ICU Occupancy in English Hospitals No Higher Than Last December
The media is full of alarming reports of NHS hospitals being on the brink of armageddon, such is the surge in coronavirus patients. “As we head into the new year we are seeing a real rise in the pressure on NHS services, particularly across London and the south-east,” Saffron Cordery, the Deputy Chief Executive of NHS Providers told the Guardian.
A letter from NHS chiefs sent to the chief executives of all NHS trust and foundation trusts on December 23rd contained this alarming paragraph:
With COVID-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks. This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity. Timely and safe discharge should be prioritised, including making full use of hospices. Support for staff over this period will need to remain at the heart of our response, particularly as flexible redeployment may again be required.
And the Independent reports that the London Ambulance Service has issued a warning saying it can no longer guarantee an ambulance will turn up if women giving birth at home require emergency care.
Sounds like a major crisis, right? Better move the rest of England into Tier 4, make mask-wearing mandatory in all settings and close schools until Easter.
Or is it?
If you look at ICU occupancy in NHS hospitals across England on December 20th it was lower than the December average in 2019 in most of the country – and it’s worth remembering that the 2019-20 flu season was unusually mild.
Admittedly, the total number of ICU beds occupied in London on Dec 20th was quite a bit higher than the average for December 2019, but according to the ZOE app daily symptomatic cases in London are falling. The ZOE data in the graph below shows rising and falling daily symptomatic cases up to December 27th.
It’s also worth bearing in mind that there are more ICU beds this year than last year, so if you calculate the percentage of ICU beds occupied in NHS hospitals across England and compare that to the average percentage in December 2019 the picture looks even less bleak. In every region, including London, the percentage of ICU beds occupied at the moment is lower than it was this time last year.
East:
Dec 2019 average: 76.3%
On Dec 20th 2020: 74.0%London:
Dec 2019 average: 88.7%
On Dec 20th 2020: 86.3%Midlands:
Dec 2019 average: 82.2%
On Dec 20th 2020: 67.0%North East and Yorkshire:
Dec 2019 average: 78.4%
On Dec 20th 2020: 69.8%North West:
Dec 2019 average: 82.6%
On Dec 20th 2020: 68.7%South East:
Dec 2019 average: 83.7%
On Dec 20th 2020: 75.4%South West:
Dec 2019 average: 79.5%
On Dec 20th 2020: 73.3%
I’m not suggesting that NHS hospitals aren’t under pressure – nor even that they aren’t under more pressure than they were this time last year. But the issue isn’t a lack of ICU beds and it doesn’t appear to be a surging number of patients admitted to ICU beds with COVID-19. After all, if those numbers were surging on top of the usual December admissions for respiratory diseases you’d expect the total number of ICU beds occupied to be much higher this year than last and, as you can see from the Spectator data, the totals are lower in four of England’s seven NHS regions.
The reason for the crisis – if indeed there is a crisis – must lie elsewhere.
My money’s on a combination of higher-than-average staff absences and poor management. Disappointing, considering the NHS has had over six months to prepare for this “crisis”.
Lockdowns Pose Greatest Threat to Mental Health Since Second World War
According to the country’s leading psychiatrist, the ongoing restrictions pose the greatest threat to mental health since the Second World War. The Guardian has more.
Dr Adrian James, the president of the Royal College of Psychiatrists, said a combination of the disease, its social consequences and the economic fallout were having a profound effect on mental health that would continue long after the epidemic is reined in.
As many as 10 million people, including 1.5 million children, are thought to need new or additional mental health support as a direct result of the crisis.
“This is going to have a profound effect on mental health,” James said. “It is probably the biggest hit to mental health since the Second World War. It doesn’t stop when the virus is under control and there are few people in hospital. You’ve got to fund the long-term consequences.”
Demand for mental health services dropped at the start of the pandemic as people stayed away from GP surgeries and hospitals, or thought treatment was unavailable. But the dip was followed by a surge in people seeking help that shows no sign of abating.
Data from NHS Digital reveals that the number of people in contact with mental health services has never been higher, and some hospital trusts report that their mental health wards are at capacity. “The whole system is clearly under pressure,” James said.
Modelling by the Centre for Mental Health forecasts that as many as 10 million people will need new or additional mental health support as a direct result of the coronavirus epidemic. About 1.3 million people who have not had mental health problems before are expected to need treatment for moderate to severe anxiety, and 1.8 million treatment for moderate to severe depression, it found.
The overall figure includes 1.5 million children at risk of anxiety and depression brought about or aggravated by social isolation, quarantine or the hospitalisation or death of family members. The numbers may rise as the full impact becomes clear on Black, Asian and minority ethnic communities, care homes and people with disabilities.
Worth reading in full.
Conservative MPs Urge Boris to Keep Schools Open
A number of Conservative MPs have pleaded with Boris not to close schools in January even if it increases the R number. Camilla Turner in today’s Telegraph has more.
Their intervention comes ahead of crunch talks due to take place today between Number 10 and Department for Education officials about whether to delay the return to the classroom in January.
Downing Street has repeatedly said that keeping schools open is a “national priority” but scientists are warning that closures may be necessary to slow the spread of the new COVID-19 variant.
The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG ), which advises the Government, has said that the new variant of the virus may spread far more effectively in children than the original strain.
They said that might explain why the rate of the virus continued to increase in some areas during the second lockdown, when schools were open but more adults stayed at home.
Prof Neil Ferguson, the Imperial College London epidemiologist who became known as “Professor Lockdown” due to his instrumental role in pressing the Government into the first lockdown in March, has raised similar concerns.
He said data so far suggested that the new variant “has a higher propensity to infect children” with “statistically significantly higher” rates found among under-15s compared with those of the standard virus.
But Conservative MPs have told the Prime Minister that schools must be kept open even if it means a rise in the R number. “The view of most Tory MPs is that schools do need to stay open,” one backbencher said.
“It is the health people who are saying ‘oh gosh, the hospitals will be full’. We know that schools being open does increase the R rate. The question is, is that a price we are willing to pay and in my view it should be. Frankly, children don’t get harmed so why on earth should we punish them?”
Another senior Tory MP said it is regrettable that closing schools is now “on the table” but added that many MPs would oppose this.
“Until the Chief Medical Officer gets up and says ‘this is a disaster if we keep schools open because the new strain will threaten parents’, then fine, even I would accept that,” he said.
He added that “Professor Lockdown” is a “fanatic who wants to shut down everything” adding: “I think it’s absolutely wrong for him to start scaring parents and children without actually having the scientific evidence.”
Worth reading in full.
Stop Press: In the US, school administrators are rethinking quarantine rules, according to the Wall St Journal.
Ten More Reasons to be Anti-Lockdown
A reader has sent us a good piece setting out 10 reasons to be opposed to lockdowns which we’re publishing today. Here are the first three:
The research: While those who oppose lockdowns have rigorously sought to justify their position with research – and can reference tens of studies as to the lack of efficacy of lockdowns (or stringent measures under different names) – the Government has been capable only of publishing one graph in their cost-benefit analysis of the tiers which appeared to show a correlation between Tier 3 measures and a reduction in cases (since discredited).
The use of data: While those who oppose lockdowns have analysed all data in as close to real time as possible, the ‘data’ used to justify lockdowns have been cherry-picked and often predictive, while being based on spurious assumptions that have repeatedly been proved inaccurate.
The source and balance of information: While those who oppose lockdowns possess no bias in obtaining their information, the Government is informed on the risks by a number of committees (SAGE NERVTAG, SPI-M) whose sole responsibility is to consider the virus and present the risks of that virus.
Then there’s my favourite, number 9:
Censorship and debate: While those who oppose lockdowns are constantly appealing for open debate and free speech, the Government avoids open debate, seeking instead to censor dissenting voices. Further, as there is a push to censor any “misinformation”, one can quite easily conclude that the mass of information available, and uncensored, from dissenting voices must therefore be much closer to irrefutable having had to pass a much higher standard in order to simply be available.
Worth reading in full.
BBC’s Alarmist Report on Fake News Contains Fake News
A report by the BBC’s “disinformation reporter” raises the alarm about the dangers of fake news. According to Marianna Spring, the “flurry of online falsehoods about coronavirus” are “destroying relationships and endangering lives”.
But what sort of deadly misinformation is the reporter talking about? Scroll down and you find this paragraph:
We catalogued mass poisonings and overdoses of hydroxychloroquine – a drug that world leaders like Donald Trump and Jair Bolsonaro falsely claimed cures or prevents COVID-19.
Hang on a second. The claim that HCQ cures or prevents COVID-19 is false?
I’m afraid that doesn’t pass the fact-checking test, Ms Spring. Over 200 studies have shown HCQ is an effective treatment for Covid. Trump and Bolsonaro may have exaggerated the preventative and curative properties of HCQ, but that doesn’t mean it’s completely ineffective and anyone taking it is likely to poison themselves. On the contrary, it’s almost certainly no more dangerous than any of the Covid vaccines.
Stop Press: David Goodhart wrote an excellent piece for the Telegraph yesterday about the moment he lost his faith in television news.
I believe it was on Monday April 20th that it struck me most forcefully: that day, a grim milestone was reached, with 100 health and social care workers reported to have died from COVID-19 – and I was witnessing a national panic. I realised then that we can no longer do television news for grown-ups.
For the preceding three weeks, I had been watching the same thing every night on the BBC Ten O’Clock News: here is a shocking statistic about Covid, here’s someone who died, here’s a sobbing relative or frontline hero telling you to stay at home, save lives and protect the NHS.
The coverage was relentlessly emotional and infantilising, lacking explanation and context. Was the 100-plus NHS staff deaths from Covid a lot, or a little? There are 600,000 patient-facing staff in the NHS, so a few probably die from infections they catch from patients every month in normal times. Was 100 deaths since the start of the crisis, about a month earlier, twice the normal rate or 50 times? How did it compare to other countries?
Not a word. In Britain, we are supposed to be good at media. And no doubt in some niches we still are. But at the start of the crisis, our main channels of electronic communication became showcases for our contemporary vices: emotionalism, virtue-signalling and a querulously adolescent attitude to authority.
At the same time, I was keeping an eye on the main TV bulletins in Germany and France and while, reassuringly, they were having exactly the same debates as us about inadequate PPE supplies and the disease ravaging old peoples’ homes, the news seemed to be delivered with more rigour and authority and without the British reflex of blaming the Government for everything that was going wrong.
naufrage/sauvetage 