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  • Writer's pictureRichard Cree

Command & Control

Updated: Dec 16, 2021

15th December 2021

UK COVID Deaths – Daily 165 / 7-Day average 115

Total UK COVID Deaths within 28 days – 146,791

Total UK Deaths with COVID-19 on the death certificate – 170,911 (up to 3 Dec)

James Cook Hospital – Total COVID deaths – 720

All COVID cases within South Tees Hospitals Trust – 44

James Cook Critical Care

COVID cases – 6 (6 ventilated)

Non-COVID cases – 46 (25 ventilated)


As of yesterday, the hospital is on something of an emergency footing. NHS England has taken command of every hospital trust in the country in order to coordinate the health service’s response to the ever-growing number of Omicron cases. Once again, we are back to working out how we will manage the anticipated wave of admissions. The whole situation is eerily familiar and, like the beginning of the first wave, we are carefully watching what is happening in London. We know all too well, that what happens there will surely happen here.


There were a record 78,610 new cases of COVD-19 reported today but the true number of cases is believed to be much, much higher. The Omicron variant looks to be responsible for over half of all new cases in London, meaning it is already the dominant variant in the capital.


Locally, the picture is much better; there have been 100 cases confirmed in the North East of England and it is estimated that the Omicron variant is currently responsible for 5-6% of all COVID-19 infections in the region. As yet, no Omicron patients have been admitted to our hospital. The number of Delta patients we are admitting remains low and the number of patients within Critical Care has remained static. To be honest, I had expected that we might be seeing more Delta admissions by now and I’m delighted that the number of such patients in the hospital has continued to fall. Perhaps we have reached a point where the level of immunity within our local population is finally enough to stop most hospital admissions? If so, then it’s very disheartening to know that this level of immunity won’t be enough to stop Omicron.


The public is still clearly divided on their opinion of just how much of a threat the new variant presents. Many people are understandably concerned - long queues are to be found outside vaccination centres and Christmas parties and restaurant bookings are being cancelled in their droves. Even if they don’t anticipate becoming seriously ill, many people don’t want to risk the chance of an Omicron infection ruining their holiday plans.


Others are accusing the Government of over-reacting to what they believe will turn out to be a much milder disease. I dearly hope they are right. Unfortunately, as yet, there is still no objective evidence that Omicron causes fewer hospital admissions than its cousins. Even if it does turn out to be a milder variant, this would not be especially comforting given the sheer number of infections that will occur. Whilst ‘milder’ respiratory viruses, such as influenza, parainfluenza or respiratory syncytial virus, may not result in the same degree of direct lung inflammation, they are often complicated by secondary bacterial pneumonias and many people still require hospital treatment.


So, we still don’t know how many people will be admitted to hospital or how many of those that are admitted will require CPAP or ventilation. It may be that it is A&E and the acute medical wards that will bear the brunt of the Omicron onslaught. In the meantime, the plan is pretty similar to the one we rolled out for the first two waves. We need to know that we can find more beds, more nurses and more ventilators, whilst hoping that we won’t need them. All eyes are on London’s hospitals now. How they fare in the run-up to Christmas will begin to give the rest of us an idea of what we’re up against.



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24 Comments


drdawnk
Dec 21, 2021

HI Richard


I wanted to just send a message to perhaps give you some light at the end of the tunnel with Omicron.

Here is South Africa, we are already seeing a decline in cases in Gauteng. We had 16000 per day in this province a little over a week ago and yesterday 1500. Our hospital admissions have remained low. A 350 bed hospital, with approximately 50 critical care beds, has remained at around 20 admissions for covid. There are currently 4 ventilated patients but these are patients that had incidental covid and were ventilated for non-covid reasons like PPH and trauma.

I am not sure if it is because our government is very strict about mask wearing…

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peter.nms
Dec 22, 2021
Replying to

There has been a huge rise in hospitalisations in England over the past few days. The last overall figure of 813 for the UK was on the 18th Dec, as of 20th, just two days later 1061 admitted for England alone.


Hopefully this is a blip and not a trend but given the cases and the risk of infections bubbling up the age range over xmas, I fear January will once again be a problem.



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angela_carvell
Dec 17, 2021

Thankyou for your informed update richard its a matter of watch this space?

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Richard Cree
Richard Cree
Dec 18, 2021
Replying to

Hi Angela Absolutely! Cheers, Richard

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peter.nms
Dec 16, 2021

Hi Richard,


I find the whole way that some elements in the country are behaving about this virus to be appalling, especially some backbench Tory MP's who are absolutely unfit to hold office due to stating that it's no more serious than a cold.


Some have even blamed restrictions on preventing cancer treatment .... I am not sure how anyone comes to that conclusion. Perhaps 11 years of Conservative cuts have something to do with a lack of capacity and a difficulty in attracting staff.


Once again all you good people in the NHS face a Christmas and New Year from hell, something you don't get a choice about.


I think all sane and normal people just hope Omicron is…


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Richard Cree
Richard Cree
Dec 18, 2021
Replying to

Not sure I need to add to this thread but obviously it is the fact that hospitals have been treating lots of COVID patients for 14 out of the past 20 months that has limited our ability to do more cancer- work. We are frequently having to cancel cancer patients due to a lack of ICU beds. This is because one of our three ICUs is always occupied by COVID patients. Cheers, Richard

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drdawnk
Dec 16, 2021

Hi Richard


It’s always interesting to read your blog. The UK numbers have been pretty scary all along. We seem to have reached our peak in Gauteng here in South Africa. The rest of the country is now escalating.

Admissions have been steadily rising but are still very manageable and very few are ventilated. I am attaching in a link our current country stats from our National Institute of Communicable Diseases. Observationally, this has been less crazy in the hospitals so far in comparison to Delta. Time will tell.

https://www.nicd.ac.za/latest-confirmed-cases-of-covid-19-in-south-africa-15-december-2021/

We have had a few cancellations on elective lists for positives but the patients are otherwise well. All patients need a PCR test prior to admission. Today…

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Richard Cree
Richard Cree
Dec 18, 2021
Replying to

Hi Dawn Let’s hope we mirror your experience. Fingers crossed. The NHS is already beyond full capacity so we will struggle even if we only see a moderate increase in cases. You’re right about vaccines - unfortunately our use of the AZ vaccine leaves us quite exposed to Omicron. London is reporting big problems with staffing and may have to resort to ‘come back to work when you feel well’ rather than waiting ten days. Hope things remain OK-ish at your end! Cheers, Richard

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irommanjon
Dec 16, 2021

Hi Richard


Thank you as ever for your balanced and thoughtful comments. It's clear your readers, including me, greatly appreciate and value them.


I've read Omicron is doubling every two days. Clearly that can't continue on such a steep exponential curve because it will run out of humans to infect. But it is difficult to see how it will be possible to avoid almost everyone becoming infected. The most that can be achieved is a slowing of the rate of infection to avoid the NHS, and indeed the whole UK economy, shutting down due to illness and the need to isolate.


There inevitably becomes a time when isolation is pointless (ie when a high proportion of the population have already…


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Richard Cree
Richard Cree
Dec 18, 2021
Replying to

Hi Jon I may already have answered some of your questions in my previous reply to pi.detective, but yes, eventually the only people left to infect will be those that are being very careful or hiding away. Even with a good level of protection against severe illness in the ever-growing boosted population, the sheer number of infections will ensure the hospitals will suffer. Clearly, if it wasn’t Christmas we would have more restrictions in place already so you can expect them as soon as Boxing Day is over. If the situation in London looks like it’s unravelling then Boris may have to give in early and face ‘ruining Christmas again’. I think that due to the higher levels of infection across Teesside…

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