1st January 2021
UK COVID Deaths – Daily 613 / 7-Day average 554
Total UK COVID Deaths within 28 days – 74,125
Total UK Deaths with COVID-19 on the death certificate – 82,624 (up to 18th Dec)
James Cook Hospital – Total COVID deaths – 394
All COVID cases within South Tees Hospitals Trust – 114
James Cook Critical Care
COVID cases – 19 (10 ventilated)
Non-COVID cases – 28 (14 ventilated)
The beginning of 2021 has not been something that Nicky and I have been looking forward to. Like most of our colleagues we have known for some time that January and February were going to be tough months. We have been on leave for the past seven days which is pretty unusual at this time of year but we have both needed the break. I would love to say that we are refreshed and ready to go again but we’re both still fairly knackered.
It was a quieter Christmas than usual but we have spent a lot of time with the kids and managed to get out walking, cycling and sledging as well as eating and drinking far too much (well, the grown-ups anyway). Nicky and I have tried very hard to try to switch off and not pay too much attention to what has been happening at the hospital. I’m not sure we completely succeeded but we have certainly had moments where COVID-19 hasn’t been first and foremost on our minds.
Nicky’s father, Gordon, has spent the entire Christmas holiday in hospital with COVID pneumonitis. He remained very unwell over most of the Christmas holiday and, just when we were starting to really worry that he wasn’t showing any signs of improvement, his oxygen requirement started to slowly decrease. Over the past few days he has continued to improve to the point where, whilst he still needs the oxygen, he can tolerate short spells without it. Nicky and I both know how unpredictable COVID pneumonitis can be. We have seen plenty of patients deteriorate even after many days of their condition remaining relatively stable. Gordon’s continuing high demand for oxygen was concerning both of us and so the news that he is getting better is an enormous relief. Gordon has had a pretty dreadful Christmas and hopefully he can begin to look forward to returning home at some point in the near future.
Over the holiday period I did have cause to visit the hospital briefly in order to receive my second vaccination dose. It now looks highly likely that I may be one of the relatively few people in the country to receive both doses. The Government have changed their vaccination plans in order to protect as many people as possible by only administering a single dose of either the Pfizer/BioNTech or the Oxford/AstraZeneca vaccine. My understanding is that the initial dose of either one will confer a significant amount of protection but it is not clear exactly how strong this protection will be. This has led to some concern amongst the more vulnerable patients who, when they consented to vaccination, were promised a level of protection that they now will not receive. However, it is important to understand that the available evidence does suggest that a single dose of either vaccine is likely to protect the vast majority of patients from a severe COVID-19 infection. I fully understand what the Government is trying to achieve but I cannot understand why they didn’t make this their original plan right from the outset.
Case numbers have risen in most areas of Teesside. The Redcar and Cleveland borough is the only area locally where case numbers remain relatively low. This has not helped the area escape being placed into tier four along with their neighbours. Tier four restrictions are similar to the lockdown regulations that were imposed in November and mean you should not leave your home without a reasonable excuse. The area of North Yorkshire where I live has also seen a steep rise in case numbers and consequently has been moved from tier two into tier three. This was inevitable as it appears that tier two restrictions do little to prevent case numbers from growing.
Today was Nicky’s first day back at work. It came as no surprise to find that the situation at the hospital is worsening. We have not seen the deluge of COVID admissions that they have in London and the South-East but we are worried that this is coming our way. The London hospitals have admitted nearly 800 patients over the last fortnight, five times the number that we admitted across the North-East during the same period.
Unsurprisingly, we have had to once again tear down the partition that separates the two ICUs in order to recreate a large, single COVID ICU. We are also using half of the repurposed Female SAU for COVID patients. Whilst we have exceeded our regular ICU footprint, we still have space to look after more patients, assuming we can magic some nurses from somewhere. In the rest of the hospital, another COVID ward has been opened, increasing the total to six such wards. There are also a growing number of CPAP patients being looked after outside the ICU and in the past this has proved to be a reliable harbinger of difficult times to come. On the plus side, we have had the quietest New Year’s Eve we have ever known, with only one drug/alcohol-related assault admitted to Critical Care and our numbers of non-COVID patients have decreased over the holiday period.
The North of England is still yet to see a huge number of infections that are due to the new B117 variant of the virus but the proportion is increasing. A study from Imperial College, London, has attempted to quantify just how much more infectious the new variant is. They have found that the new mutations that are present in this latest version of the virus serve to increase the reproduction or R number from anywhere between 0.4 and 0.7. This means that every ten people who are infected with the new variant are likely to infect somewhere between four and seven extra people when compared to the common-or-garden variant. Whilst not surprising, this is far from welcome news.
My Christmas holiday finishes tonight and I’m back at work tomorrow. Sadly, for Nicky and me, 2021 still feels an awful lot like 2020.