Levelling Off

22nd November 2020

UK COVID Deaths – Daily 398 / 7-Day average 441

Total UK COVID Deaths within 28 days – 55,024

Total UK Deaths with COVID-19 on the death certificate – 63,873 (up to 6th Nov)

James Cook Hospital – Total COVID deaths – 339

All COVID cases within South Tees Hospitals Trust – 128

James Cook Critical Care

COVID cases – 20 (11 ventilated)

Non-COVID cases – 31 (12 ventilated)

It’s been Nicky’s turn for a busy few days at work. The acute wards and Critical Care continue to be very busy but there are signs that the situation is stabilising. The numbers of new COVID patients admitted each day and the total number of COVID patients in the hospital has stopped rising over the past few days. This is a relief - we currently have about 80% of the peak number of COVID patients that we saw back in April. This is more than enough, thank you very much.

It’s important to point out that, despite the increased workload, we are still able to meet the demand for urgent and emergency care. Anyone who needs treatment, gets it. Of course, non-urgent operations and appointments are likely to be delayed but we are still pressing ahead with important surgery such as vital cancer operations, carotid artery surgery to prevent strokes, urgent repairs of large abdominal aortic aneurysms and many other procedures that cannot wait until the pandemic is over. The fact that we are achieving all this is due, in no small part, to an enormous amount of effort on everyone’s part. This is undoubtedly taking its toll; we have all worked very hard over the last nine months but at least we are still able to cope. Everyone has been very worried about how bad the situation could have been by Christmas if we had continued to see patient numbers rising at the rate they had been.

It's not just the hospital that is seeing a slow-down in the rate of new cases. The published daily case figure and, more accurately, information from the Office of National Statistics (ONS) also suggest that the situation is improving and that the growth in new cases is levelling off. The ONS survey tested thousands of people in households throughout the UK during the week ending 14th November. One in 80 people in England tested positive for COVID-19, compared to one in 155 in Scotland. This is equivalent to about 39,000 infections a day across the UK and is significantly lower than the previous week’s figure of nearly 50,000. The COVID symptom app which looks at one million people who reported positive swab tests, estimates there are about 34,000 cases a day during the two weeks up until 15th November. This too represents a fall in case numbers compared to the previous period studied.

There are still marked regional differences across the country. The rate of new infections is falling in the north and the Midlands but cases are still rising in London and the south-east. The highest levels of infection are still seen in good old Yorkshire and the north-west. Whilst overall, the R number remains above one (meaning the epidemic is still growing), this is still good news as this fall in the rate of new infections is occurring a bit too soon to be entirely as a result of the lockdown. It appears that the tiered system of restrictions that was introduced in October had already started working. The addition of lockdown on top of these restrictions means that we are now seeing case numbers begin to fall. Most of the effect from the tiered system seems to have been due to the imposition of tier three restrictions in the worst virus hotspots. Tier two restrictions also had an effect but the impact was much smaller.

Fortunately, there is now is now a chance that things may remain more or less under control at the hospital in the lead up to Christmas. The current lockdown is due to end on 2nd December and the Government, when they announce their winter plans tomorrow, look set to announce a return to a tougher three-tier system than existed before. They will justify this action as necessary in order to allow the nation to enjoy a significant relaxation of restrictions over Christmas.

Exactly to what degree restrictions will be lifted over the festive period remains to be seen. Everything depends on how effective this lockdown has been and we will have to wait until the end of next week before we know that. There is clearly a fear that the public, sick to the back teeth of the effects of lockdown and perpetual restrictions, will do what they want over the holiday season anyway. It therefore looks as if the Government’s strategy will have to be one of damage-control rather than prevention. We are all being warned to expect even tougher restrictions in January in order to bring the situation back under control.

So, what of my Christmas plans? Well, like many people, Nicky and I have resigned ourselves to a somewhat different Christmas from usual. We are currently not scheduled to work either Christmas Day or Boxing Day. This is unusual, one or both of us normally has to work at least one of the bank holidays. Much as we’d like to, it’s unlikely that we will be attending any parties or gathering our extended families around the dinner table on Christmas Day. Both sets of our parents are getting on a bit and could well be considered vulnerable when it comes to the complications of COVID-19. It looks like it might just be us, the kids and the cat this year. It would be very wrong to complain about this – it’s hardly what I would call a hardship. We will simply have to defer our family celebrations until the spring once everyone has been vaccinated.