Nightingale Hospitals - winding down?

[Biscuit0110]

I can not be the only one that thinks this is a good thing!!

The reporting is really strange, almost a disappointment that we did not see rows and rows of dying people at the Nightingales. I, for one feel really relieved that we didn't need them in the end, and our NHS coped so well.

The footage coming out of China, Italy, New York and Spain was just horrendous. Patients dying on the floor, and in corridors. In the case of China on the street. That could have been us, without a back up. Many, many more lives would have been lost.

My second thought is why are they closing them so soon? We can see from the modelling that a second wave is very likely, so if it does come in the middle of the winter surely we will need them then? Particularly as even during a normal winter hospitals are often overcrowded.

Or being optimistic do we think the vaccine is quietly gaining momentum, and we may be ready for the winter with much of the public vaccinated?

No government in the world has handled this crisis perfectly. I am sure an inquiry will be held in due course to see how we can improve next time.
The idea you can hold the government accountable when we are in mid crisis really displays a more political agenda, or one that is persistently looking for fault and blame.

You I don't agree at all Cat, indeed I would go as far as to say I am pleased with how the government managed it all, for all of their faults they did well, especially given we nearly lost the PM in the midst of it all.

My understanding has been as others have already said
The Nightingale London could not take the very ill as there was was no facility for managing the other health issues Covid caused such as Renal ,Liver and haematological issues when the criteria was set (hugely argued between the different disciplines involved) the decision was made to only take Covid patients who had no underlying risks or comorbidities as they would be less likely to need additional support from renal dialysis etc i.e young fit patients who had it moderately but who could be managed if they worsened
Staffing was also an issue as a lot of the retired return to work HCP could not cope wirh the very complex care required for the sickest of cases, especially when the NHS was trying to avoid an Italy,China etc overload with London being the epicentre
Unless you work day to day in critical icare ts a steep learning curve for any staff to get to the required standard to manage and provide care for this group of patients
The other Nightingales as i understood it were always going to be step down units
Colleagues i know who worked there are returning to their NHs jobs but are standing by to be recalled if the second wave is worse than expected
To those people that say why wasn't everything shipped out to the nightingale I hope that helps answer your question but equally there are two hospitals working within any NHS hospital the red area for kovid and a completely separate blue area clean area for for everything else and the two had to be kept separate you couldn't be swapping staff over without increasing risk

You can see the vote above : 81% of people on YANBU so I guess that is the real guide.

New Zealand have handled this perfectly.

It's not about a political agenda. It's about people's deaths.

The government were told what the recommended actions were back in January by the WHO and they chose to ignore that. That was way before Johnson got the virus. If they had acted then thousands of lives would have been saved.

car thanks car that is a very informative post. What would be your suggestion should the need arise again? Would you change the set up? London particularly was always a worry due to the size.

Where have I denied that obesity is a increased risk factor for Covid?

It's simply irrelevant here because the key is early treatment pre ICU. It's proved relatively successful with patients - obese or not.

3-4% isn't a huge difference btw. Germany with around 23% obese isn't that far behind us with about 26%.

You mention the US. As you say lots of obesity. Yet a much lower death rate per million population than us.

This is about the need for early treatment.

Do your medic friends not agree with other medics that it's best to treat patients before a need for ICU?

With smoking, the potential of (likely the nicotine) as a Covid preventative or treatment is in very early trial stages. But it's certainly being looked into.

Covid-19 isn't like other lung diseases. In fact experts increasingly believe it's an inflammatory illness (that affects the lungs amongst all other parts of the body). Hence the use by some countries of immunosuppressants as a treatment. Of course I'm not suggesting people take up smoking but I'm surprised your friends aren't aware of the evidence around lower numbers of Covid patients who are smokers.

New Zealand have an incredibly low population rate, and they live in areas that are naturally spaced out with very few cities (and ones we would not even consider to be a city in real terms) Large towns would be a better description, and NZ were in the middle of the summer when the virus began.

You can hardly compare world cities of millions with NZ! It is just ridiculous.

New Zealand's population: 4.6 million
UK population: 66. 6 million

I don't think we can take your posts very seriously. You don't seem to have much of a handle on the stats or the impact of population size when it comes to viruses.

toffee I think my medic friends would take real exception to your accusation that they have not done enough, or treated patients early enough actually. They are beyond exhausted!

New Zealand have had fewer than 100 deaths.

And where has Toffee said that medics haven't done enough? It's the government who haven't done enough and they have failed those medics by not providing proper PPE.

It's as YouTheCat says. Medics have been failed more than most. Too many already have died, partly as said because of lack of PPE. It's the government decisions, policy, and planning that I'm calling out. I made that quite clear when I said question needed to be asked of the government.

@Biscuit0110 NZ may have a small population but most people there live in towns, villages and cities just like here. It's not a nation of hermits.

The elderly in most cases are too frail to endure full ventilation.

That's the treatment of last resort though. I gather that the thinking now is that if people came in sooner and were given CPAP type support with their breathing the outcomes would be better.

additionally we are very far down the list when we are comparing death rates versus overall population.

Not so far down (image hopefully attached)! If you ignore Andora and San Marino (as too small to be statistically significant) we are 4th, behind Belgium, Italy and Spain. We are behind Italy and Spain by 2-3 weeks though so would be more meaningful to compare with their death rate 2 weeks ago.

The idea you can hold the government accountable when we are in mid crisis really displays a more political agenda, or one that is persistently looking for fault and blame

At what point does it become acceptable to hold them to account?

I don't think we could ever have been in the NZ situation. We aren't an island 8 hours flight away from everywhere else. And tbh I don't see how NZ is going to go on from here. Now that CV is out there, ultimately the only ways out of this are via herd immunity or vaccine (at least a year away). A track and trace to try to prevent vulnerable people getting it might have been possible in the country for longer had we not had multiple hundreds of seed points after Feb half term's skiing trips. NZ never had the same volume of seed points as us. Having opted to try to stamp it out NZ's only option is to totally isolate their country from the rest of the world until a vaccine comes along, or quarantine every person over the border for ever which destroys their tourist and business travel completely. I am willing to have it explained to me by someone better qualified in epidemiology but I can't see -unless and until a safe vaccine comes along - how this virus can be eluded by countries that maintain any kind of global trade or travel.

To think that the UK could have locked down back when that super spreader first showed up in Brighton and allowed no further travel or schools or anything is pie in the sky. And that's so tragic because if we could have, many people would still be alive. I do wish we'd been more proactive with travel but in the end it wasn't (mostly) tourists from other countries bringing covid here, it was our tourists coming home with it. It was the multiple seed points that has been both our curse and blessing. Curse because it made track and trace unsustainable. Blessing because it has meant that no one area of the country was totally overwhelmed like Lombardy.

So we say and do nothing and patients continue to be denied timely and effective treatment?

No politics behind my motivation. My motivation is simple. Prevent needless deaths - which would also mitigate the economic damage caused by this pandemic. And whilst I personally care about other people, it's basic self interest to not want HCP dead. Who cares for you if you're sick and they're not around?

It's no good waiting until after the pandemic to raise this. Not if we want to stop it continuing. Many many patients are still not receiving timely treatment. No antivirals nor timely antibiotics (to prevent secondary infection), oxygen too late.

It's absolutely vital this is raised asap. We can't go back but we can start giving timely treatment from now on in.

Re politics. I've said this on other threads. No one political party is to blame for the long-term issues with the NHS. It's suffered decades of underfunding and mismanagement from all governments.

This is about raising the issue as a matter of urgency to stop the scandal of lack of timely and effective treatment. We need to start treating patients and treating them early. That won't happen if we ignore what's happening.

If poorer countries can manage it, so can we.

Back to the Nightingale hospitals, and whether they will be used or adapted in the near future. If nothing else when I saw that huge hospital installed in just over a week with so many beds ready, I felt massively reassured that we were ready for this hideous virus, that we could deal with it. Up to then I felt terrified the country would never ever manage. It can't manage on a busy Friday night here some weeks, so I was just so worried.
I felt a sense of security that the country could rise to the challenge when needed. It played a vital part in a psychological way even if it was not needed, thankfully.

Now, I just need to find some confidence to have my scan, and surgery. I don't know when I will ever feel comfortable to go into a hospital voluntarily, and there must be thousands like me, in a much more serious condition in some cases.

we were always going to have lots of deaths from CoVid

Why? Countries like New Zealand, Laos and Vietnam have had almost none.

Ah, I see NZ is being explained away as “too small.” South Korea then.

They were staffed by the military and retired nhs worker volunteers.
If they weren't there and we needed them, there would have been criticisms.
They built them and they were not filled. Thanks goodness. Still there is criticism.
Damned if you do and damned if you don't.

Biscuit Hopefully we will soon finally follow the lead of other countries in mass testing and early treatment. It shouldn't be too risky to go to hospital once that happens. I'd also say if you have anything urgent to go now if you can. It's likely safer whilst we're in lockdown and hospitals are quieter.

Try not to feel too scared. It's not an overly difficult task for our government to do what many other countries are doing. Get hold of more tests and PPE and drug treatments. We also have progress with the vaccines. If course it's a while off but it's good news.

Far more businesses closed than the govt expected, which is why need was less than expected. The deciding point will come when workplaces and bars reopen. We may need them yet which is why they are on standby.

the need was less than expected???
There's plenty of need. Of course we have capacity if it's not being used - despite the (very great) need.

We simply didn't treat people or treated too late. Hence the very high death rate.

Reopen businesses? Well yes, that would be good. So let's get hold of the PPE we need, the amount of testing we need, and the drugs we need. Shouldn't be too difficult. Many other countries, some with smaller economies than us, managed it.

I do think it is worth noting that many asian countries including South Korea learnt a great deal from having to deal with SARS, they are quite open about the fact they were completely set up and ready when coronavirus hit them. Most countries have never experienced anything like this, and do not have the benefit of prior experience. SK, HK and others already had systems in place, they knew how to deal with it, and they are much less worried about privacy laws than we are.

My friends on arrival back home were tagged! Yes tagged for two weeks and monitored throughout, including children. I can't imagine that ever happening anywhere in the west!

Many of the systems they are using would not be accepted here. Contract tracing is a name and shame process as you are identified. So although they are to be applauded for their great response, they had the benefit of a previous epidemic AND had no worries about setting very draconian measures in place immediately.

Although coronavirus does still spread in warmer climates, it is weakened in sunlight/heat. Many of the countries appearing to do well are either on the equator or in the summer season.

uk.reuters.com/article/us-health-coronavirus-trump/sunlight-heat-and-humidity-weaken-coronavirus-u-s-official-says-idUKKCN2253SA

As I said, the UK is not perfect, I am not saying for a minute there are not lesson to be learnt, simply that I am very glad we have the Nightingales, and I hope we keep them so we have some security against a second wave.