👏👏🎄🍾🥂