Worst Case Scenario
Updated: Nov 3, 2020
2nd November 2020
UK COVID Deaths – Daily 136 / 7-Day average 265
Total UK COVID Deaths within 28 days - 46,853
Total UK Deaths with COVID-19 on the death certificate - 58,925 (up to 16 Oct)
James Cook Hospital – Total COVID deaths – 287
All COVID cases within South Tees Hospitals Trust – 77
James Cook Critical Care COVID cases – 13 (9 ventilated)
We are now only two days away from the introduction of a second national lockdown. We all knew that cases were increasing but I think everyone has been surprised by the sudden, rather scary announcement that came on Halloween. Not surprisingly, the news was all trick and no treat. Boris was preceded on stage by Chris Whitty and Patrick Vallance who, between them, delivered a stark warning of what could happen if the Government did not act to control the second wave of cases. The key point they were making was that the numbers of new infections were rising at a rate that exceeded their ‘reasonable worst case scenario’ for the winter.
This reasonable worst case scenario had been presented to the public at the end of September when the growth in cases was low and the death rate even lower. As a result, most people refused to believe such a prophecy. It turns out that everyone was wrong and that the situation looks much worse than even gloom-mongers like me had feared. Whilst I was expecting the imminent announcement of a lockdown, I thought that it would be a ‘firebreak’ or ‘circuit-breaker’ lockdown like the Welsh are currently experiencing.
However, sadly, it looks now like we have passed the point at which this is a viable option for England. The revised projection, which is based on four different models, states that the growth in new cases will increase dramatically over the next two months. By Christmas, this would result in hospitals being unable to cope and maybe being unable to admit any patients at all. The death rate amongst COVID and non-COVID patients alike would soar to a completely unforgiveable level.
Whether this second lockdown will continue beyond the designated four-week period is unknown. Its efficacy is also being strongly debated. Schools are to remain open and so it will not be as effective as lockdown 1.0. However, the time for complacency is over. Everyone needs to play their part in preventing the spread of the virus. Only this will ensure that lockdown will not last any longer than is absolutely necessary.
At the hospital, case numbers have risen still further to a peak of 93 COVID patients over the weekend. We now have significant numbers of patients requiring CPAP on the three COVID wards and more ventilated patients on the ICU. The ever-increasing number of COVID admissions is having a worsening effect on the hospital’s ability to function normally. As if to highlight this, we have had to suspend some routine surgery at the James Cook Hospital today. This disruption is likely to continue for the rest of the week. However, the organisation continues to do its utmost to ensure that most surgery will continue as normal and there is to be no disruption to urgent and emergency operations.
We are also seeing more deaths. I returned from my week off to some very sad news. One of our younger patients has died. Doubtless many of you will have read in the local media about the sad death of Julie Donaldson, local radio presenter for Zetland FM in Redcar. Julie had been admitted to our Intensive Care Unit three weeks ago after contracting COVID-19 and had avoided ventilation until just a few days ago. This allowed many of us to get to know her during her time on the unit. Her death has greatly upset the entire ICU team and our thoughts and condolences are with her husband and family.
When talking about the large numbers of deaths that could occur over the winter, it’s all too easy to be dismissive and forget that each individual death is a tragedy. Perhaps we all need to narrow our focus and imagine what it must be like to lose a loved one under such circumstances. It’s only when we can do this that we can begin to truly consider what a worst-case scenario would bring.