The CPAP Queen

11th January 2021

UK COVID Deaths – Daily 529 / 7-Day average 915

Total UK COVID Deaths within 28 days – 81,960

Total UK Deaths with COVID-19 on the death certificate – 82,624 (up to 18th Dec)

James Cook Hospital – Total COVID deaths – 412

All COVID cases within South Tees Hospitals Trust – 172

James Cook Critical Care

COVID cases – 26 (15 ventilated)

Non-COVID cases – 34 (13 ventilated)

Back at work today and, to my relief, things have not worsened as much as I had feared they might. The number of daily admissions decreased a little over the weekend but the number of patients in the hospital continues to rise at a fair pace. The wards are very, very busy and, as of this morning, we had 25 patients receiving CPAP outside of Critical Care.

It’s important to understand how unprecedented this is. Normally these patients would have to be admitted to a Critical Care area such as an ICU, HDU or the Respiratory Support Unit. When the first wave kicked off, a decision was made to keep such patients on the ward in order to keep Critical Care beds free for the very sickest people. This was remarkably prescient as one of our successes during the first wave was the way we used CPAP to treat large numbers of patients and, in doing so, avoid ventilation in many of them. Little did we imagine that we would be treating almost twice as many CPAP patients six months later during a third wave.

The Critical Care Outreach team continue to support the ward staff in providing this service. Over the past few days they have been rushed off their feet, continually reviewing patients and informing us of anyone they think is worsening to the point that we need to admit them to ICU. According to their Fitbits, they are all clocking up at least 10 kilometres a day walking around the hospital seeing patients. To be perfectly honest, the Outreach team is the primary reason that the ICU has avoided being over-run.

They have acquired their skills in this area from one of my consultant colleagues – Isabel, our CPAP Queen. What Isabel doesn’t know about CPAP is not worth knowing and to be honest, we would have been lost without her. Her ability to get things done is legendary – you simply do not say no to Isabel!

Today it was announced that a total of two million people had already been vaccinated against COVID-19 as seven mass-vaccination centres opened up around the UK. Each will have the capacity to vaccinate four people every minute. It’s worth pointing out that James Cook Hospital is no slow-coach in this regard and is currently vaccinating over 1000 people a day. Nicky had her second dose of the Pfizer/BioNTech vaccine on Friday and unfortunately spent the weekend feeling pretty dreadful as a result. The hospital had made the decision, like many vaccination centres, to honour those who already had an appointment for a second dose of the vaccine. Her suffering was made less bearable by the fact that my second dose hadn’t seemed to affect me at all. My reassurance that the way she was feeling was a small price to pay for immunity just didn’t seem to cheer her up. Nor did my assurance that I was sure she would be feeling better just in time to return to work.