Jhe game is changing now. Last I wrote, Omicron had just been identified and was becoming the dominant variant. Cases were piling up and me and my colleagues were bracing for another wave of Covid like the ones we had seen with Alpha and then Delta. Why wouldn’t we?
Data at the time showed that Omicron was extremely contagious and the number of cases was skyrocketing. It seemed quite logical, in my experience of the past two years, that this was going to be followed by an increase in hospital admissions, serious illnesses and deaths. It felt like a foolish roll of the dice not to take him more seriously. And – whatever one may say – officials did not know otherwise at the beginning of December.
Decisions were made on a day-to-day basis, trying to guess from our admissions one day whether hospitalizations would increase the next. If they had, it would have been too late for further action to stem the tide.
But we were lucky. Omicron is not the same disease as Delta and Alpha. Although it’s incredibly contagious – just look at how many of your family members and friends have had it recently – it’s not as dangerous now. That’s not to say it can be trivialized, though.
If you have not been vaccinated, you will still be at risk; severe Covid pneumonia in healthy people remains primarily a disease of the unvaccinated. But the majority of patients arriving at hospital with Covid these days are admitted for other reasons and simply test positive, reflecting the huge community prevalence. Not to mention the large number of people who catch it in our rooms; this has been a big problem from the start, but with Omicron it’s getting harder and harder to avoid.
The last two months, however, have been difficult. Winter pressures felt stronger than normal, our hospital fuller, with critical incidents being reported more often than usual as we ran out of beds. Infection control has been a nightmare as we battle to contain outbreaks in our wards, shutting down and reversing wards between Covid and non-Covid on an almost hourly basis.
Omicron was just tough enough to push our already overloaded system to the limit more and more often. And yet, the number of hospitalizations is finally decreasing. We only have one or two Covid wards left in our hospital now, as we are slowly regaining territory. Just recently I did the first shift in a long time where for 12 hours on call I didn’t admit anyone who had Covid.
The number of people in intensive care with Covid is low and population immunity is high. Largely due to a combination of high vaccination rates and widespread exposure through near-disastrous pandemic management, Covid is no longer the killer it once was.
Yet there is no time to relax. We have a brilliant, new and ambitious elective recovery plan to continue. We will be inundated with billions of pounds – but not as much as was wasted on unusable PPE, I note – to sustain us as we try to pretend the pandemic never happened.
As far as I know, that means goals and paperwork. It will take months for new funds to arrive. We have been mandated to develop local plans for how – without new resources, the same fragmented and exhausted workforce, infection control constraints, among a host of other issues – we will reduce our backlog of more and more referrals are coming in due to care being delayed by the pandemic. And money is useless without staff.
As things stand we can’t fill our vacancies and we don’t even have secure funding to keep people in place during the long Covid disposition that we have managed to put in place. It is a difficult and exhausting struggle.
And this is the moment our PM, out of the blue, chose to announce the early removal of all restrictions. Everyone I spoke to was surprised by this. Are we still “following the science”? And, in practice, what will that mean?
Do we regularly stop testing ourselves and come to work coughing and spitting on our vulnerable patients? And also, now that plans to mandate vaccination of healthcare workers have been quietly dropped, increase the risk of infecting potentially unvaccinated colleagues? Although hospitalizations with Covid are manageable at the moment, there were more than 66,000 new cases on Thursday, even with continued mask-wearing, lateral flow testing and self-isolation.
The cases will certainly increase accordingly. It remains to be seen whether hospitalizations will also be, even a little. But it would take a little to destabilize the system.
And that’s the crux of the problem for me. I love the NHS. The colleagues I work with and the friendliness, expertise and quality we have are truly second to none; it beats the private sector hands down. I am incredibly privileged to do the work that I do. But overall, the NHS is currently a broken system, unable to deliver good enough healthcare to our people.
Current wait times for non-emergency care; pressure on underfunded staff to deliver results that are completely unrealistic; difficulties encountered by patients in accessing the care they need; all of this is completely unacceptable. This makes me furious.
But it wasn’t Covid that got us to this point. Decades of underfunding, hospital closures, poor workforce planning and social inequities in health have left us so close to the wind that the fight against the pandemic has led to the collapse continuity of planned care even two years later.
We need to recognize how precious, precious and fragile our NHS is. Yet the crafting of the recovery plan suggests to me that we are simply aiming to get back to where we were in 2019. And even that is being gambled – again – by rushing to remove restrictions ahead of an expected timetable.
We need strong and careful leadership, as we will for many years to come. I don’t mean to be overly cautious, but it’s not appropriate for officials to put our health at risk by doing what politically suits them at any given time. We all deserve better than that.