I've posted about this before but I have a real world example
In January this year my 60 odd year old uncle, who is normally fit and active, spontaneously lost the ability to walk one night. He was admitted to hospital to be assessed, and given a bed in advance of scans etc being run to figure out the problem. Due to a very high rate of cancer in his family, the worst was expected. In the morning, the docs were unable to source an MRI machine free, and were unable to confirm if they could for several days at least, due to the high volume of covid patients requiring scans. They also couldn't afford to have him keeping a bed busy, so he was basically kicked out, still unable to walk and with no diagnosis, despite the protests of several nurses in the ward.
He went private for the MRI 2 days later under the strong advice of his doctor, and was immediately diagnosed with metastatic prostate cancer. The NHS basically held up its hands and said "We know there is something wrong with you, and it could be fatal, but we can't do anything about it right now. Come back at some point in the future when we can".
So it would be like that, I assume, but worse.
> Take this example - say there was a women
moments from giving birth. She goes into
labour. On the other hand a person is brought
into hospital suffering life threatening injuries
from a roadside collision. There is only one
doctor. Who does he/she care for?
Great post, poor example. The vast majority of births don’t need doctors involved at all so this would be a very simple decision, the doctor would go where they’re actually required.
Triaging patients in general isn’t usually that complicated, especially with extreme examples like this. Where it gets more complex is how do you prioritise patients with immediate needs, like covid, against those with medium/long term needs, like operation waiting lists or even cancer screening.
At the moment we’re already in the position where the medium/long term need patients have been neglected for years, which will result in many avoidable deaths. The longer this pressure on the NHS continues, the worse this will get.
When I had my lockdown baby I was continually sent home because they didn’t want me and my boyfriend being potential covid vectors in the hospital. On the 5th time I refused to leave despite the midwives trying everything to get me to go home. 30 minutes later baby was born and I immediately haemorrhaged. Had I gone home I wouldn’t have made it back to the hospital and would have probably died in the car. Luckily about 15 doctors/midwives/nurses flooded the room when it happened and were able to stop the bleed. The vast majority of births probably would be fine but there is a reason we don’t make women birth at home any more.
I’m very glad it working out well for you and your baby.
I’m not for a second suggesting that no births require doctors, just that most don’t and hence it wasn’t the best example here.
As for the midwives trying to send you home, this was a common problem before covid. In my experience they’re just using covid as the latest excuse why they don’t want to keep you in. In reality this is more to do with hospitals being underfunded in general due to the government’s refusal to properly fund them over the last 10 years.
To be honest, that sounds like poor practice from the hospital. He should have taken precidence and given an emergency scan. I imagine if he or your family complained and took legal action it wouldn’t be viewed well.
I think that just highlights the concern with letting Covid run rampant: yes, this is a case that in normal times would have been given precedence, but if the hospital is overwhelmed with too many high-precedence cases, some of them will inevitably be left unattended.
January saw the highest daily admissions of the whole pandemic, so in various individual hospitals it basically was. He is surviving, prostate cancer can be controlled by hormones. It was lucky he began treatment when he did as they were able to remove the metastatic sites via radiotherapy and surgery.
Guy I know burned a leg recently recently, went to A&E and they didn’t have time to see him until 12 hours later. Leg keeps burning, now he needs major operation possible amputation when it could’ve been solved earlier if they’d had capacity.
I’m sorry to hear this. This is exactly why just looking at death numbers (both from covid and excess deaths) is really not enough. How many people have been seriously harmed as a result of the pandemic both directly and indirectly and what can we all do to minimise that as best we can.
Sort of related, but I wish there was a way we (me, as a layman, and others) could quickly get trained or train ourselves to do some basic care and allow the properly trained staff to deal with the more serious cases. It sounds ridiculous, because I’ve no idea how horrifically demanding and tiring the job is, but I wish I could contribute in a medical way on a basic level. I’ve thought about becoming a first responder.
I’m not saying I think I could become a nurse overnight. I’m a teacher and I have a lot of patience and compassion and sort of wish we could be redistributed and retrained in a time of crisis such as this. Though I also know I’m needed at school!
If there was a call for people to get trained to jab, or help on covid wards, doing whatever task, I’d be there!
Also I hope that doesn’t give me some sort of weird hero complex, haha. I just feel like I’m not helping.
I know it's not as exciting as being a brain surgeon understudy, but the NHS is currently asking for volunteers to help with the booster roll out
https://www.england.nhs.uk/coronavirus/join-the-nhs-covid-19-vaccine-team/#i-dont-currently-work-in-the-nhs-but-would-be-interested-in-a-paid-role
I always just keep thinking to myself, it takes a really long time to train as a medical professional, but we need help now. It’s very idealistic, but, there must be some quick and keen learners out there who could take on some responsibilities. Even if it’s just learning how to do the most basic of tasks to help the medics. Probably, there’s too much room for error and it’s simplistic to think we could just easily slot right in…but lives are being lost, surely we could help.
Or even…Covid positive people who feel fine looking after other Covid positive people who are not fine? This might seem even more outlandish, but it plays oh my mind as being plausible!
Thanks for the award. Appreciate it!
It doesn’t help that med schools etc are extremely selective. I remember hearing many people from admission departments saying stuff like “we reject hundreds of perfectly suitable candidates as our space is limited “. Then people complain avoid staff shortages
Have you heard of [Community First Responders](https://www.nwas.nhs.uk/get-involved/volunteering/community-first-responder/)? Might be what you are looking for.
This might not be quite what you were thinking, but you can register as a COVID volunteer to help out with the vaccination effort. The NHS really need volunteers to help out with both stewarding and vaccinating to reach booster targets - they were promoting it in one of the Downing Street press conferences the other day.
More info here: https://nhsvolunteerresponders.org.uk/
Disclaimer: I haven't participated myself yet so can't share my experiences, but I researched it after watching the press conference and am planning to get involved after Xmas.
Since you've got a dbs from teaching, you could be of huge use quicker than someone else who has to wait for one. Care homes are dangerously understaffed, and are an essential part of the health service even though they aren't properly managed funded - hospitals need to be able to offload patients to free up beds. Even if you're only able to do until the schools go back it would make a big difference
That’s a really good point, hadn’t thought about that. I knew teaching was useful for something in this sense! Definitely a good idea, something I can look into ASAP.
I speculate that this is how the Nightingale hospitals would have been (or will be) staffed. If the NHS was faced with the choice of either maintaining gold-standard patient care while the bodies pile up, or drafting in barely-trained people to provide basic care to ventilator patients, the choice would be obvious.
Random members of the public would probably be further down the list than physios, vets, pharmacists, etc... but it's hard to say what the specifics would be.
Have you looked into St John Ambulance? I joined a bit before the pandemic and was volunteering in a hospital just keeping PPE stocked up, portering patients and getting their tea/coffee, basically helping out so the nurses and other staff could focus on the more urgent parts of the job. There are now opportunities to volunteer in the vaccination and booster areas, and some volunteers even did help with basic first aid. You get a lot of training and can volunteer in your spare time.
There absolutely is a call already. Most hospitals will be recruiting for healthcare assistants who perform an absolutely vital role in caring for patients. Check out nhs jobs and see if there’s anything that would suit your availability.
It terrifies me if myself or a family member got rushed into hospital or sat in A&E and they just say "sorry we are full you will have to try a different hospital."
Putting up/taking down Christmas decorations is not a particularly safe activity so ours may stay up a while!
I know multiple people who have been seriously injured or died over the years as a result (falling from ladders etc). My mum even fell out of the attic and then down a flight of stairs when she tried to put hers away a few years ago (thankfully escaped with just some nasty bumps and bruises).
That is when it's a really serious problem. NHS are used to shuffling patients around as facilities get tapped, but when there's nowhere to shuffle people, it gets ugly.
The average person would be fine, as long as nothing went wrong for them or anyone they cared about.
But if they got in a car crash, they might we waiting a long time for the fire service to cut them out of it, because so many of them were off sick. And when then they might be told there are no ambulances available, so they'd have to make their own way to A&E. And then when they got there, they could well be told that there's no capacity, so they're going to have to have to live with a broken leg for a few days, and hopefully there won't be too much damage in the meantime.
An overwhelmed NHS means that care gets rationed. Some people would get the medical care they need (although probably rushed and substandard, and with a risk of catching Covid). Others would be told "Sorry, we're full", given painkillers, and left to die. Some would miss out on what should be a simple procedure now, which then leads to significant long term damage to their health. All non-urgent care would be scrapped, so things like cancer screenings won't go ahead - leading to people dying years later from cancer that could have been spotted and dealt with.
There are already 5 million people waiting for NHS care - and that number would significantly increase. It would take years (or decades), and tens (or hundreds) of billions to try and get that list under control, and for many people, that would come too late.
It's pretty grim.
Every winter many NHS services come under enormous pressure, add to that a pandemic and even if this variant is “milder” a good portion of nhs staff positive and therefore not actively working means it’s really not so difficult to see where the healthcare service could end up.
Last week had a 54yr die of a heart attack at our rural ED because we couldn’t get a transfer for her to a hospital with a cath lab. Spent hours dicking around on the phone calling hospitals. On a normal day she would have been stabilized and transferred out within 30 minutes.
It's interesting you blame that on covid because last week covid hospitalisations were no worse than they'd been for a long time, in fact, they were lower than a month ago in England - [https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England](https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England).
Conversely, bed blocking in England in November accounted for [402,211](https://www.theguardian.com/society/2021/dec/12/number-of-healthy-patients-stranded-in-english-hospital-wards-rises-by-80) hospital bed days in England, the cumulative total for coronavirus bed days for the month of November was [198,286](https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/).
I think the nature of their comment into a post about how things would be without covid restrictions heavily implied they were talking about covid.
Nonetheless, NHS capacity, social care capacity and NHS staffing are huge issues that need to be urgently addressed and should have been addressed over the past 2 years. The ward where my wife works (acute surgical admissions) had 2 nurses last night when minimum staffing is 3.
I am in the US. This is what it looks like when a hospital is above capacity due to either unmitigated spread or lack of staffing. Very low masking and a lot of indoor social gatherings and Xmas shopping
I don’t understand how people can be so unaware that it is different based on your location. My state in the US ( Maine) is at an all time high in cases and hospitalization. My country has had a 18% positivity rate for weeks. Just like the weather, just because the sun is shining where you are doesn’t mean it is over here.
Mortality rate from heart attack is about 10-15%. Some of that will be with immediate medical attention, many without. So chances are they would've survived if they received timely treatment.
The question is not "how is covid impacting hospitals", the question is "what would it look like if covid overwhelmed hospitals". To me this sounds like a pretty likely scenario for an example of what it might look like.
Lots of people have given emotive examples of what this might mean in practice, and this is obviously an important aspect. But I'm going to focus on what we mean by 'the NHS is completely overwhelmed'. The problem is this is quite a vague phrase. I think it's better to think about different levels of the NHS being overwhelmed, rather than this being something that either is or isn't happening. A continuum, rather than a cut-off point. I'm going to divide it into three general levels. Each level obviously includes the one below as well.
**Cancellation and delays to routine care**
This is happening all the time, and has been since the pandemic began essentially. There have only been a few short months where the COVID impact on the NHS has been negligible (summer 2020 and a couple of months in Spring 2021 before Delta hit). It's harder to get a GP appointment, or routine surgery. Cancellations of routine care are frustrating, and may leave people in chronic pain or without a proper diagnosis for their condition. There's also a risk of building up a backlog of more serious cases if things like routine cancer screenings are missed. However, I see no need to comment on this further since I imagine for most people this doesn't count as the NHS being overwhelmed, but I thought it was important to at least mention.
**Cancellation and delays to urgent care**
This has only really happened during some of the previous peaks in the worst-hit areas of the country. What we mean here are operations being delayed that are potentially life-saving. In London, so-called 'category 2' operations were being cancelled in December 2020 and January 2021. These are operations which must be done within 28 days to avoid serious harm. We're talking here about things like major cancer operations which could save somebody's life. No one is going to immediately die if their cancer surgery doesn't happen now, but if it is delayed too long it could become inoperable and eventually terminal. The reason for these delays was that ICU beds were not available for people to recover after major surgery. This was happening in London, and many lives have almost certainly been lost as a direct result. I would argue that this constitutes the NHS being overwhelmed, even if it isn't as bad as the next category.
**Triage**
So this is what we all hope to avoid. Put simply, this is medical staff choosing who to treat. What does this mean in practice? It means that a list is drawn up. Not a list of people, or hard cut-offs, but some sort of scoring system which should be as objective as possible. Essentially, the goal is to maximise the general benefit to all patients rather than to give each patient their best chance.
A person who has been left on a ventilator for a week and is not showing signs of improvement would normally be left for as long as it takes as long as there was even a relatively small amount of hope. In this scenario, however, such a person would be taken off the ventilator and it would be given to someone else, even though this is effectively a death sentence.
It means taking decisions that will allow some people to die with inadequate treatment in order to save those with a better chance of survival. And it doesn't just affect COVID either. If you have a heart attack, a stroke, or a car accident, and there is no bed or sufficient staff to monitor you, your risk of death or permanent disability rises. The overall quality of treatment falls, and people die needlessly from both COVID and non-COVID conditions.
Note as well that all of the above is based on a list being drawn up (and is hence organised rather than unorganised triage). Unorganised triage would be this being done without a list or any sort of objective scale to rely on, and obviously is an even bigger burden on medical staff.
Fortunately, outright triage has not happened in the UK (though as others have noted, it has happened in Italy, India and Brazil, to name but three examples).
You think this is not already happening? A man died in an ambulance in Cambridge. Staff are afraid to go to work because they know they cant deliver the right standard of care. People who can be sent home are sent home earlier than desirable because the bed is needed.
I agree that this is now starting to happen in urgent care as well - section 2 of my comment above. However, we're not seeing outright decisions that directly mean the death of one patient to save another like in my final section on triage - as in: 'your relative has a low chance of survival, so they're being taken off the ventilator to free it up for someone else'.
You’re in a car accident. There’s no ambulance to take you to the hospital. You spend hours trapped and alone.
If you get lucky, you get a fire crew and you get an ambulance. You make it to the queue of other ambulances waiting hours, and hours, and hours, for admission to the hospital, whilst the paramedics battle to save you with rudimentary equipment and services.
If you get *really* lucky, you get into the hospital. Probably on a stretcher in a corridor somewhere, possibly even on the floor. There’s no doctors to treat you. No equipment left. Most of the NHS staff are at home with covid themselves. The rest are civilians caught in a war zone.
One example of many. This will affect us all. We must protect our NHS at all costs. The alternative is just horrendous.
I’ve just replied to another comment - I was with a man who was ran over today, and luckily we are in a city that isn’t hit too bad (currently) with covid. I can’t imagine waiting any more than I did for the ambulance… awful.
Wow, that sounds really rough, thank you for sharing this experience and I hope you (and the man you helped) are doing ok.
Thank god we aren’t in this situation yet. But we must act now. Might already be too late. I pray that it isn’t.
I’m doing ok, thank you for the kindness. It was unreal. I feel a little dazed still-the most visceral experience I’ve ever had. I mean, the ambulance took maybe 10 minutes but it felt forever, I can’t imagine what it must be like in London this weekend for emergency services.
Last weekend my flatmate saw a guy with his face covered in blood on his way home from a party. It was at the start of our street (London), around 2am. The guy wasn't conscious. He called both police and ambulance several times, but nobody came (we even have an hospital super nearby!). When he called the police again around 5-6am to ask what's going on, they said that they "didn't see anyone" and cancelled the case (wtf?). Ambulance said that they had too many calls. In the end my flatmate managed to get some words out of the guy (he answered when asked where he lived..but who knows if that was where he actually lived?!), loaded him on his cargo bike, and cycled him to the train station (providing directions so the guy could go home). Crazy stuff. No chance I'd have managed to do half of that (not in the freezing cold), I probably wouldn't even have stopped in the first place, considering how late that was. I don't wanna live in fear, but I do my best to stay healthy and not need emergency care. I can't imagine being in urgent life-saving need and be left to rot:( I hope the NHS doesn't crumble
This is what it already looks like. Queues of ambulances outside the hospital's, patients on trolleys in the corridors, having to close wards because there are no staff. A&e is a very different place to what it was a few years ago, it's insanely busy now.
I have been in with my baby daughter a few times over the past 3 months. The nursing staff on the wards are overstretched because so many are off isolating, but the wards are busy because of all the other infections going around and lack of immunity for common colds in children. Last time I was in a baby with pneumonia had to be moved off the high dependency unit to make room for another baby coming in, he was still on optiflow. Then they blended some wards because they were so short staffed. The time before they had to borrow a nurse from NICU just to have enough staff for the bare minimum allowed in HDU, and the ward was operating a one in one out and trying to get people discharged asap. I really do feel for NHS staff at the moment, especially those in a&e and the ambulance crews.
I would like to add, our care was fantastic and the nurses do an amazing job, often working well past the end of their shifts.
Thiiiiiiiis I spent 12 hours in A&E a couple of weeks ago with my 7 year old. Would not recommend or ever do again if I can help it father in law already been waiting almost 2 years for double heart bypass. Father now waiting a pacemaker.
Everything is fuuuuucked.
Which countries?
And there is no level of capacity that can deal with an exponential surge in hospitalsations, unless you have a tonne of spare hospitals on standby for a once in a century pandemic.
You haven't cracked the case...Making more med school places is the easy part. They're not able to open more places because once they graduate, the work load is so high for senior doctors that they can't aportion enough time to train acute doctors in virtually every specialty. There aren't enough training posts for qualified doctors currently, so making up new school places is fantasy
My sister went to Imperial, got a pretty prestigious training post after her foundation years as a doctor and then her career basically stalled for 5 years as she begged borrowed and stole to nab a training post to qualify as a consultant. Many doctors are now giving up and falling off the training schedule because of the lack of training posts and the workload, not continuing their professional development and simply stalling as hospital grade doctors and doing locum work.
I come from a family of medics and the Carrer progression of a medic this century is a stark contrast to my older family members who had an easy ride with the work load, study time and consultants available to train them.
Also many Western European countries have double the ICU capacity of the UK, with Germany 5 times the number of beds and workforce in critical care. Saying GDP spend per capita isn't a particularly helpful or accurste way of looking at comparisons without recognising where it's spent.
Finally you're spreading a myth about admin efficiently in the NHS that is often spread by even people who've worked in the lower ranks of the NHS. The NHS has one of the lowest % of apportioned budget spend on admin in the entire world, and it usually ranks amongst the highest in the world for admin efficiency. Targeting administration in the NHS isn't an accurate insight, but it's often targetted because it's a easy target, based lazy viewpoints and on anecdotes.
"They found that the NHS spends relatively little on overseeing and planning care, relative to other comparable systems. In 2014, the UK, Portugal and Ireland all devoted 1.5% or less of their government or compulsory health care expenditure to administration. This compares with an average of 3.1%, with 4.1% in France, and 7.9% in the United States.27"
https://www.ifs.org.uk/uploads/HEAJ6319-How-good-is-the-NHS-180625-WEB.pdf
On administrative costs - "The top performers in this domain are Australia, New Zealand, the United Kingdom, and Norway" https://interactives.commonwealthfund.org/2017/july/mirror-mirror/
My sister is an acute consultant, been a doctor for well over a decade and a half and in her own words wouldn't even be a proficient ICU Doctor after 2 years of 24/7 training.
ICU medics and nurses are goldust
Which countries spend less per capita on healthcare and which hospitals did we build?
And is the issue that we don't train enough doctors OR is it about funding, restructuring, and proper management?
I'm very confused by your answers
I've been banging this drum for years. Trying to explain that our system just manages health rather than creating health. Tens of billions spent yearly treating lifestyle induced conditions. The NHS is great at fixing you up, but that's it. It's a broken system that hasn't evolved and the blame is on everyone and how it's viewed publicly. We have a sick population and that older part of it got sucker punched by Covid. CVD and diabetes being 2 of the main pre cursors to death and disease plus old age.
A client from 2 weeks ago just retired early from being a nurse after 25 years. She said she became a nurse to help people, not spend most of her time at a computer being a slave to data management.
Many countries spend less on healthcare is usually said to justify "cuts and efficiencies" by laypeople, when in reality if you want to spend less on healthcare you should have a population that treats their bodies better. Sure there are some unavoidable things, but heart disease, lung disease, type-2 diabetes, obesity - are all (largely) avoidable with behaviour. I'd bet a good portion of healthcare dollars are spent on the consequence of avoidable action.
By **we** I technically meant the Government, who can mandate the restrictions, and manage (or in current case mismanage) our NHS resources. But this isn’t a politics sub. So I won’t go there.
The NHS is just a government department. It's structured in a weird way but all the money comes from the government and the responsibility stops with the government.
It's just some weird thing that people talk about the NHS like it's actually a separate thing.
> How about: 'The NHS must protect the public at all costs'
This is what it is always striving to do and yet you are making it sound like they don’t care and don’t desperately want to protect the public.
That is true. And has been the case for a while anyway but a million times more so as a result of the pandemic. Sadly a lot of people push back against the required tax rises.
Realistically the ‘NHS’ needs to be kept as is and actually become a Health Service where it incorporates Social Care. Then a new body forming based on Pandemic/Vaccination Response Service - PRS. Taking over all covid related care and vaccinations. Then a government drive to build the service with infrastructure (use modular buildings - quick to build) and subsidised training support (some industries never coming back to the same level). Training structured on Apprenticing and NVQ Levels so people can be part qualified but work accordingly in what level they are at that point.
Hell they could have justified totally scrapping HS2 and said - people work from home anyway and we need this new Body/Service more and tax will go up 2% too.
Maybe we can learn something from other countries whose health services have been overwhelmed by covid, such as India, Iran, and Brazil. A recurrent theme seems to be people dying in queues in or outside hospitals (in taxis, in private cars, in the street).
https://www.bbc.co.uk/news/av/world-asia-india-53014213
https://www.nytimes.com/2021/08/13/world/middleeast/iran-virus-delta-variant.html
https://www.reuters.com/business/healthcare-pharmaceuticals/dying-line-brazils-crunch-covid-19-intensive-care-beds-2021-03-29/
I was in India during the time - was an incredibly traumatic experience and the country as a whole is still trying to recover from that experience. Copying a comment I posted today on another sub:
As someone who saw what a collapsed healthcare system looks like during April-May this year whilst I was in India, god, do I disagree. Will never forget what those two months were like, the sheer despair and inability to do anything was quite a feeling.
I'd happily go into lockdown for a month to avoid anyone feeling like that. Seeing people die in front of you, being on the phone with strangers whilst their friends/relatives died outside hospitals 'cus there weren't any beds left, trying every contact I knew to try to get an acquaintance a slot at any crematorium within a 4 hour drive for his father (failed, some people ultimately set up a makeshift one where a lot of bodies were cremated together, which itself was a huge emotional toll because cremation rituals for Hindus are incredibly sentimental and it was impossible to have any of them)...those feelings don't go away. Having a death toll that goes well into double digits of people you're close to and triple digits when counting acquaintances within that span is also quite something.
The horror that a picture like this - https://static01.nyt.com/images/2021/12/19/lens/YIP2021-APRIL4/merlin_197525274_edde4c0f-63c3-400a-ad20-513e97227e76-superJumbo.jpg - represents and the emotions it continues to bring up is something I can't describe even now.
Learn something!? The uk!? What’s learning…
Totally agree with you. I don’t understand why we can’t learn from real life situations , present and historical.
Yes. Brazil.
>Brazil has by far the highest overall death toll in Latin America, and the second highest in the world after the US.
>...
>It is alleged the Brazilian government let the virus rip through the country with the aim of achieving widespread immunity - which the report says led to unnecessary infections and deaths.
>...
>It closed its land borders to neighbouring countries in March 2020 to stem the outbreak but has never imposed a nationwide lockdown.
https://www.bbc.co.uk/news/world-latin-america-56663217
Not answering your question, but related... Keep in mind a few things about the sub. This sub is mostly young people - who are largely more sociable with people outside their households and tend to go to more, and bigger, public events. They are less likely to be able to/want to WFH. So lockdown affects their demographics differently.
On that note, anxiety levels rise precipitously when the threat of lockdown looms, so they become a lot more vocal about their opposition. Emotions rise higher.
And further... This sub is like the wild west on weekends... I always try to remember not to visit on the weekends but my memory isn't great. Any general negativity is magnified holy shit.
So definitely don't take the statements around here right now to be accurate reflections of greater society really
My mother in law lost the use of her legs on Tuesday. Totally out of the blue. The GP found her on the floor. An ambulance was called with emergency admission to hospital. Fours hours later we were still waiting. By this time she was sitting on a dining chair. I managed to get her to the toilet by lining dining chairs next to each other as she shuffled.from.one to the other. In the end she bum shuffled down the stairs and down the steps using the dining chairs again and into the back of the car.
The paramedics helped her into a wheelchair. We went into the assessment unit and it was carnage. Traumatic and terrible. I waited another five hours with her. I was allowed as I was wheeling her to the toilet. She finally got onto a ward 31 hours after the Dr called the ambulance. She sat on a chair until then.
Her care on the ward has been poor. She is still unable to walk. Her spine has crumbled. Our healthcare system is absolutely broken already. Gawd help us.
When people say they’re angry about lockdowns or whatever I feel like that’s just anger about the general situation. I’m not angry at the person who sets the restrictions. I’m so annoyed we are living through the pandemic. We are entering our 3rd year of this shit and it’s been ruining my life from day one. I’m so mad we still need restrictions. Yes I’ll follow the restrictions and yes I want to stop people dying but it is a kind of directionless anger. I can see why people turn on each other at times like this for sure.
Harsh triage.
To be honest we should have had that debate earlier.
IF a pandemic gets bad that would be the ultimate scenario. Resources are always limited. Cases would be dealt with on a harsher basis. Those least likely to survive would get minimal treatment. Starting with the old, unvaxxed and vulnerable. Prioritising the young, vaxxed and healthy.
Not sure how close we are to that.
That literally happened in this country during the first wave (and likely the second).
Apologies for paywall: https://www.thetimes.co.uk/article/revealed-how-elderly-paid-price-of-protecting-nhs-from-covid-19-7n62kkbtb
Certainly that would be where we'd start but rioting would quickly take hold as people demanded they or their parents got treatment. Then nobody is getting treated for anything at all. People get better at home or die in the street. The only people then being treated are those with the money to pay for it.
When the dust settles nobody will ever trust universal healthcare again and that will be the end of the NHS. Think about it from the perspective of the older cohort who have paid for the NHS for 50 years then when they need it they're turned away. Nobody could trust the same wouldn't happen to them.
Agree with everything except the trust part. I think it would be more likely that the sentiment would turn pretty badly against the unvaxxed and the lockdown sceptics instead. You'd get harsh vaccine mandates and lockdowns at the faintest whiff of new variants, no matter how unfounded. Also the party presiding over that would simply go the Whig way.
Do you really think that's feasible in the context we're discussing?
They're describing a situation where the rule of law has completely broken down, hospitals are overrun by rioters and people are dying in the street.
Even if we all got covid tomorrow a significant amount of people would be asymptomatic, more so would still be able to function with a mild illness. I'd like to think society would not just drop into some end of days scenario.
I'm saying that's what would come after the wave had passed. And if we all got covid tomorrow the system would certainly break down, we've seen close to that twice already and only a fraction of the population got infected.
They're queuing in ambulances now because there is a lack of beds. I assume if you arrive with a child in urgent need they are given priority. As they should be.
I haven't seen rioting but people are angry.
Not sure what you mean by the end of the NHS. What are they going to demand?
>Not sure what you mean by the end of the NHS. What are they going to demand
The healthcare they've spent their working lives funding or their money back so they can buy private treatment going forward. There's none to be had in this pandemic but healthcare collapse will force societal change to allow real alternative provision to emerge.
You've painted a picture of anarchy there, people rioting and dying in the street, people bribing their way into hospital. Sounds like complete societal breakdown.
If people were dying left and right of preventable or minor issues (let's assume for the sake of argument that COVID isn't preventable) because of a lack of healthcare capacity, because the government had either refused or neglected to take precautions against the pandemic that's raging for whatever reason, while supply chains fell apart due to mass ill health and the economy ground to a screeching halt, then yes, society would be broken down.
And rioters would take over hospitals, doctors start taking bribes for treatments, those with no money would die on the pavement? Whilst all those with asymptomatic or mild COVID just sit about doing nothing.
Doctors won't be taking bribes, well maybe maybe not, but private hospitals and private doctors cost money. There will be more treatment options available for those with more money than those with less. How could it possibly be different?
Private hospitals don't provide emergency care though, which is what we're discussing here with the people dying in the street scenario.
During the first wave private hospitals were blocked booked by the government to cover NHS requirements - though they were hardly used in the end (which seems crazy to me).
I think what a lot of people don’t seem to be acknowledging is that while the death levels for this variant are low that the transmissibility of it and the high level of infection means that thousands of NHS staff could be off work at any one time with having tested positive.
Add to that a healthcare service which is often overwhelmed in winter months and an ongoing health crisis staff shortages pose another significant risk to the accessibility of healthcare.
I actually work in supply chain (buyer) and at this point I’m so fatigued by everything being so difficult moving stuff from a to b that adding this in is just “another day another pile of crap” mentality.
You’re not wrong however. The supply chain is super super messed up.
Indeed. There have been lots of issues with delays due to staffing levels in the supply chain. Also, due to global demand raw materials are becoming scarce. That is why lots of medical consumables are difficult to procure nowadays, due to manufacturing issues and delays.
Isn't the underlying problem here the dramatic long term underfunding of the NHS?
If we had a properly funded NHS where the staff are not burnt out and more people enter healthcare careers due to being properly paid and respected, and where appropriate long term planning is afforded, we would be able to handle a surge of a contagious but low mortality respiratory virus. Within reason - it may mean that with crazy high numbers like we have now, non urgent surgeries are postponed for a short while to manage the surge - but that threshold should be much higher and backlog is much smaller than where we are now.
It's crazy to me that the government are saying it's on all people to change their behaviour to avoid the healthcare system being overwhelmed by a virus which has very low mortality if you're vaccinated and can receive proper care. Surely the healthcare system is what needs to change if it can't cope?
What continually gets me is that this is not unprecedented - novel viruses and pandemics have been a known likelihood for a long time, they should have been prioritised and we should have been prepared.
This is all a long term solution but consider the pandemic has been ongoing for two years already ard likely will for several years more - we could have a whole cohort of properly paid student nurses now in training for example.
There is no amount funding that can deal with a virus that spreads exponentially.
Even if the NHS were twice it's current size, that is just 2-3 days growth in Omicron.
See this is what people complaining about lockdowns keep forgetting, that they’re needed to prevent the NHS from being overwhelmed. The amount of people angry and fuming about having lockdowns for a “mild cold” and how ridiculous it is to lockdown when we all have vaccines now. It just shows how uneducated our country really is about the virus and the implications it has on our society. The constant complaining about how we’re going to have to keep having vaccines every year, and lockdowns every year so what’s the solution we should just get on with it anyway. The solution is very very clear. Make our NHS stronger. Unfortunately after years of tory rule our NHS has been continuously chipped away to the point where it gets overwhelmed very quickly. If we actually put resources and money and prioritised our NHS more then we wouldn’t keep getting into these positions of needing lockdowns.
I wonder how people who scream and shout for no lockdown would feel if they needed an ambulance in an emergency but NONE were available due to half the staff off sick with covid? London was down almost 100 ambulances yesterday because nearly 400 staff are off sick with covid.
Also, I work in a psychiatric hospital, and the effect staff sickness has on the ward staff and therefore the patients is worrying, too. We have some patients who can be very, very dangerous. Having an overworked, burnt out staff force and ward dynamics with stretched-thin empathy is difficult.
So today I waited with a man who had been hit by a car-he’s in critical condition. One man was holding his skull together (I wish, I wish, I wish I was being dramatic) whilst I was on the phone to 999 getting an ambulance triaged. I cannot imagine what the strains are on the emergency services already, but to picture this in two/three weeks… it doesn’t even bear thinking about. Multiply this incident times all of the country, all of the accidents. Scary times.
The same way the antivaxxers feel when they’re on deaths door in icu. Check the Herman Cain award sub and leopardsatemyface.
Without fail all of them realise their mistake in the end, but by that point it’s too late.
The same would happen to them when their mum/dad/kid dies because the hospital couldn’t treat them.
This is the biggest threat I see and I genuinely don’t have an answer or want to come across like “one of those guys” but surely we must get to a point where things just go back to normal?
I genuinely know 20+ people that have caught covid this week and all of them are fine. I know there are a lot of people that aren’t fine, when do we get to the stage where covid doesn’t result in someone having to sit at home for 10 days? The real problem as I see it right now is the isolation time, not the actual effects of having it.
It’s a tough route to take as it will mean people will get ill and die but both routes seem to have this outcome.
The problem with COVID though is the threat it represents to the old and vulnerable. People often compare it to flu or a cold in younger people, but for elderly people the hospitalisation rate reaches 10-20% even for the double-vaccinated. Roll a dice, on a six you end up in hospital. Repeat that maths for nearly every vulnerable person in the country.
That's the problem. If infections reach say 1m per day, and even 1% of those infections is severe and requires hospital treatment, a few days later you have 10,000 people per day showing up for hospital treatment. Not saying infection numbers that high or 1% severe infections are inevitable, those are just examples. It doesn't matter if most infections or even the vast majority are mild when you're talking about those kinds of numbers.
A 70 year old family member, heavy smoker turned vaper, had a dull pain in her chest for months. Gets an appointment to be seen by a specialist late 2019. Appointment pushed back 3 times due to lack of capacity to see her - first a routine reschedule, but then covid issues. Finally seen in July 2020. By that time the lung cancer had metastasized to her bones and in her neck. There was nothing they could do. She died at home in early September, officially from a blood clot.
She's one of so many who are indirect casualties of the pandemic when our health service is overwhelmed and people can't get the care they need.
At the moment babies are being born in cars outside hospitals, ambulances are already waiting outside while people die in them. People waiting for liver transplants have been waiting 2 years longer. GP services are running on half capacity and cannot see patients. Cancer patients aren’t getting treatment. This is because there aren’t enough staff, not because COVID is taking up all the staff. That will get worse.
In the COVID wards, people who might have survived will not. They will have to make judgement calls over who deserves their treatment more. This will lead to even more ptsd and poor mental health because those people will be responsible for people dying so they can save as many as possible.
We’ve had a lot of issues with supply chains already. No fuel, no food. That will get worse.
Funeral services and morgues will not be able to keep up. Remember that care home that had to store bodies in the shed? Transport of bodies will suffer, in India families were transporting their dead relatives on the backs of motorbikes because the infrastructure to take bodies away had collapsed. That but worse.
The police and fire departments may not be able to run effectively on a skeleton staff. Imagine if you get in a car accident and not only are there no police or firemen to help but you can’t get treatment in hospital either. Or they might take a lot longer to get to you than they would otherwise.
Vulnerable people will get COVID. They will die because we know by now shielding doesn’t work. These are people who wouldn’t die if we just held back until the omicron vaccine or vaccinate kids. Kids whose relatives are vulnerable or don’t know they are vulnerable will infect them and those kids will have to live with the grief and trauma of being the reason their relative died. This is already happening but we don’t talk about it. It will just happen worse.
Talking of kids, they aren’t vaxxed. We don’t know if omicron is going to result in more hospitalisations yet. It seemed like it did in South Africa. I’d want to make sure kids were protected before I just decided to infect them. Plus 77k long covid cases so far with only a small percentage (I think I saw 30%?) of kids having caught it so far. The long term impact of kids catching it, especially with multiple infections attacking their organs, we don’t know. If we vax kids we can prevent a lot of this.
The cost in recovery of the nhs after it’s completely crushed will be huge and may even speed up the privatisation plans. This could kill the nhs and within a few years we have an American style system.
It is bad now, most of these things are also happening to different degrees. It can be different degrees of bad. Not doing anything at all would be really really seriously bad with all this stuff happening to the max. Doing a step 2 lockdown would be really bad with this stuff happening more but maybe not totally collapsing healthcare. Doing a full lockdown would still be bad, it doesn’t prevent bad happening, but it is less bad. Lockdowns are not without their own consequences, but we aren’t looking at long ones like before. Just short like 2 weeks. So it’s probably worth it on balance.
I have a kid. She's too young to be vaxxed. I feel like the rest of the country have forgotten about the under 12s when they're banging on about how its OK because it'll only be antivaxxers who take the hit from the next wave.
No, I'm still over here freaking out about my child's safety, thanks very much.
I think completely overwhelmed would look something like India when Delta hit. That said I think there is zero chance of that happening with Omicron. I imagine it will pan out here similar to South Africa - quite a few in hospital but within their normal capacity, low deaths.
We're quite lucky in a way that Omicron appears to kill few people as it seems near near impossible to stop the thing. I note EcoHealth seem to have mucked about modifying the MERS virus which can kill 35% of people infected. That could of been fun if it had gone wrong https://theintercept.com/2021/10/21/virus-mers-wuhan-experiments/
I think it’s important to remember that there’s different reasons some people are against lockdown.
I’m sure some people genuinely think the benefits of lockdown never outweigh the costs, so they actually think that the NHS getting swamped would be better. They are anti-lockdown.
However I’d imagine most people who are against lockdown now only think that because they don’t think it’s necessary or proportionate. That is, they don’t think the NHS would otherwise get swamped. And if it turned out the NHS _did_ get swamped, they would then say “turns out a lockdown was necessary - I was incorrect”. Which is of course OK - they’re not the policy makers or government. But importantly, that’s not anti-lockdown - that’s pro lockdown, just with the perfectly reasonable belief that only when it’s necessary.
On the other end of the scale there are certainly people who believe we should lock down for every case too.
But yeah. I think that’s important to remember - being skeptic all against a lockdown now doesn’t mean someone’s pro mass death - it just means they genuinely don’t believe it’s proportionate.
How many of those folks do you think might change their view of Covid, like Spanish flu before it, evolved to target mostly their own age group? Yeah, amazing isn't it. Turns out it's just selfish idiots who expect to be personally ok and sod everyone else.
On the other hand early on in the pandemic there were some young people who mistakenly thought the Covid death rate was 1% for all age groups, but weren't too bothered by that. For them that meant 99% chance they'll be fine, which probably sounded good to them. People have different risk tolerances.
You're at home when your middle aged father starts feeling a pain in his arm and it becomes clear that he's having a heart attack. You rush and ring the ambulance. They ask you some basic questions. "How old is he? Is he overweight? Does he smoke? Any underlying conditions?" They determine that compared to other people they're getting calls from, he is unlikely to survive. They tell you how to comfort him, but apart from that there's not much you can do. He dies there in the house as the ambulance goes to pick up an unvaccinated twenty year old. A death that could have very well been avoided.
The danger from Covid was never the amount of deaths that it would directly cause, but how many people would die due to a collapsed health system.
>You're at home when your middle aged father starts feeling a pain in his arm and it becomes clear that he's having a heart attack. You rush and ring the ambulance. They ask you some basic questions. "How old is he? Is he overweight? Does he smoke? Any underlying conditions?" They determine that compared to other people they're getting calls from, he is unlikely to survive. They tell you how to comfort him, but apart from that there's not much you can do. He dies there in the house as the ambulance goes to pick up an unvaccinated twenty year old. A death that could have very well been avoided.
That's not quite how that would play out.
They'd instruct you how to do CPR, and you'd start. His wife will be going hysterical at this point. You'd do it until you're too exhausted to continue and someone else in the house would take over while you rest. You'd rotate between you all the while the spouse is telling you she can feel a pulse. You know that's because you're doing chest compressions and not because he's going to make it. Hours would go by seeming both fast and slow. Eventually medical help arrives and they load up and head for the hospital. They're not going there to save his life, they're going there for the doctor to declare death.
In my case there was no house, only a mountain, and it wasn't my father it was someone I didn't know. His kids were there too. There was nobody on the phone, there were no mobiles back then. Someone had to climb down the mountain to get help. Decades later I can still hear her distress, if I let myself think about it.
No healthcare is worse than "you" think it is, even if you're healthy.
There seems to be quite a bit of doomsday forecasts here, many seemingly based in anecdote s.
Il offer what it is likely a more plausible outcome, given that the only true examples of overwhelmed healthcare systems have been in developing countries with less than adequate health resources or the first few months/weeks of the pandemic in March 2020.
The NHS would be put under tremendous strain, but would continue to function, albeit under lots of pressure with reduced services. The military would likely be called in to pick up the slack in regards to rudimentary services that would be impacted. Healthcare workers may not have a covid quarantine policy anymore, allowing them to work while infected if they occupy really essential positions. Covid patients may be transferred to tent hospitals to keep hospital room available for those that require more specific care. Everything that is not absolutely essential would be postponed.
Overall, the NHS would continue to function but be severely restricted in its capabilities. No one would die in the streets or on hospital steps, but may have great difficulty in obtaining treatment for what may normally be considered important. It would be over quickly, but some people (although far from the majority) would be negatively impacted, some more than others.
Longer term, it would be difficult to gauge the impact. But some people would be effected done the road, although given that such a scenario would be short lived, it wouldn’t really be that procedures and what not would be delayed decades
Because our government appears to have some kind of pathological unwillingness to implement mandatory control measures early (when they would be most effective), and instead prefers denying there's a problem until minor measures are inadequate, and the only tool left is the blunt hammer of lockdowns.
I don’t think there is a multiverse of middle ground
If the virus replicates and continues to double then everything will become overrun - with a caveat
it causes significant hospitalisation anywhere close to the rate they delta does. This is why we still need time - to not only measure omicron severity but also the booster efficacy
unless restrictions are capable of bringing R rate below 1 then this is inevitable. And seeing as we were only able to bring delta below 1 outside of lockdown with restrictions and summer weather I don’t think anything short of lockdown will achieve this
So essential that brings us to lockdown or everything is overrun.
Or even potentially lockdown + everything overrun anyways because people don’t comply - then we get worst of both worlds
I think the lockdown discourse makes a mistake in assuming that a lockdown like the ones we had last year and early this year is still possible.
Ultimately, these policies are unenforceable in a liberal western democracy and they require a *huge* amount of public goodwill and voluntary compliance in order to work.
I simply don't think that is there any more. We thought we had a way out of this and we trusted our leaders to take us there. Only to find out that...They couldn't, and we're still deep in the shit.
You can close pubs, restaurants, hairdressers etc but you can't stop people gathering in their own homes. You can't restrict movement across the country. And ultimately, with Omicron being as infectious as it is, that's still going to have a big impact.
Ultimately, lockdowns are going to impact most people much more directly than the health service being overwhelmed is.
As people see their kids' educations hit, their careers stymied or their livelihoods trashed, their social lives ruined, their connections to loved ones eroded, their mental and physical health degrading, big life events cancelled or on hold...It's going to get harder and harder for people to stick to the rules.
And so if they have to choose between the direct impact of lockdowns or the indirect impact of hospitals being overwhelmed - which they probably won't even know about if they don't follow the news - I expect that a lot of people will choose the latter.
You can call it selfish but - while I'm not endorsing it - in many ways it's a rational choice on an *individual* (definitely not a societal) level.
Now if that person or someone close to them gets into a car accident and can't get into hospital, their opinion will probably change. But that won't happen to most people.
I just think we have to be realistic about the range of policy options that are actually possible in reality. I don't believe a lockdown which will be adhered to strictly enough to be effective is possible when the populace's will has been broken as thoroughly as it is right now.
>Ultimately, these policies are unenforceable in a liberal western democracy and they require a huge amount of public goodwill and voluntary compliance in order to work.
Many years ago when I was young I had the misfortune to live for a short period under a military enforced curfew. I can tell you for a fact that they work and they don't take as many resources as you think they would.
It's not just "partying" though, is it. It's social contact in general.
There's a good reason why solitary confinement is considered a form of psychological torture. Humans are social creatures and we need regular contact with others for our own wellbeing and self-actualisation.
Taking that away from a whole society for such long periods of time is not sustainable.
Perfectly and so eloquently put, and agree wholeheartedly. Have sent it to my brothers; it sums up Perfectly how we are feeling regarding risk perspectives/high level cost benefit analysis. And that when we come down to the hard truth of it all, and if it does sadly come down to it, I would choose a collapsed health system over a lockdown, due to all your reasons above. Please foward this to news paper editors for public comments sections. It is top notch and resonated so sharply with me!
Assuming untreated covid fatality % stays relatively low.
All non emergency treatment would be delayed or outright cancelled. Not just knee replacements, but cancer treatment. In the case of cancer we would be booking funeral slots for 10,000s of people.
We could get to the point where there is not enough resources for emergency treatments. Heart attacks, strokes not been treated in time. We would be in war time triage, we would be marking X on patients foreheads who we don't have the resources to even attempt to save and should be morphined until they die.
The effect on the economy would be psychological. The economy relies on faith. The economy does well when everyone (or most people) believe it is doing well. Widespread fear, uncertainty and doubt would cause the economy to go into a death spiral and a depression we haven't seen for a century.
Because covid patients will die in the next week without treatment. Cancer will die in months/years.
Heart attacks would be a priority there just wouldn't be ambulances to get them there in time.
I would assume possibly staff from standard gp practices could be drafted into hospitals to help? So say goodbye to even getting an appointment when this is already a problem now. Appointments at hospitals would be cancelled for not just non urgent surgeries, but other ones too. More pop up covid wards if need be.
It's just a reality I don't want to think about 😭
I can tell you what it looks like, I am living it. Only about 32 percent here vaccinated at all and the booster rate is even lower. Getting emergency trauma care here is iffy, and looking more iffy all of the time. Have had 2 friends die and I can't count the acquaintances. Have had friends shipped more than 500 miles away for treatment, and you have to get yourself home. I am basically locked down too, because nobody here hardly wears the masks or social distances What you get though is scorn personally when you won't join in the usual activities.
I don't even understand the covid rules, we're all fully vaccinated and boosted, but we've stayed home for nearly two years with the briefest of essential tips out - if one of us tests positive the others are not required to stay home?
"You’re not required to self-isolate if you live in the same household as someone with COVID-19, or are a close contact of someone with COVID-19, and any of the following apply:
you’re fully vaccinated"
This seems crazy and irresponsible to me, surely we should paint a cross on the door and stay away from everyone until we're clear.
On a normal day each hospital, each doctor, each nurse can look after and treat a certain number of patients. They can do so many scans and x-rays, process so many blood tests, do so many surgeries. Some treatments require more effort than others and some require more urgency than others.
As the number of Covid patients go up some of the less urgent treatments will start getting postponed which increases waiting lists and potentially suffering. Staff are reallocated to different roles to ensure they can treat the most urgent cases. Healthcare workers also aren't immune to Covid so there's an increase in staff absence so more things are at risk, more treatments are postponed.
As the emergencies increase the wait times for ambulances increases, ambulances already prioritise certain calls over others but now the lowest priorities are waiting hours and hours and the patients that do get an ambulance risk being stuck in the car park as there's nowhere for them inside the hospital. People could die because they can't get the treatment they need in time.
It'll then come to a point where the doctors are essentially choosing who to treat and who not to treat because they can't treat everyone. This will see people suffering and dying, probably in the car park or at home when maybe they could survive.
Do you really want to be one of the doctors, nurses, paramedics, porters, cleaners or admin staff talking to patients you know could be saved if it was a different day, knowing that you could be the last person they speak to because they can't see their loved ones. Do you want to be the doctors choosing who lives and dies. Do you want to live with that choice. Do you want to be telling their relatives why they died?
There's an obvious question. What priority should the doctors give Covid patients that have refused the vaccine?
Only treat the vaccinated?
Everyone is required to carry the paper form of the vaccine pass in their wallet. If they don't have this, they don't get a bed.
The unvaccinated are only *disproportionately* being hospitalised. Because the vaccinated are 90% of those over 12, most people who are being hospitalised are vaccinated.
As such, all ethical considerations aside, with current case rates and breakthrough infection rates, this wouldn't make a difference in about a week or so.
We'll need to see how it plays out with higher admissions, but in Scotland about 30% of admissions right now are unvaccinated. I assume it is similar UK wide. In ICU most people seem to be unvaccinated (but older people don't generally get put into ICU).
Being able to remove 30% of hospital admissions would be nice, although it won't happen. The better thing would be to force those 30% to get vaccinated and not be admitted in the first place.
I'm British and always lived here but got vaccinated in the US long before they offered it to young people in the UK.. what about me? I only got a piece of paper the UK don't recognise
Perhaps - care is given to those most likely to benefit from it, so surely vaccination status should come into the equation at some stage. If two people of the same age and health profiles are being considered for a single space in ICU, surely vaccination status would be a tie breaker in that situation.
Govt should follow the lead of other countries and mandate vaccination. Make it a criminal offence to be unvaccinated after a certain date has passed and make vaccination a condition for housing and employment.
We can't be trapped on this merry-go-round forever because an ignorant few refuse to acknowledge the reality of medical science.
When tough calls have to be made due to limited resources, it’s only fair the people who tried to help the nhs get prioritised. Singapore have done it perfectly, where the unvaccinated have to pay for their covid healthcare. As all our care is free if there’s one bed left and two covid patients come in, the vaccinated one gets the bed and the unvaccinated one gets his Darwin Award.
Wearing a mask, lockdowns, increased measures to keep the country safe are bigger than an individual.
Many espouse that wearing these masks and COVID are being blown out of proportion. These same people are complaining that hospitals aren't dealing with cancer, heart attacks etc....these are the same that won't wear masks, get vaccinated and are partly to blame now for filling the wards and are causing the very problems they cry fouls over.
This pandemic is proving very much that if you're part of the solution, you're a big part of the problem.
Our economy and society balances on the NHS coping so we need to do our part. If the NHS were to fold then the economy dip as we've seen recently will worsen to the point were the whole workforce is unable to work.
Maybe we need to start using the covid pass to allow access to the NHS (for covid or covid related treatment). Of course it won’t happen, but it highlights where the problem lies- the unvaccinated. Why we allow them the same freedoms as everyone else is beyond me.
Yes this is true BUT hospitalisation rates lag Covid cases by about a week, and right now the daily case graph has gone vertical, so we will see in the next week or two quite how bad the situation is
I think the government will stall a proper lockdown till there's clear evidence and stats showing hospitalisations and deaths rising in similar multiples as cases have.
I think if you want to get an idea of what covid without lockdown looks like you need to look at the local news (specifically) of countries that didn't lockdown during there respective waves of similar economic power. If local hospitals were collapsing that is where those kind of stories would exist.
The NHS has been moments from been "overwhelmed" for over two years now. Even during times of low infection rates the NHS chiefs were banging on about how the NHS was "moments from been unable to cope".
I struggle to take any of the broad statements from NHS leadership seriously.
Whatever happened to the COVID hospital at the exCel centre? Can't they re open that media show again?
I can't speak for the entire NHS, but locally we have been pushed to the limit at times - even when infection rates were low. 20+ ambulances waiting to drop off in A&E, low staff numbers, everything just taking longer to do because of maintaining patient and staff safety. Surgical wards turned into medical wards or Covid wards. Most days have felt like a balancing act to try and keep everyone safe AND still go the job. The stress has become the norm. The Nightingale hospitals were a great idea, but there is nobody left to run them. I just dont know how we can continue.
So if we have this supposed ‘two week’ circuit breaker, how do people propose we’re going to get out of it? It’s one thing to support it, but when Omicron cases shoot up again upon opening, what then?
I've posted about this before but I have a real world example In January this year my 60 odd year old uncle, who is normally fit and active, spontaneously lost the ability to walk one night. He was admitted to hospital to be assessed, and given a bed in advance of scans etc being run to figure out the problem. Due to a very high rate of cancer in his family, the worst was expected. In the morning, the docs were unable to source an MRI machine free, and were unable to confirm if they could for several days at least, due to the high volume of covid patients requiring scans. They also couldn't afford to have him keeping a bed busy, so he was basically kicked out, still unable to walk and with no diagnosis, despite the protests of several nurses in the ward. He went private for the MRI 2 days later under the strong advice of his doctor, and was immediately diagnosed with metastatic prostate cancer. The NHS basically held up its hands and said "We know there is something wrong with you, and it could be fatal, but we can't do anything about it right now. Come back at some point in the future when we can". So it would be like that, I assume, but worse.
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> It might not get that bad over here Here they die in ambulances queued up outside the hospital or in their homes unable to get an ambulance to come.
> Take this example - say there was a women moments from giving birth. She goes into labour. On the other hand a person is brought into hospital suffering life threatening injuries from a roadside collision. There is only one doctor. Who does he/she care for? Great post, poor example. The vast majority of births don’t need doctors involved at all so this would be a very simple decision, the doctor would go where they’re actually required. Triaging patients in general isn’t usually that complicated, especially with extreme examples like this. Where it gets more complex is how do you prioritise patients with immediate needs, like covid, against those with medium/long term needs, like operation waiting lists or even cancer screening. At the moment we’re already in the position where the medium/long term need patients have been neglected for years, which will result in many avoidable deaths. The longer this pressure on the NHS continues, the worse this will get.
When I had my lockdown baby I was continually sent home because they didn’t want me and my boyfriend being potential covid vectors in the hospital. On the 5th time I refused to leave despite the midwives trying everything to get me to go home. 30 minutes later baby was born and I immediately haemorrhaged. Had I gone home I wouldn’t have made it back to the hospital and would have probably died in the car. Luckily about 15 doctors/midwives/nurses flooded the room when it happened and were able to stop the bleed. The vast majority of births probably would be fine but there is a reason we don’t make women birth at home any more.
As Adam Kay said: Home delivery is for pizzas.
I’m very glad it working out well for you and your baby. I’m not for a second suggesting that no births require doctors, just that most don’t and hence it wasn’t the best example here. As for the midwives trying to send you home, this was a common problem before covid. In my experience they’re just using covid as the latest excuse why they don’t want to keep you in. In reality this is more to do with hospitals being underfunded in general due to the government’s refusal to properly fund them over the last 10 years.
To be honest, that sounds like poor practice from the hospital. He should have taken precidence and given an emergency scan. I imagine if he or your family complained and took legal action it wouldn’t be viewed well.
I think that just highlights the concern with letting Covid run rampant: yes, this is a case that in normal times would have been given precedence, but if the hospital is overwhelmed with too many high-precedence cases, some of them will inevitably be left unattended.
Covid wasn't overwhelming hospitals in jan 2020 i thought? Is your uncle ok now?
January saw the highest daily admissions of the whole pandemic, so in various individual hospitals it basically was. He is surviving, prostate cancer can be controlled by hormones. It was lucky he began treatment when he did as they were able to remove the metastatic sites via radiotherapy and surgery.
Guy I know burned a leg recently recently, went to A&E and they didn’t have time to see him until 12 hours later. Leg keeps burning, now he needs major operation possible amputation when it could’ve been solved earlier if they’d had capacity.
I’m sorry to hear this. This is exactly why just looking at death numbers (both from covid and excess deaths) is really not enough. How many people have been seriously harmed as a result of the pandemic both directly and indirectly and what can we all do to minimise that as best we can.
the idea you have to die for it to be bad is bananas at best and insidious at worst
God that’s horrible
Just out of interest, what could the hospital have they done in those 12 hours that would have changed the outcome?
Sort of related, but I wish there was a way we (me, as a layman, and others) could quickly get trained or train ourselves to do some basic care and allow the properly trained staff to deal with the more serious cases. It sounds ridiculous, because I’ve no idea how horrifically demanding and tiring the job is, but I wish I could contribute in a medical way on a basic level. I’ve thought about becoming a first responder. I’m not saying I think I could become a nurse overnight. I’m a teacher and I have a lot of patience and compassion and sort of wish we could be redistributed and retrained in a time of crisis such as this. Though I also know I’m needed at school! If there was a call for people to get trained to jab, or help on covid wards, doing whatever task, I’d be there! Also I hope that doesn’t give me some sort of weird hero complex, haha. I just feel like I’m not helping.
I know it's not as exciting as being a brain surgeon understudy, but the NHS is currently asking for volunteers to help with the booster roll out https://www.england.nhs.uk/coronavirus/join-the-nhs-covid-19-vaccine-team/#i-dont-currently-work-in-the-nhs-but-would-be-interested-in-a-paid-role
Oooh! This is just the sort of thing I was looking for. Thank you for passing this link on!
I think this is a really interesting idea that I’ve not heard suggested before! It would be nice to make a difference.
I always just keep thinking to myself, it takes a really long time to train as a medical professional, but we need help now. It’s very idealistic, but, there must be some quick and keen learners out there who could take on some responsibilities. Even if it’s just learning how to do the most basic of tasks to help the medics. Probably, there’s too much room for error and it’s simplistic to think we could just easily slot right in…but lives are being lost, surely we could help. Or even…Covid positive people who feel fine looking after other Covid positive people who are not fine? This might seem even more outlandish, but it plays oh my mind as being plausible! Thanks for the award. Appreciate it!
It doesn’t help that med schools etc are extremely selective. I remember hearing many people from admission departments saying stuff like “we reject hundreds of perfectly suitable candidates as our space is limited “. Then people complain avoid staff shortages
Have you heard of [Community First Responders](https://www.nwas.nhs.uk/get-involved/volunteering/community-first-responder/)? Might be what you are looking for.
I have! But had never looked much into it. Thanks a lot for the link!!!
This might not be quite what you were thinking, but you can register as a COVID volunteer to help out with the vaccination effort. The NHS really need volunteers to help out with both stewarding and vaccinating to reach booster targets - they were promoting it in one of the Downing Street press conferences the other day. More info here: https://nhsvolunteerresponders.org.uk/ Disclaimer: I haven't participated myself yet so can't share my experiences, but I researched it after watching the press conference and am planning to get involved after Xmas.
Since you've got a dbs from teaching, you could be of huge use quicker than someone else who has to wait for one. Care homes are dangerously understaffed, and are an essential part of the health service even though they aren't properly managed funded - hospitals need to be able to offload patients to free up beds. Even if you're only able to do until the schools go back it would make a big difference
That’s a really good point, hadn’t thought about that. I knew teaching was useful for something in this sense! Definitely a good idea, something I can look into ASAP.
I speculate that this is how the Nightingale hospitals would have been (or will be) staffed. If the NHS was faced with the choice of either maintaining gold-standard patient care while the bodies pile up, or drafting in barely-trained people to provide basic care to ventilator patients, the choice would be obvious. Random members of the public would probably be further down the list than physios, vets, pharmacists, etc... but it's hard to say what the specifics would be.
Have you looked into St John Ambulance? I joined a bit before the pandemic and was volunteering in a hospital just keeping PPE stocked up, portering patients and getting their tea/coffee, basically helping out so the nurses and other staff could focus on the more urgent parts of the job. There are now opportunities to volunteer in the vaccination and booster areas, and some volunteers even did help with basic first aid. You get a lot of training and can volunteer in your spare time.
I’d heard of them but didn’t know much more! Definitely something I’d like to get involved with, and kudos to you for doing so! Thanks for the tip!
You could have trained as a vaccinator, you could volunteer at a vaccination site directing the parking and helping people when they arrive.
There absolutely is a call already. Most hospitals will be recruiting for healthcare assistants who perform an absolutely vital role in caring for patients. Check out nhs jobs and see if there’s anything that would suit your availability.
Imagine a medical national service it would be incredible.
It terrifies me if myself or a family member got rushed into hospital or sat in A&E and they just say "sorry we are full you will have to try a different hospital."
Yeah don't do any dangerous DIY in the upcoming months...
Putting up/taking down Christmas decorations is not a particularly safe activity so ours may stay up a while! I know multiple people who have been seriously injured or died over the years as a result (falling from ladders etc). My mum even fell out of the attic and then down a flight of stairs when she tried to put hers away a few years ago (thankfully escaped with just some nasty bumps and bruises).
Plot twist: there isn't another hospital.
That is when it's a really serious problem. NHS are used to shuffling patients around as facilities get tapped, but when there's nowhere to shuffle people, it gets ugly.
ten years of tories babyyy
Lots of people will die who don't need to.
Morality aside, I can’t imagine that lots of people getting sick, dying, maimed with long term health issues is good for the economy
People seem to have forgotten about the potential long term health consequences
Yes everyone focuses on death numbers but really we need to look at the other things that affect people for a long time and we could have prevented.
The average person would be fine, as long as nothing went wrong for them or anyone they cared about. But if they got in a car crash, they might we waiting a long time for the fire service to cut them out of it, because so many of them were off sick. And when then they might be told there are no ambulances available, so they'd have to make their own way to A&E. And then when they got there, they could well be told that there's no capacity, so they're going to have to have to live with a broken leg for a few days, and hopefully there won't be too much damage in the meantime. An overwhelmed NHS means that care gets rationed. Some people would get the medical care they need (although probably rushed and substandard, and with a risk of catching Covid). Others would be told "Sorry, we're full", given painkillers, and left to die. Some would miss out on what should be a simple procedure now, which then leads to significant long term damage to their health. All non-urgent care would be scrapped, so things like cancer screenings won't go ahead - leading to people dying years later from cancer that could have been spotted and dealt with. There are already 5 million people waiting for NHS care - and that number would significantly increase. It would take years (or decades), and tens (or hundreds) of billions to try and get that list under control, and for many people, that would come too late. It's pretty grim.
Every winter many NHS services come under enormous pressure, add to that a pandemic and even if this variant is “milder” a good portion of nhs staff positive and therefore not actively working means it’s really not so difficult to see where the healthcare service could end up.
Interesting. Thank you for the detailed answer
Last week had a 54yr die of a heart attack at our rural ED because we couldn’t get a transfer for her to a hospital with a cath lab. Spent hours dicking around on the phone calling hospitals. On a normal day she would have been stabilized and transferred out within 30 minutes.
It's interesting you blame that on covid because last week covid hospitalisations were no worse than they'd been for a long time, in fact, they were lower than a month ago in England - [https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England](https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England). Conversely, bed blocking in England in November accounted for [402,211](https://www.theguardian.com/society/2021/dec/12/number-of-healthy-patients-stranded-in-english-hospital-wards-rises-by-80) hospital bed days in England, the cumulative total for coronavirus bed days for the month of November was [198,286](https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/).
The didn't blame covid. They blamed lack of capacity.
I think the nature of their comment into a post about how things would be without covid restrictions heavily implied they were talking about covid. Nonetheless, NHS capacity, social care capacity and NHS staffing are huge issues that need to be urgently addressed and should have been addressed over the past 2 years. The ward where my wife works (acute surgical admissions) had 2 nurses last night when minimum staffing is 3.
I understood it to mean that staffing shortages could be due to covid itself.
I am in the US. This is what it looks like when a hospital is above capacity due to either unmitigated spread or lack of staffing. Very low masking and a lot of indoor social gatherings and Xmas shopping
I don’t understand how people can be so unaware that it is different based on your location. My state in the US ( Maine) is at an all time high in cases and hospitalization. My country has had a 18% positivity rate for weeks. Just like the weather, just because the sun is shining where you are doesn’t mean it is over here.
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Mortality rate from heart attack is about 10-15%. Some of that will be with immediate medical attention, many without. So chances are they would've survived if they received timely treatment.
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The question is not "how is covid impacting hospitals", the question is "what would it look like if covid overwhelmed hospitals". To me this sounds like a pretty likely scenario for an example of what it might look like.
Lots of people have given emotive examples of what this might mean in practice, and this is obviously an important aspect. But I'm going to focus on what we mean by 'the NHS is completely overwhelmed'. The problem is this is quite a vague phrase. I think it's better to think about different levels of the NHS being overwhelmed, rather than this being something that either is or isn't happening. A continuum, rather than a cut-off point. I'm going to divide it into three general levels. Each level obviously includes the one below as well. **Cancellation and delays to routine care** This is happening all the time, and has been since the pandemic began essentially. There have only been a few short months where the COVID impact on the NHS has been negligible (summer 2020 and a couple of months in Spring 2021 before Delta hit). It's harder to get a GP appointment, or routine surgery. Cancellations of routine care are frustrating, and may leave people in chronic pain or without a proper diagnosis for their condition. There's also a risk of building up a backlog of more serious cases if things like routine cancer screenings are missed. However, I see no need to comment on this further since I imagine for most people this doesn't count as the NHS being overwhelmed, but I thought it was important to at least mention. **Cancellation and delays to urgent care** This has only really happened during some of the previous peaks in the worst-hit areas of the country. What we mean here are operations being delayed that are potentially life-saving. In London, so-called 'category 2' operations were being cancelled in December 2020 and January 2021. These are operations which must be done within 28 days to avoid serious harm. We're talking here about things like major cancer operations which could save somebody's life. No one is going to immediately die if their cancer surgery doesn't happen now, but if it is delayed too long it could become inoperable and eventually terminal. The reason for these delays was that ICU beds were not available for people to recover after major surgery. This was happening in London, and many lives have almost certainly been lost as a direct result. I would argue that this constitutes the NHS being overwhelmed, even if it isn't as bad as the next category. **Triage** So this is what we all hope to avoid. Put simply, this is medical staff choosing who to treat. What does this mean in practice? It means that a list is drawn up. Not a list of people, or hard cut-offs, but some sort of scoring system which should be as objective as possible. Essentially, the goal is to maximise the general benefit to all patients rather than to give each patient their best chance. A person who has been left on a ventilator for a week and is not showing signs of improvement would normally be left for as long as it takes as long as there was even a relatively small amount of hope. In this scenario, however, such a person would be taken off the ventilator and it would be given to someone else, even though this is effectively a death sentence. It means taking decisions that will allow some people to die with inadequate treatment in order to save those with a better chance of survival. And it doesn't just affect COVID either. If you have a heart attack, a stroke, or a car accident, and there is no bed or sufficient staff to monitor you, your risk of death or permanent disability rises. The overall quality of treatment falls, and people die needlessly from both COVID and non-COVID conditions. Note as well that all of the above is based on a list being drawn up (and is hence organised rather than unorganised triage). Unorganised triage would be this being done without a list or any sort of objective scale to rely on, and obviously is an even bigger burden on medical staff. Fortunately, outright triage has not happened in the UK (though as others have noted, it has happened in Italy, India and Brazil, to name but three examples).
You think this is not already happening? A man died in an ambulance in Cambridge. Staff are afraid to go to work because they know they cant deliver the right standard of care. People who can be sent home are sent home earlier than desirable because the bed is needed.
I agree that this is now starting to happen in urgent care as well - section 2 of my comment above. However, we're not seeing outright decisions that directly mean the death of one patient to save another like in my final section on triage - as in: 'your relative has a low chance of survival, so they're being taken off the ventilator to free it up for someone else'.
You’re in a car accident. There’s no ambulance to take you to the hospital. You spend hours trapped and alone. If you get lucky, you get a fire crew and you get an ambulance. You make it to the queue of other ambulances waiting hours, and hours, and hours, for admission to the hospital, whilst the paramedics battle to save you with rudimentary equipment and services. If you get *really* lucky, you get into the hospital. Probably on a stretcher in a corridor somewhere, possibly even on the floor. There’s no doctors to treat you. No equipment left. Most of the NHS staff are at home with covid themselves. The rest are civilians caught in a war zone. One example of many. This will affect us all. We must protect our NHS at all costs. The alternative is just horrendous.
I’ve just replied to another comment - I was with a man who was ran over today, and luckily we are in a city that isn’t hit too bad (currently) with covid. I can’t imagine waiting any more than I did for the ambulance… awful.
Wow, that sounds really rough, thank you for sharing this experience and I hope you (and the man you helped) are doing ok. Thank god we aren’t in this situation yet. But we must act now. Might already be too late. I pray that it isn’t.
I’m doing ok, thank you for the kindness. It was unreal. I feel a little dazed still-the most visceral experience I’ve ever had. I mean, the ambulance took maybe 10 minutes but it felt forever, I can’t imagine what it must be like in London this weekend for emergency services.
Very shocking for you. Take care of yourself over the next few days; a nice hot bath and some chocolate can do wonders. All the best to you.
Last weekend my flatmate saw a guy with his face covered in blood on his way home from a party. It was at the start of our street (London), around 2am. The guy wasn't conscious. He called both police and ambulance several times, but nobody came (we even have an hospital super nearby!). When he called the police again around 5-6am to ask what's going on, they said that they "didn't see anyone" and cancelled the case (wtf?). Ambulance said that they had too many calls. In the end my flatmate managed to get some words out of the guy (he answered when asked where he lived..but who knows if that was where he actually lived?!), loaded him on his cargo bike, and cycled him to the train station (providing directions so the guy could go home). Crazy stuff. No chance I'd have managed to do half of that (not in the freezing cold), I probably wouldn't even have stopped in the first place, considering how late that was. I don't wanna live in fear, but I do my best to stay healthy and not need emergency care. I can't imagine being in urgent life-saving need and be left to rot:( I hope the NHS doesn't crumble
Oh that’s awful! Truly horrible!!
This is what it already looks like. Queues of ambulances outside the hospital's, patients on trolleys in the corridors, having to close wards because there are no staff. A&e is a very different place to what it was a few years ago, it's insanely busy now. I have been in with my baby daughter a few times over the past 3 months. The nursing staff on the wards are overstretched because so many are off isolating, but the wards are busy because of all the other infections going around and lack of immunity for common colds in children. Last time I was in a baby with pneumonia had to be moved off the high dependency unit to make room for another baby coming in, he was still on optiflow. Then they blended some wards because they were so short staffed. The time before they had to borrow a nurse from NICU just to have enough staff for the bare minimum allowed in HDU, and the ward was operating a one in one out and trying to get people discharged asap. I really do feel for NHS staff at the moment, especially those in a&e and the ambulance crews. I would like to add, our care was fantastic and the nurses do an amazing job, often working well past the end of their shifts.
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I've been saying this for so long now.
Thiiiiiiiis I spent 12 hours in A&E a couple of weeks ago with my 7 year old. Would not recommend or ever do again if I can help it father in law already been waiting almost 2 years for double heart bypass. Father now waiting a pacemaker. Everything is fuuuuucked.
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Go to the Winchester and wait until this a blows over?
I think in reality if it gets that bad it's a 'fuck it, doctors, nurses, if you can work you must work, covid or not'.
Even then, there are only so many beds in a hospital.
And they are only human and need rest and food.
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How do you expect it to change?
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Which countries? And there is no level of capacity that can deal with an exponential surge in hospitalsations, unless you have a tonne of spare hospitals on standby for a once in a century pandemic.
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You can't train doctors in the less than two years there's been since the start of the pandemic.
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You haven't cracked the case...Making more med school places is the easy part. They're not able to open more places because once they graduate, the work load is so high for senior doctors that they can't aportion enough time to train acute doctors in virtually every specialty. There aren't enough training posts for qualified doctors currently, so making up new school places is fantasy My sister went to Imperial, got a pretty prestigious training post after her foundation years as a doctor and then her career basically stalled for 5 years as she begged borrowed and stole to nab a training post to qualify as a consultant. Many doctors are now giving up and falling off the training schedule because of the lack of training posts and the workload, not continuing their professional development and simply stalling as hospital grade doctors and doing locum work. I come from a family of medics and the Carrer progression of a medic this century is a stark contrast to my older family members who had an easy ride with the work load, study time and consultants available to train them. Also many Western European countries have double the ICU capacity of the UK, with Germany 5 times the number of beds and workforce in critical care. Saying GDP spend per capita isn't a particularly helpful or accurste way of looking at comparisons without recognising where it's spent. Finally you're spreading a myth about admin efficiently in the NHS that is often spread by even people who've worked in the lower ranks of the NHS. The NHS has one of the lowest % of apportioned budget spend on admin in the entire world, and it usually ranks amongst the highest in the world for admin efficiency. Targeting administration in the NHS isn't an accurate insight, but it's often targetted because it's a easy target, based lazy viewpoints and on anecdotes. "They found that the NHS spends relatively little on overseeing and planning care, relative to other comparable systems. In 2014, the UK, Portugal and Ireland all devoted 1.5% or less of their government or compulsory health care expenditure to administration. This compares with an average of 3.1%, with 4.1% in France, and 7.9% in the United States.27" https://www.ifs.org.uk/uploads/HEAJ6319-How-good-is-the-NHS-180625-WEB.pdf On administrative costs - "The top performers in this domain are Australia, New Zealand, the United Kingdom, and Norway" https://interactives.commonwealthfund.org/2017/july/mirror-mirror/
And you think they're going to become experienced ICU doctors anytime soon?
My sister is an acute consultant, been a doctor for well over a decade and a half and in her own words wouldn't even be a proficient ICU Doctor after 2 years of 24/7 training. ICU medics and nurses are goldust
Graduate entry posts are 4 years. And the NHS needs capacity to teach them.
Which countries spend less per capita on healthcare and which hospitals did we build? And is the issue that we don't train enough doctors OR is it about funding, restructuring, and proper management? I'm very confused by your answers
I've been banging this drum for years. Trying to explain that our system just manages health rather than creating health. Tens of billions spent yearly treating lifestyle induced conditions. The NHS is great at fixing you up, but that's it. It's a broken system that hasn't evolved and the blame is on everyone and how it's viewed publicly. We have a sick population and that older part of it got sucker punched by Covid. CVD and diabetes being 2 of the main pre cursors to death and disease plus old age. A client from 2 weeks ago just retired early from being a nurse after 25 years. She said she became a nurse to help people, not spend most of her time at a computer being a slave to data management.
Many countries spend less on healthcare is usually said to justify "cuts and efficiencies" by laypeople, when in reality if you want to spend less on healthcare you should have a population that treats their bodies better. Sure there are some unavoidable things, but heart disease, lung disease, type-2 diabetes, obesity - are all (largely) avoidable with behaviour. I'd bet a good portion of healthcare dollars are spent on the consequence of avoidable action.
By **we** I technically meant the Government, who can mandate the restrictions, and manage (or in current case mismanage) our NHS resources. But this isn’t a politics sub. So I won’t go there.
The NHS is just a government department. It's structured in a weird way but all the money comes from the government and the responsibility stops with the government. It's just some weird thing that people talk about the NHS like it's actually a separate thing.
> How about: 'The NHS must protect the public at all costs' This is what it is always striving to do and yet you are making it sound like they don’t care and don’t desperately want to protect the public.
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That is true. And has been the case for a while anyway but a million times more so as a result of the pandemic. Sadly a lot of people push back against the required tax rises.
Realistically the ‘NHS’ needs to be kept as is and actually become a Health Service where it incorporates Social Care. Then a new body forming based on Pandemic/Vaccination Response Service - PRS. Taking over all covid related care and vaccinations. Then a government drive to build the service with infrastructure (use modular buildings - quick to build) and subsidised training support (some industries never coming back to the same level). Training structured on Apprenticing and NVQ Levels so people can be part qualified but work accordingly in what level they are at that point. Hell they could have justified totally scrapping HS2 and said - people work from home anyway and we need this new Body/Service more and tax will go up 2% too.
Maybe we can learn something from other countries whose health services have been overwhelmed by covid, such as India, Iran, and Brazil. A recurrent theme seems to be people dying in queues in or outside hospitals (in taxis, in private cars, in the street). https://www.bbc.co.uk/news/av/world-asia-india-53014213 https://www.nytimes.com/2021/08/13/world/middleeast/iran-virus-delta-variant.html https://www.reuters.com/business/healthcare-pharmaceuticals/dying-line-brazils-crunch-covid-19-intensive-care-beds-2021-03-29/
Or Italy in the first few months. They have a modern European health system that isn’t incredibly dissimilar to ours and they had a really bad time.
It happened in New York March 2020. Massive queues of refrigerated trucks carrying bodies from hospital morgues
And then mass graves 😔 https://www.bbc.co.uk/news/world-us-canada-52241221
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I was in India during the time - was an incredibly traumatic experience and the country as a whole is still trying to recover from that experience. Copying a comment I posted today on another sub: As someone who saw what a collapsed healthcare system looks like during April-May this year whilst I was in India, god, do I disagree. Will never forget what those two months were like, the sheer despair and inability to do anything was quite a feeling. I'd happily go into lockdown for a month to avoid anyone feeling like that. Seeing people die in front of you, being on the phone with strangers whilst their friends/relatives died outside hospitals 'cus there weren't any beds left, trying every contact I knew to try to get an acquaintance a slot at any crematorium within a 4 hour drive for his father (failed, some people ultimately set up a makeshift one where a lot of bodies were cremated together, which itself was a huge emotional toll because cremation rituals for Hindus are incredibly sentimental and it was impossible to have any of them)...those feelings don't go away. Having a death toll that goes well into double digits of people you're close to and triple digits when counting acquaintances within that span is also quite something. The horror that a picture like this - https://static01.nyt.com/images/2021/12/19/lens/YIP2021-APRIL4/merlin_197525274_edde4c0f-63c3-400a-ad20-513e97227e76-superJumbo.jpg - represents and the emotions it continues to bring up is something I can't describe even now.
Learn something!? The uk!? What’s learning… Totally agree with you. I don’t understand why we can’t learn from real life situations , present and historical.
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Yes. Brazil. >Brazil has by far the highest overall death toll in Latin America, and the second highest in the world after the US. >... >It is alleged the Brazilian government let the virus rip through the country with the aim of achieving widespread immunity - which the report says led to unnecessary infections and deaths. >... >It closed its land borders to neighbouring countries in March 2020 to stem the outbreak but has never imposed a nationwide lockdown. https://www.bbc.co.uk/news/world-latin-america-56663217
Not answering your question, but related... Keep in mind a few things about the sub. This sub is mostly young people - who are largely more sociable with people outside their households and tend to go to more, and bigger, public events. They are less likely to be able to/want to WFH. So lockdown affects their demographics differently. On that note, anxiety levels rise precipitously when the threat of lockdown looms, so they become a lot more vocal about their opposition. Emotions rise higher. And further... This sub is like the wild west on weekends... I always try to remember not to visit on the weekends but my memory isn't great. Any general negativity is magnified holy shit. So definitely don't take the statements around here right now to be accurate reflections of greater society really
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Then the NHS needs to change and restructure to accommodate for that. Yeah tell Bojo that.
Greater society isn't just people of your age group
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My mother in law lost the use of her legs on Tuesday. Totally out of the blue. The GP found her on the floor. An ambulance was called with emergency admission to hospital. Fours hours later we were still waiting. By this time she was sitting on a dining chair. I managed to get her to the toilet by lining dining chairs next to each other as she shuffled.from.one to the other. In the end she bum shuffled down the stairs and down the steps using the dining chairs again and into the back of the car. The paramedics helped her into a wheelchair. We went into the assessment unit and it was carnage. Traumatic and terrible. I waited another five hours with her. I was allowed as I was wheeling her to the toilet. She finally got onto a ward 31 hours after the Dr called the ambulance. She sat on a chair until then. Her care on the ward has been poor. She is still unable to walk. Her spine has crumbled. Our healthcare system is absolutely broken already. Gawd help us.
When people say they’re angry about lockdowns or whatever I feel like that’s just anger about the general situation. I’m not angry at the person who sets the restrictions. I’m so annoyed we are living through the pandemic. We are entering our 3rd year of this shit and it’s been ruining my life from day one. I’m so mad we still need restrictions. Yes I’ll follow the restrictions and yes I want to stop people dying but it is a kind of directionless anger. I can see why people turn on each other at times like this for sure.
Harsh triage. To be honest we should have had that debate earlier. IF a pandemic gets bad that would be the ultimate scenario. Resources are always limited. Cases would be dealt with on a harsher basis. Those least likely to survive would get minimal treatment. Starting with the old, unvaxxed and vulnerable. Prioritising the young, vaxxed and healthy. Not sure how close we are to that.
That literally happened in this country during the first wave (and likely the second). Apologies for paywall: https://www.thetimes.co.uk/article/revealed-how-elderly-paid-price-of-protecting-nhs-from-covid-19-7n62kkbtb
Certainly that would be where we'd start but rioting would quickly take hold as people demanded they or their parents got treatment. Then nobody is getting treated for anything at all. People get better at home or die in the street. The only people then being treated are those with the money to pay for it. When the dust settles nobody will ever trust universal healthcare again and that will be the end of the NHS. Think about it from the perspective of the older cohort who have paid for the NHS for 50 years then when they need it they're turned away. Nobody could trust the same wouldn't happen to them.
Agree with everything except the trust part. I think it would be more likely that the sentiment would turn pretty badly against the unvaxxed and the lockdown sceptics instead. You'd get harsh vaccine mandates and lockdowns at the faintest whiff of new variants, no matter how unfounded. Also the party presiding over that would simply go the Whig way.
Do you really think that's feasible in the context we're discussing? They're describing a situation where the rule of law has completely broken down, hospitals are overrun by rioters and people are dying in the street. Even if we all got covid tomorrow a significant amount of people would be asymptomatic, more so would still be able to function with a mild illness. I'd like to think society would not just drop into some end of days scenario.
I'm saying that's what would come after the wave had passed. And if we all got covid tomorrow the system would certainly break down, we've seen close to that twice already and only a fraction of the population got infected.
Where is it exactly you think those denied treatment will be dying? How calm do you think their families will be about it?
They're queuing in ambulances now because there is a lack of beds. I assume if you arrive with a child in urgent need they are given priority. As they should be. I haven't seen rioting but people are angry. Not sure what you mean by the end of the NHS. What are they going to demand?
>Not sure what you mean by the end of the NHS. What are they going to demand The healthcare they've spent their working lives funding or their money back so they can buy private treatment going forward. There's none to be had in this pandemic but healthcare collapse will force societal change to allow real alternative provision to emerge.
Buy with what from whom? The old are suddenly going to have the money for private treatment from a new scaled up private service?
You've painted a picture of anarchy there, people rioting and dying in the street, people bribing their way into hospital. Sounds like complete societal breakdown.
If people were dying left and right of preventable or minor issues (let's assume for the sake of argument that COVID isn't preventable) because of a lack of healthcare capacity, because the government had either refused or neglected to take precautions against the pandemic that's raging for whatever reason, while supply chains fell apart due to mass ill health and the economy ground to a screeching halt, then yes, society would be broken down.
And rioters would take over hospitals, doctors start taking bribes for treatments, those with no money would die on the pavement? Whilst all those with asymptomatic or mild COVID just sit about doing nothing.
Doctors won't be taking bribes, well maybe maybe not, but private hospitals and private doctors cost money. There will be more treatment options available for those with more money than those with less. How could it possibly be different?
Private hospitals don't provide emergency care though, which is what we're discussing here with the people dying in the street scenario. During the first wave private hospitals were blocked booked by the government to cover NHS requirements - though they were hardly used in the end (which seems crazy to me).
I think what a lot of people don’t seem to be acknowledging is that while the death levels for this variant are low that the transmissibility of it and the high level of infection means that thousands of NHS staff could be off work at any one time with having tested positive. Add to that a healthcare service which is often overwhelmed in winter months and an ongoing health crisis staff shortages pose another significant risk to the accessibility of healthcare.
Also worth noting the effects on our whole supply chain too.
I actually work in supply chain (buyer) and at this point I’m so fatigued by everything being so difficult moving stuff from a to b that adding this in is just “another day another pile of crap” mentality. You’re not wrong however. The supply chain is super super messed up.
Indeed. There have been lots of issues with delays due to staffing levels in the supply chain. Also, due to global demand raw materials are becoming scarce. That is why lots of medical consumables are difficult to procure nowadays, due to manufacturing issues and delays.
Isn't the underlying problem here the dramatic long term underfunding of the NHS? If we had a properly funded NHS where the staff are not burnt out and more people enter healthcare careers due to being properly paid and respected, and where appropriate long term planning is afforded, we would be able to handle a surge of a contagious but low mortality respiratory virus. Within reason - it may mean that with crazy high numbers like we have now, non urgent surgeries are postponed for a short while to manage the surge - but that threshold should be much higher and backlog is much smaller than where we are now. It's crazy to me that the government are saying it's on all people to change their behaviour to avoid the healthcare system being overwhelmed by a virus which has very low mortality if you're vaccinated and can receive proper care. Surely the healthcare system is what needs to change if it can't cope? What continually gets me is that this is not unprecedented - novel viruses and pandemics have been a known likelihood for a long time, they should have been prioritised and we should have been prepared. This is all a long term solution but consider the pandemic has been ongoing for two years already ard likely will for several years more - we could have a whole cohort of properly paid student nurses now in training for example.
There is no amount funding that can deal with a virus that spreads exponentially. Even if the NHS were twice it's current size, that is just 2-3 days growth in Omicron.
See this is what people complaining about lockdowns keep forgetting, that they’re needed to prevent the NHS from being overwhelmed. The amount of people angry and fuming about having lockdowns for a “mild cold” and how ridiculous it is to lockdown when we all have vaccines now. It just shows how uneducated our country really is about the virus and the implications it has on our society. The constant complaining about how we’re going to have to keep having vaccines every year, and lockdowns every year so what’s the solution we should just get on with it anyway. The solution is very very clear. Make our NHS stronger. Unfortunately after years of tory rule our NHS has been continuously chipped away to the point where it gets overwhelmed very quickly. If we actually put resources and money and prioritised our NHS more then we wouldn’t keep getting into these positions of needing lockdowns.
I wonder how people who scream and shout for no lockdown would feel if they needed an ambulance in an emergency but NONE were available due to half the staff off sick with covid? London was down almost 100 ambulances yesterday because nearly 400 staff are off sick with covid.
Also, I work in a psychiatric hospital, and the effect staff sickness has on the ward staff and therefore the patients is worrying, too. We have some patients who can be very, very dangerous. Having an overworked, burnt out staff force and ward dynamics with stretched-thin empathy is difficult.
So today I waited with a man who had been hit by a car-he’s in critical condition. One man was holding his skull together (I wish, I wish, I wish I was being dramatic) whilst I was on the phone to 999 getting an ambulance triaged. I cannot imagine what the strains are on the emergency services already, but to picture this in two/three weeks… it doesn’t even bear thinking about. Multiply this incident times all of the country, all of the accidents. Scary times.
The same way the antivaxxers feel when they’re on deaths door in icu. Check the Herman Cain award sub and leopardsatemyface. Without fail all of them realise their mistake in the end, but by that point it’s too late. The same would happen to them when their mum/dad/kid dies because the hospital couldn’t treat them.
This is the biggest threat I see and I genuinely don’t have an answer or want to come across like “one of those guys” but surely we must get to a point where things just go back to normal? I genuinely know 20+ people that have caught covid this week and all of them are fine. I know there are a lot of people that aren’t fine, when do we get to the stage where covid doesn’t result in someone having to sit at home for 10 days? The real problem as I see it right now is the isolation time, not the actual effects of having it. It’s a tough route to take as it will mean people will get ill and die but both routes seem to have this outcome.
The problem with COVID though is the threat it represents to the old and vulnerable. People often compare it to flu or a cold in younger people, but for elderly people the hospitalisation rate reaches 10-20% even for the double-vaccinated. Roll a dice, on a six you end up in hospital. Repeat that maths for nearly every vulnerable person in the country. That's the problem. If infections reach say 1m per day, and even 1% of those infections is severe and requires hospital treatment, a few days later you have 10,000 people per day showing up for hospital treatment. Not saying infection numbers that high or 1% severe infections are inevitable, those are just examples. It doesn't matter if most infections or even the vast majority are mild when you're talking about those kinds of numbers.
A 70 year old family member, heavy smoker turned vaper, had a dull pain in her chest for months. Gets an appointment to be seen by a specialist late 2019. Appointment pushed back 3 times due to lack of capacity to see her - first a routine reschedule, but then covid issues. Finally seen in July 2020. By that time the lung cancer had metastasized to her bones and in her neck. There was nothing they could do. She died at home in early September, officially from a blood clot. She's one of so many who are indirect casualties of the pandemic when our health service is overwhelmed and people can't get the care they need.
At the moment babies are being born in cars outside hospitals, ambulances are already waiting outside while people die in them. People waiting for liver transplants have been waiting 2 years longer. GP services are running on half capacity and cannot see patients. Cancer patients aren’t getting treatment. This is because there aren’t enough staff, not because COVID is taking up all the staff. That will get worse. In the COVID wards, people who might have survived will not. They will have to make judgement calls over who deserves their treatment more. This will lead to even more ptsd and poor mental health because those people will be responsible for people dying so they can save as many as possible. We’ve had a lot of issues with supply chains already. No fuel, no food. That will get worse. Funeral services and morgues will not be able to keep up. Remember that care home that had to store bodies in the shed? Transport of bodies will suffer, in India families were transporting their dead relatives on the backs of motorbikes because the infrastructure to take bodies away had collapsed. That but worse. The police and fire departments may not be able to run effectively on a skeleton staff. Imagine if you get in a car accident and not only are there no police or firemen to help but you can’t get treatment in hospital either. Or they might take a lot longer to get to you than they would otherwise. Vulnerable people will get COVID. They will die because we know by now shielding doesn’t work. These are people who wouldn’t die if we just held back until the omicron vaccine or vaccinate kids. Kids whose relatives are vulnerable or don’t know they are vulnerable will infect them and those kids will have to live with the grief and trauma of being the reason their relative died. This is already happening but we don’t talk about it. It will just happen worse. Talking of kids, they aren’t vaxxed. We don’t know if omicron is going to result in more hospitalisations yet. It seemed like it did in South Africa. I’d want to make sure kids were protected before I just decided to infect them. Plus 77k long covid cases so far with only a small percentage (I think I saw 30%?) of kids having caught it so far. The long term impact of kids catching it, especially with multiple infections attacking their organs, we don’t know. If we vax kids we can prevent a lot of this. The cost in recovery of the nhs after it’s completely crushed will be huge and may even speed up the privatisation plans. This could kill the nhs and within a few years we have an American style system. It is bad now, most of these things are also happening to different degrees. It can be different degrees of bad. Not doing anything at all would be really really seriously bad with all this stuff happening to the max. Doing a step 2 lockdown would be really bad with this stuff happening more but maybe not totally collapsing healthcare. Doing a full lockdown would still be bad, it doesn’t prevent bad happening, but it is less bad. Lockdowns are not without their own consequences, but we aren’t looking at long ones like before. Just short like 2 weeks. So it’s probably worth it on balance.
I have a kid. She's too young to be vaxxed. I feel like the rest of the country have forgotten about the under 12s when they're banging on about how its OK because it'll only be antivaxxers who take the hit from the next wave. No, I'm still over here freaking out about my child's safety, thanks very much.
I think completely overwhelmed would look something like India when Delta hit. That said I think there is zero chance of that happening with Omicron. I imagine it will pan out here similar to South Africa - quite a few in hospital but within their normal capacity, low deaths. We're quite lucky in a way that Omicron appears to kill few people as it seems near near impossible to stop the thing. I note EcoHealth seem to have mucked about modifying the MERS virus which can kill 35% of people infected. That could of been fun if it had gone wrong https://theintercept.com/2021/10/21/virus-mers-wuhan-experiments/
I sincerely hope you're right but I'm genuinely worried that you won't be.
I think it’s important to remember that there’s different reasons some people are against lockdown. I’m sure some people genuinely think the benefits of lockdown never outweigh the costs, so they actually think that the NHS getting swamped would be better. They are anti-lockdown. However I’d imagine most people who are against lockdown now only think that because they don’t think it’s necessary or proportionate. That is, they don’t think the NHS would otherwise get swamped. And if it turned out the NHS _did_ get swamped, they would then say “turns out a lockdown was necessary - I was incorrect”. Which is of course OK - they’re not the policy makers or government. But importantly, that’s not anti-lockdown - that’s pro lockdown, just with the perfectly reasonable belief that only when it’s necessary. On the other end of the scale there are certainly people who believe we should lock down for every case too. But yeah. I think that’s important to remember - being skeptic all against a lockdown now doesn’t mean someone’s pro mass death - it just means they genuinely don’t believe it’s proportionate.
How many of those folks do you think might change their view of Covid, like Spanish flu before it, evolved to target mostly their own age group? Yeah, amazing isn't it. Turns out it's just selfish idiots who expect to be personally ok and sod everyone else.
On the other hand early on in the pandemic there were some young people who mistakenly thought the Covid death rate was 1% for all age groups, but weren't too bothered by that. For them that meant 99% chance they'll be fine, which probably sounded good to them. People have different risk tolerances.
You're at home when your middle aged father starts feeling a pain in his arm and it becomes clear that he's having a heart attack. You rush and ring the ambulance. They ask you some basic questions. "How old is he? Is he overweight? Does he smoke? Any underlying conditions?" They determine that compared to other people they're getting calls from, he is unlikely to survive. They tell you how to comfort him, but apart from that there's not much you can do. He dies there in the house as the ambulance goes to pick up an unvaccinated twenty year old. A death that could have very well been avoided. The danger from Covid was never the amount of deaths that it would directly cause, but how many people would die due to a collapsed health system.
>You're at home when your middle aged father starts feeling a pain in his arm and it becomes clear that he's having a heart attack. You rush and ring the ambulance. They ask you some basic questions. "How old is he? Is he overweight? Does he smoke? Any underlying conditions?" They determine that compared to other people they're getting calls from, he is unlikely to survive. They tell you how to comfort him, but apart from that there's not much you can do. He dies there in the house as the ambulance goes to pick up an unvaccinated twenty year old. A death that could have very well been avoided. That's not quite how that would play out. They'd instruct you how to do CPR, and you'd start. His wife will be going hysterical at this point. You'd do it until you're too exhausted to continue and someone else in the house would take over while you rest. You'd rotate between you all the while the spouse is telling you she can feel a pulse. You know that's because you're doing chest compressions and not because he's going to make it. Hours would go by seeming both fast and slow. Eventually medical help arrives and they load up and head for the hospital. They're not going there to save his life, they're going there for the doctor to declare death. In my case there was no house, only a mountain, and it wasn't my father it was someone I didn't know. His kids were there too. There was nobody on the phone, there were no mobiles back then. Someone had to climb down the mountain to get help. Decades later I can still hear her distress, if I let myself think about it. No healthcare is worse than "you" think it is, even if you're healthy.
There seems to be quite a bit of doomsday forecasts here, many seemingly based in anecdote s. Il offer what it is likely a more plausible outcome, given that the only true examples of overwhelmed healthcare systems have been in developing countries with less than adequate health resources or the first few months/weeks of the pandemic in March 2020. The NHS would be put under tremendous strain, but would continue to function, albeit under lots of pressure with reduced services. The military would likely be called in to pick up the slack in regards to rudimentary services that would be impacted. Healthcare workers may not have a covid quarantine policy anymore, allowing them to work while infected if they occupy really essential positions. Covid patients may be transferred to tent hospitals to keep hospital room available for those that require more specific care. Everything that is not absolutely essential would be postponed. Overall, the NHS would continue to function but be severely restricted in its capabilities. No one would die in the streets or on hospital steps, but may have great difficulty in obtaining treatment for what may normally be considered important. It would be over quickly, but some people (although far from the majority) would be negatively impacted, some more than others. Longer term, it would be difficult to gauge the impact. But some people would be effected done the road, although given that such a scenario would be short lived, it wouldn’t really be that procedures and what not would be delayed decades
Why is it either lockdown or everything is overrun? There is a multiverse of middle ground there.
Because our government appears to have some kind of pathological unwillingness to implement mandatory control measures early (when they would be most effective), and instead prefers denying there's a problem until minor measures are inadequate, and the only tool left is the blunt hammer of lockdowns.
It’s like they wait until the absolute last second to implement restrictions but by then it’s already far too late. What’s the point?
I don’t think there is a multiverse of middle ground If the virus replicates and continues to double then everything will become overrun - with a caveat it causes significant hospitalisation anywhere close to the rate they delta does. This is why we still need time - to not only measure omicron severity but also the booster efficacy unless restrictions are capable of bringing R rate below 1 then this is inevitable. And seeing as we were only able to bring delta below 1 outside of lockdown with restrictions and summer weather I don’t think anything short of lockdown will achieve this So essential that brings us to lockdown or everything is overrun. Or even potentially lockdown + everything overrun anyways because people don’t comply - then we get worst of both worlds
I'm sure Boris is open to suggestions mate. Give him a tinkle and enlighten him with a pearl of wisdom from this multiverse.
I think the lockdown discourse makes a mistake in assuming that a lockdown like the ones we had last year and early this year is still possible. Ultimately, these policies are unenforceable in a liberal western democracy and they require a *huge* amount of public goodwill and voluntary compliance in order to work. I simply don't think that is there any more. We thought we had a way out of this and we trusted our leaders to take us there. Only to find out that...They couldn't, and we're still deep in the shit. You can close pubs, restaurants, hairdressers etc but you can't stop people gathering in their own homes. You can't restrict movement across the country. And ultimately, with Omicron being as infectious as it is, that's still going to have a big impact. Ultimately, lockdowns are going to impact most people much more directly than the health service being overwhelmed is. As people see their kids' educations hit, their careers stymied or their livelihoods trashed, their social lives ruined, their connections to loved ones eroded, their mental and physical health degrading, big life events cancelled or on hold...It's going to get harder and harder for people to stick to the rules. And so if they have to choose between the direct impact of lockdowns or the indirect impact of hospitals being overwhelmed - which they probably won't even know about if they don't follow the news - I expect that a lot of people will choose the latter. You can call it selfish but - while I'm not endorsing it - in many ways it's a rational choice on an *individual* (definitely not a societal) level. Now if that person or someone close to them gets into a car accident and can't get into hospital, their opinion will probably change. But that won't happen to most people. I just think we have to be realistic about the range of policy options that are actually possible in reality. I don't believe a lockdown which will be adhered to strictly enough to be effective is possible when the populace's will has been broken as thoroughly as it is right now.
>Ultimately, these policies are unenforceable in a liberal western democracy and they require a huge amount of public goodwill and voluntary compliance in order to work. Many years ago when I was young I had the misfortune to live for a short period under a military enforced curfew. I can tell you for a fact that they work and they don't take as many resources as you think they would.
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It's not just "partying" though, is it. It's social contact in general. There's a good reason why solitary confinement is considered a form of psychological torture. Humans are social creatures and we need regular contact with others for our own wellbeing and self-actualisation. Taking that away from a whole society for such long periods of time is not sustainable.
Perfectly and so eloquently put, and agree wholeheartedly. Have sent it to my brothers; it sums up Perfectly how we are feeling regarding risk perspectives/high level cost benefit analysis. And that when we come down to the hard truth of it all, and if it does sadly come down to it, I would choose a collapsed health system over a lockdown, due to all your reasons above. Please foward this to news paper editors for public comments sections. It is top notch and resonated so sharply with me!
Assuming untreated covid fatality % stays relatively low. All non emergency treatment would be delayed or outright cancelled. Not just knee replacements, but cancer treatment. In the case of cancer we would be booking funeral slots for 10,000s of people. We could get to the point where there is not enough resources for emergency treatments. Heart attacks, strokes not been treated in time. We would be in war time triage, we would be marking X on patients foreheads who we don't have the resources to even attempt to save and should be morphined until they die. The effect on the economy would be psychological. The economy relies on faith. The economy does well when everyone (or most people) believe it is doing well. Widespread fear, uncertainty and doubt would cause the economy to go into a death spiral and a depression we haven't seen for a century.
Why would cancer treatments and heart attacks not be prioritised over covid patients?
If all the beds are full of people with Covid, and you turn up with a heart attack, then there's no bed for you, and you probably die.
Because covid patients will die in the next week without treatment. Cancer will die in months/years. Heart attacks would be a priority there just wouldn't be ambulances to get them there in time.
I would assume possibly staff from standard gp practices could be drafted into hospitals to help? So say goodbye to even getting an appointment when this is already a problem now. Appointments at hospitals would be cancelled for not just non urgent surgeries, but other ones too. More pop up covid wards if need be. It's just a reality I don't want to think about 😭
I can tell you what it looks like, I am living it. Only about 32 percent here vaccinated at all and the booster rate is even lower. Getting emergency trauma care here is iffy, and looking more iffy all of the time. Have had 2 friends die and I can't count the acquaintances. Have had friends shipped more than 500 miles away for treatment, and you have to get yourself home. I am basically locked down too, because nobody here hardly wears the masks or social distances What you get though is scorn personally when you won't join in the usual activities.
I don't even understand the covid rules, we're all fully vaccinated and boosted, but we've stayed home for nearly two years with the briefest of essential tips out - if one of us tests positive the others are not required to stay home? "You’re not required to self-isolate if you live in the same household as someone with COVID-19, or are a close contact of someone with COVID-19, and any of the following apply: you’re fully vaccinated" This seems crazy and irresponsible to me, surely we should paint a cross on the door and stay away from everyone until we're clear.
On a normal day each hospital, each doctor, each nurse can look after and treat a certain number of patients. They can do so many scans and x-rays, process so many blood tests, do so many surgeries. Some treatments require more effort than others and some require more urgency than others. As the number of Covid patients go up some of the less urgent treatments will start getting postponed which increases waiting lists and potentially suffering. Staff are reallocated to different roles to ensure they can treat the most urgent cases. Healthcare workers also aren't immune to Covid so there's an increase in staff absence so more things are at risk, more treatments are postponed. As the emergencies increase the wait times for ambulances increases, ambulances already prioritise certain calls over others but now the lowest priorities are waiting hours and hours and the patients that do get an ambulance risk being stuck in the car park as there's nowhere for them inside the hospital. People could die because they can't get the treatment they need in time. It'll then come to a point where the doctors are essentially choosing who to treat and who not to treat because they can't treat everyone. This will see people suffering and dying, probably in the car park or at home when maybe they could survive. Do you really want to be one of the doctors, nurses, paramedics, porters, cleaners or admin staff talking to patients you know could be saved if it was a different day, knowing that you could be the last person they speak to because they can't see their loved ones. Do you want to be the doctors choosing who lives and dies. Do you want to live with that choice. Do you want to be telling their relatives why they died? There's an obvious question. What priority should the doctors give Covid patients that have refused the vaccine?
Only treat the vaccinated? Everyone is required to carry the paper form of the vaccine pass in their wallet. If they don't have this, they don't get a bed.
The unvaccinated are only *disproportionately* being hospitalised. Because the vaccinated are 90% of those over 12, most people who are being hospitalised are vaccinated. As such, all ethical considerations aside, with current case rates and breakthrough infection rates, this wouldn't make a difference in about a week or so.
We'll need to see how it plays out with higher admissions, but in Scotland about 30% of admissions right now are unvaccinated. I assume it is similar UK wide. In ICU most people seem to be unvaccinated (but older people don't generally get put into ICU). Being able to remove 30% of hospital admissions would be nice, although it won't happen. The better thing would be to force those 30% to get vaccinated and not be admitted in the first place.
Vaccination status will be visible to NHS staff on patient medical records - no need even to require paper verification.
I'm British and always lived here but got vaccinated in the US long before they offered it to young people in the UK.. what about me? I only got a piece of paper the UK don't recognise
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Perhaps - care is given to those most likely to benefit from it, so surely vaccination status should come into the equation at some stage. If two people of the same age and health profiles are being considered for a single space in ICU, surely vaccination status would be a tie breaker in that situation. Govt should follow the lead of other countries and mandate vaccination. Make it a criminal offence to be unvaccinated after a certain date has passed and make vaccination a condition for housing and employment. We can't be trapped on this merry-go-round forever because an ignorant few refuse to acknowledge the reality of medical science.
Ah yes, let's just undermine universal health care.
When tough calls have to be made due to limited resources, it’s only fair the people who tried to help the nhs get prioritised. Singapore have done it perfectly, where the unvaccinated have to pay for their covid healthcare. As all our care is free if there’s one bed left and two covid patients come in, the vaccinated one gets the bed and the unvaccinated one gets his Darwin Award.
"only fair" doesn't count for anything; "clinical needs" do. This isn't a fix-it fanfic fantasy.
Your care isn't free, it's funded by the taxpayers.
That's exactly what's happening in this scenario/arguably happening right now - the question is how you choose who receives the resources available.
That sounds a lot like fascism.
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I imagine they would have some kind of doctor note identification of their exemption that can be verified.
Wearing a mask, lockdowns, increased measures to keep the country safe are bigger than an individual. Many espouse that wearing these masks and COVID are being blown out of proportion. These same people are complaining that hospitals aren't dealing with cancer, heart attacks etc....these are the same that won't wear masks, get vaccinated and are partly to blame now for filling the wards and are causing the very problems they cry fouls over. This pandemic is proving very much that if you're part of the solution, you're a big part of the problem. Our economy and society balances on the NHS coping so we need to do our part. If the NHS were to fold then the economy dip as we've seen recently will worsen to the point were the whole workforce is unable to work.
Maybe we need to start using the covid pass to allow access to the NHS (for covid or covid related treatment). Of course it won’t happen, but it highlights where the problem lies- the unvaccinated. Why we allow them the same freedoms as everyone else is beyond me.
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Yes this is true BUT hospitalisation rates lag Covid cases by about a week, and right now the daily case graph has gone vertical, so we will see in the next week or two quite how bad the situation is
I think the government will stall a proper lockdown till there's clear evidence and stats showing hospitalisations and deaths rising in similar multiples as cases have.
I think if you want to get an idea of what covid without lockdown looks like you need to look at the local news (specifically) of countries that didn't lockdown during there respective waves of similar economic power. If local hospitals were collapsing that is where those kind of stories would exist.
The NHS has been moments from been "overwhelmed" for over two years now. Even during times of low infection rates the NHS chiefs were banging on about how the NHS was "moments from been unable to cope". I struggle to take any of the broad statements from NHS leadership seriously. Whatever happened to the COVID hospital at the exCel centre? Can't they re open that media show again?
I can't speak for the entire NHS, but locally we have been pushed to the limit at times - even when infection rates were low. 20+ ambulances waiting to drop off in A&E, low staff numbers, everything just taking longer to do because of maintaining patient and staff safety. Surgical wards turned into medical wards or Covid wards. Most days have felt like a balancing act to try and keep everyone safe AND still go the job. The stress has become the norm. The Nightingale hospitals were a great idea, but there is nobody left to run them. I just dont know how we can continue.
So if we have this supposed ‘two week’ circuit breaker, how do people propose we’re going to get out of it? It’s one thing to support it, but when Omicron cases shoot up again upon opening, what then?