Wednesday 24th June 2020
Figures for 23rd June
UK COVID Deaths 280 / Total 42,927
James Cook Hospital – Total COVID deaths – 253
Yesterday saw the Government announcing further relaxation of lockdown restrictions. There appears to be a growing sense of optimism, a feeling amongst the public that the worst is behind us and that things can only get better.
None of us doctors want to be party-poopers so I’ll not dwell on the anxiety that many of us share regarding the chance of a ‘second wave’ of cases. Instead I would like to reflect on what we have achieved during the initial surge that took place over the past three months.
We saw our first COVID-19 Critical Care admission on 21st March. We admitted our second case on the day Lockdown started on 23rd March and then saw an increasing number of Critical Care admissions day by day. We had allocated one of our regular eight-bedded ICUs as the designated ‘COVID ICU’ and this was quickly filled. Our other eight-bedded ICU was quickly turned over to COVID patients.
On 25th March visiting was suspended across the Trust as the number of COVID cases within the Trust began to soar.
By 30th March, just a week later we needed to convert our 16-bedded High Dependency Unit into the third COVID ICU and we had filled the Paediatric and Cardiac ICUs with non-COVID cases. We quickly found ourselves having to expand into makeshift ICUs within Main Theatre Recovery and the Surgical Day Unit as cases kept coming.
On 11th April we reached our peak with 26 COVID positive ICU patients. We had increased our total capacity from 42 beds to 72 beds. 70 Critical Care Nurses were working each shift, almost double our regular number. We brought back 46 retired ICU nurses and employed 126 non-critical care nurses who we hastily trained to work within our units. 50 student nurses trained to become Health Care Assistants.
Our Secretaries worked through fifteen weekends and the Ward Clerks racked up 637 hours of overtime. Everyone, including medical and nursing staff, managers, physiotherapists, nutritionists, cleaners, laundry staff, catering personnel, security staff, radiographers, maintenance staff, pharmacists, occupational therapists, lab staff and porters worked harder than they ever had before to ensure that everything continued to work.
At one point we appeared to be conjuring ventilators out of thin air with six different types in play as well as several CPAP systems in use. We were beset with threatened and actual drug and equipment shortages but always seemed to find a way out of the particular problem that faced us each day.
As for the Hospital Trust as a whole, they admitted a total of 874 COVID positive patients. One hundred and four of these ended up in Critical Care. Fifty-one of these were ventilated with twenty-two of them needing dialysis for kidney failure.
On the wards, 90 patients received CPAP. Thanks to the hard work and dedication shown by the Acute Medical and Outreach Teams, these patients avoided using Critical Care beds, allowing us to continue providing care for all patients that came our way and not become overwhelmed.
Of all the COVID patients admitted to the Trust, sadly 27.9% of them died. Looking at our own 104 COVID patients within Critical Care, 38% of them died. For comparison, the average mortality rate amongst our 287 Non-COVID patients during this time was 15.7%.
We have watched many patients die but are grateful that we have been able to provide a high standard of care throughout. We have ensured that many desperately ill patients have survived as a result and we are all very proud of this achievement.
cheers richard you and your colleagues should indeed be very proud of your efforts.
your blogs have been great, theres something so reassuring about hearing information straight from the horses mouth even when its bad news, i had to stop watching the news on tv, it really was scaremongering in my opinion
I cannot begin to imagine what those months were like to actually work through and experience. You deserve medals and far more importantly, a massive, permanent pay increase. I hope people continue to appreciate how fantastic you all are and how very lucky we are to have such an amazing NHS with wonderful doctors and staff like you guys.
There are no words for how grateful the uk public should be for the hard work and dedication that all NHS and care staff everywhere have shown during this pandemic. You have all been amazing and I for one appreciate everything that you all do to keep us alive.
Hopefully the selfish won’t take over and cause that second wave. My worry is already we are taking about COVID in the past tense and it is very much still here...I wish you all the very best and hope you can get back some normality. Best regards. Sam
Richard
I think optimism is in built into a vast amount of people and in itself is a good thing. But the anxiety regarding a second wave of Covid 19 is real and shared again with a vast amount of people, let’s hope people are sensible and don’t follow the relaxation to vigorously, maybe we should just do what we have been doing for a while longer until daily figures for new cases comes down a bit.
Well done doc, credit to you and all your colleagues whatever role.
Hi Richard,
It's been a great insight to what has been happening locally during the outbreak. The love and compassion can be felt and everyone who is admitted is given the best of care.
I hope and pray everyone is sensible with lockdown easing, continue to follow the guidance and keep the virus at bay.
Again thanks to all the hard work the JCUH team are doing 24 hours a day.
Best,
Qasim