With no vaccination imminent, how long are we going to keep doing this?

[RubyandBen]

Disrupted education that will impact on some DC forever, sending perfectly healthy DC home from school for 2 weeks again and again, lockdown of university students who will only have mild symptoms (I know there's always one or two who suffer more but the vast majority won't), destroying whole industries hospitality, travel, retail, hundreds of thousands unemployed, huge recession. Not even going to mention the long term impact on all the OTHER non covid illnesses that have been shelved.
If there's no vaccination imminent what's the plan? Are we going to carry on in this horrible limbo that's going to destroy too much or admit defeat and realise people will die?
Before I'm accused of being a mass murderer, I've followed all the rules but don't know how much more I can take of this.

@NRatched ” But it is a fact that round here almost all treatments/clinics have been halted since March“

I’m sorry that you are unable to access your pain clinic but I’m going to call bullshit on your above comment.

What is almost certainly true is that during the first wave many routine outpatient clinics and elective surgery would have been rationed to all but the most urgent of cases due to staff redeployment in preparation for the predicted numbers of seriously unwell patients with Covid requiring admission to hospital. Thankfully, due to lockdown, the NHS was not overwhelmed.

From end of May onwards, as Covid admissions to hospitals reduced, many of those redeployed staff would have returned to their usual roles. However, in view of measures to reduce the risk of transmission of the virus between patients and staff including new PPE guidance and social distancing rules in hospitals and clinic spaces, there has been a dramatic change in how services are being delivered. Services are running again, but for many at reduced capacity because we must comply with new guidelines to reduce the risk of virus transmission. Just as an additional point, the guidelines change frequently as the understanding of how the virus is transmitted changes. Just this week in my department we have had to completely rearrange the furniture and computers in our office area in order to be Covid secure.

In addition to this departments are now having to play catch up with their waiting lists, as referrals to outpatient services and elective procedures may have gone down, but certainly did not stop altogether in March. In reality this means that staff will probably have had to review and re-triage their lists in order to ensure those most in need are seen first. All of this takes clinician and administration time.

Staff have had to develop new ways of working. For many of us we have had a steep learning curve in telephone and video consultation skills, and providing support and information to patients remotely.

The ability to carry on as before has also been hampered by staff shielding, sickness and isolation requirements. If a significant number of staff are unavailable for clinical work then team managers will again have to re-triage patients so those requiring the most urgent treatment are seen first.

Sadly, an area in which the NHS consistently performs poorly in is communication with patients and between departments. “This service is closed, because Covid” is trite, lazy and unhelpful, and managers should be being challenged by their staff to provide much better information and explanations of disruption of routine care to their patients.
The majority of services are running again but we are having to play catch up, we are having to working differently and at a reduced capacity, and we are now doing it facing the thought of a second peak. In reality that means that for all must the sickest of patients your care is either going to be different, delayed or both.
Believe me we in the NHS do not want this to be the case. We want as much as you do for things to go back to how they were before but our hands are tied right now.

Sending children who are Perfectly healthy home from school and disrupting their education in this way has to stop. Ludicrous. They’re not even at risk!

France have already stopped doing this.

@cardibach

Schools are closing year groups regularly which is massively disruptive to education and working parents Damn those schools, wanting to limit the risk to staff and other pupils when someone gets a positive test. How unreasonable, *@Someonesayroadtrip*

Wow, after reading my entire post that's what you took from it? 🤦‍♀️I clearly am in favour of limiting the risk of Covid. It's doesn't negate that it's disruptive, I'm a school governor and I supported the plans to close and supported plans to close bubbles if needed. I'm in favour of it but it's hellishly disruptive. Work is difficult, we have had parents who lose jobs or had to have weeks unpaid to look after children. Personally for me, I have two with ALNs including ASC and ten disruption causes massive mental toll on them. We have to prepare for change and when we can't it often results in aggressive behaviour towards others and themselves.

How you managed to read my post and come up with judgement about that when clearly closing years down is disruptive. I support it, but it's been hell in our area.

People are just not going to comply this time. They already aren't.

[quote ScribblyGum]**@NRatched* ” But it is a fact that round here almost all treatments/clinics have been halted since March“*

I’m sorry that you are unable to access your pain clinic but I’m going to call bullshit on your above comment.

What is almost certainly true is that during the first wave many routine outpatient clinics and elective surgery would have been rationed to all but the most urgent of cases due to staff redeployment in preparation for the predicted numbers of seriously unwell patients with Covid requiring admission to hospital. Thankfully, due to lockdown, the NHS was not overwhelmed.

From end of May onwards, as Covid admissions to hospitals reduced, many of those redeployed staff would have returned to their usual roles. However, in view of measures to reduce the risk of transmission of the virus between patients and staff including new PPE guidance and social distancing rules in hospitals and clinic spaces, there has been a dramatic change in how services are being delivered. Services are running again, but for many at reduced capacity because we must comply with new guidelines to reduce the risk of virus transmission. Just as an additional point, the guidelines change frequently as the understanding of how the virus is transmitted changes. Just this week in my department we have had to completely rearrange the furniture and computers in our office area in order to be Covid secure.

In addition to this departments are now having to play catch up with their waiting lists, as referrals to outpatient services and elective procedures may have gone down, but certainly did not stop altogether in March. In reality this means that staff will probably have had to review and re-triage their lists in order to ensure those most in need are seen first. All of this takes clinician and administration time.

Staff have had to develop new ways of working. For many of us we have had a steep learning curve in telephone and video consultation skills, and providing support and information to patients remotely.

The ability to carry on as before has also been hampered by staff shielding, sickness and isolation requirements. If a significant number of staff are unavailable for clinical work then team managers will again have to re-triage patients so those requiring the most urgent treatment are seen first.

Sadly, an area in which the NHS consistently performs poorly in is communication with patients and between departments. “This service is closed, because Covid” is trite, lazy and unhelpful, and managers should be being challenged by their staff to provide much better information and explanations of disruption of routine care to their patients.
The majority of services are running again but we are having to play catch up, we are having to working differently and at a reduced capacity, and we are now doing it facing the thought of a second peak. In reality that means that for all must the sickest of patients your care is either going to be different, delayed or both.
Believe me we in the NHS do not want this to be the case. We want as much as you do for things to go back to how they were before but our hands are tied right now.[/quote]
Seriously, you call bullshit as your experience is different?

My area stopped. This is outing but I'm in Swansea. My experience is that barely anything is running. It is very department dependant. I was referred for an urgent scan which they sent back and said they didn't deem it as urgent and therefore were not doing scans at this time.

I was sent via the 2 week referral scheme for a gyn referral and it was down graded to urgent and told they were not seeing any patients at this time at all, I was told it was likely to be sometime after March I would be seen. I was referred and I Complained at the same time. I was told I was accepted on the 2 week referral pathway now and was offered an appointment. The head of the department called and said they had just been ok-ed to start having appointments (that was fits week of October) and after being in A&E after fainting.

I was called this week to say my appointment is cancelled and they are not seeing anyone at this current time. I can even be seen for infusions.

So I have no bled for 88 days out of the last 107, I have blood in my urine, my liver enzymes are all over the place, I am in pain, I'm getting more and more anemic, more depressed, my children are terrified of seeing me with blood literally dripping from me, I have fainted 4 times this month, but I'm guessing I'm lying as that doesn't fit with your reality?

Saying that I saw dermatology during lockdown in May, so clearly some departments are working,and I know people who has similar symptoms to me in different parts of the country who have already been seen and treated in the past few months I've been going through this. I was a nurse before children and we have doctors in the family, so talking to others they basically say that each hospital and department has been given autonomy to do what they see fit. Some have not reopened, some have actually caught up on cases, a lot are working through the backlog. Two of my children have additional needs and they have had 1 call over the past year to discuss their medication and they said they both need reviewed but they aren't doing any face to face appointments and therefore won't have any adjustments.

Each hospital and department are different. It's incredibly frustrating because it's a literal postcode decider if you get seen and treated or if you're just left. It's great you're in an area that's so proactive, but the reality is that it's not the same for everyone.

I agree it depends on area, and I agree, ScribblyGum, that there needs to be some urgent training in communications. Cousin received letter saying that “Due to Covid 19 your colonoscopy will be conducted by telephone” The meaning was sorted out in the end, but cousin was quite intrigued and looking forward to a virtual colonoscopy...

Not a big deal in the scale of things, but DWs HRT implant just isn't happening here in Brum. No ones is, apparently. It's pills, patches or piss off.

Telephone colonoscopy😁

@IrmaFayLear

I agree it depends on area, and I agree, ScribblyGum, that there needs to be some urgent training in communications. Cousin received letter saying that “Due to Covid 19 your colonoscopy will be conducted by telephone” The meaning was sorted out in the end, but cousin was quite intrigued and looking forward to a virtual colonoscopy...

Haha. That's brilliant. I agree, lots do new ways of learning.

@Someonesayroadtrip

Yeah, I am going to standby my response of bullshit to the comment that “it is a fact that round here almost all treatments/clinics have been halted since March”

Halted implies stopped, since March. Almost all treatments and clinics in that posters area have literally stopped altogether?

That’s hyperbole.

Access to most treatments and clinics is more difficult, yes. Waiting lists are much longer, yes. My investigation/elective procedure/routine appointment and been cancelled/delayed/ rescheduled multiple times, yes. I don’t know when I’m going to be seen and I am getting zero information from the department about what is happening, yes.
All incredibly stressful, frustrating and frightening, yes. I do not dispute any of this and I do, I promise have the deepest of sympathy for all the patients whose lives have been put on hold, indefinitely while this pandemic is ongoing.

BUT that does not mean that those departments and the work being done by those clinicians has just stopped. Please reread my post as to why it may appear to have shut up shop, but in reality those teams will be working incredibly hard within the context of the previous six months we have worked through and with the second wave plus winter pressures ahead of us.

@ScribblyGum you will find that in some areas "clinics operating" will consist of things like deaf, frail 93 year olds like my dad having balance clinics by phone. Which is entirely a waste of time and just a way of ticking boxes.
You will also find that many elderly patients can't attend clinics because the transport they rely on has been cancelled. As a result some have been removed from lists as they have been unable to attend things like eye clinics for Wet AMD (also my dad).
You will also find there are diabetics still waiting for blood tests and reviews scheduled for late March to be re-scheduled ( DH).
I also have a friend whose smear test was cancelled late March and still can't book one. She has a history of abnormal results and is supposed to have regular checks.
Another friend with RA was supposed to have her medication reviewed in April, still can't get an appointment, likely to be December at best.
9yo boy with a kidney problem that may require surgery. Annual review was due May, his mum has been told not this year.
Still think bullshit?

@countrygirl99 you seem, as others have, to misunderstood the statement to which I think is bullshit. I’ve quoted it twice, do I need to do it again for you?
You seem to have in response created a series of straw men to have some sort fantasy argument with me about?

A balance assessment (with regards to falls risk I’m assuming, apologies if this is wrong) by phone, so long as the patient does not have a hearing impairment and is able to communicate, can provide a great deal of valuable information for the clinician to assist with some elements of decision making and management plans. A large element of the assessment is done through the history anyway. I should know as that’s my clinical specialty. Even better would be a video consult. The face to face assessment in the patient’s own home is the gold standard but, as I’ve repeatedly stated, these services are currently severely rationed and will be only given to patient’s in the greatest need.
That’s not a shut service though is it? That’s a service that’s running on the bones of its arse.
Maybe you could support your father with a remote consultation?

I can go through the rest of your list if you like?

None of what you say is evidence of NHS services being shut, although I can appreciate that as a patient who cannot access a service that you need, may indeed in reality feel like the same thing. What you have posted about is evidence of services that are so overwhelmed by referrals and ever growing waiting lists, so stretched by lack of staff and resources and so hampered by current Trust procedures put in place to minimise the risk of transmitting Covid that they can only function to serve the patients who are most critically at need.

Not straw men, real examples from my friends and family. Straw men, as I'm sure you well know are hypothetical.

As I stated the balance patient is deaf so actually a complete waste of everyone 's time and only a running service in a tick box way. I do not live close to my father, I work full time and my parents don't have wifi so don't give the "it's up to you to gelp bollocks".
Services that can't be accessed are as good as not running to the patient. Perhaps you can explain how no/severely delayed, as in no sign of yet, appointments are helpful to the others on my list.

There never will be a vaccine. There will never be better treatments. I find it shocking that after more than 6 months scientists still know so little about Covid 19. How is that possible?

We will continue like this until our economy and society is in rack and ruin.

There never will be a vaccine. There will never be better treatments. I find it shocking that after more than 6 months scientists still know so little about Covid 19. How is that possible?

Because science is hard ? It's hard anyway, when you are dealing with nature and it's infinite wonder. It becomes even harder when you also have to deal with politics and it's infinite stupidity.

This will not continue for 10 years - that is just chronic anxiety talking or a deliberate lie by someone who wants an excuse for non compliance.

There are other promising treatments being trialled now and in any case the virus doesnt do well in warmer weather - once the weather improves, early May at the latest and often before, many restrictions can be relaxed. The rise in virus cases means clinical trials can be completed faster and therefore better treatments and a vaccine may be available before May.

Those places controlling the virus are having less economic damage and their health care continues as normal. It is the failure to control the virus that creates all the things people complain about. If you want them to stop then you need to comply more strictly than you are doing now and to get other people to do the same.

Unless you want health care to become even more sparse than it is now and more economic damage than we have now then you avoid other people whenever you can, pressurise your schools to let children wear masks, wear your own mask properly (dont adjust or remove by grabbing the middle) and sanitise your hands often.

I’m sure I don’t know that straw men are hypothetical . You are using your real life cases to use in an argument that I am not having with anyone on this thread!

I’m not disputing that access to current NHS services is abysmal, and in many cases impossible. I know they are.

I am arguing with the statement from one particular poster: “is a fact that round here almost all treatments/clinics have been halted since March”

Just that statement.

I’m sorry that you are struggling to understand that there is a fundamental difference between a situation where a majority of NHS services have literally stopped altogether, and services that have either restarted (or never stopped), and because of the current situation we find ourselves living in, access into them is restricted. The impact of this is severe disruption to the quality and quantity of care the service can provide.

Just to be perfectly clear, I am not disputing any of what you say. I believe you.

the virus doesnt do well in warmer weather

As the low infection rates from the hotter parts of the world show.

Oh, hang on ...

@Dustballs

There never will be a vaccine. There will never be better treatments. I find it shocking that after more than 6 months scientists still know so little about Covid 19. How is that possible?

We will continue like this until our economy and society is in rack and ruin.

That’s a bizarre statement.

There are vaccines close to the end of their Phase 3 trials. The virus was isolated very early on and has been studied in great detail by many labs and in several trials, hence the various vaccines and the development of several treatments. The method of transmission is fairly well understood too.

There are vaccines close to the end of their Phase 3 trials. The virus was isolated very early on and has been studied in great detail by many labs and in several trials, hence the various vaccines and the development of several treatments. The method of transmission is fairly well understood too.

which doesn't negate the fact there's a lot that isn't understood too.

@Dustballs

There never will be a vaccine. There will never be better treatments. I find it shocking that after more than 6 months scientists still know so little about Covid 19. How is that possible?

We will continue like this until our economy and society is in rack and ruin.

Don’t be ridiculous.

[quote ScribblyGum]**@NRatched* ” But it is a fact that round here almost all treatments/clinics have been halted since March“*

I’m sorry that you are unable to access your pain clinic but I’m going to call bullshit on your above comment.

What is almost certainly true is that during the first wave many routine outpatient clinics and elective surgery would have been rationed to all but the most urgent of cases due to staff redeployment in preparation for the predicted numbers of seriously unwell patients with Covid requiring admission to hospital. Thankfully, due to lockdown, the NHS was not overwhelmed.

From end of May onwards, as Covid admissions to hospitals reduced, many of those redeployed staff would have returned to their usual roles. However, in view of measures to reduce the risk of transmission of the virus between patients and staff including new PPE guidance and social distancing rules in hospitals and clinic spaces, there has been a dramatic change in how services are being delivered. Services are running again, but for many at reduced capacity because we must comply with new guidelines to reduce the risk of virus transmission. Just as an additional point, the guidelines change frequently as the understanding of how the virus is transmitted changes. Just this week in my department we have had to completely rearrange the furniture and computers in our office area in order to be Covid secure.

In addition to this departments are now having to play catch up with their waiting lists, as referrals to outpatient services and elective procedures may have gone down, but certainly did not stop altogether in March. In reality this means that staff will probably have had to review and re-triage their lists in order to ensure those most in need are seen first. All of this takes clinician and administration time.

Staff have had to develop new ways of working. For many of us we have had a steep learning curve in telephone and video consultation skills, and providing support and information to patients remotely.

The ability to carry on as before has also been hampered by staff shielding, sickness and isolation requirements. If a significant number of staff are unavailable for clinical work then team managers will again have to re-triage patients so those requiring the most urgent treatment are seen first.

Sadly, an area in which the NHS consistently performs poorly in is communication with patients and between departments. “This service is closed, because Covid” is trite, lazy and unhelpful, and managers should be being challenged by their staff to provide much better information and explanations of disruption of routine care to their patients.
The majority of services are running again but we are having to play catch up, we are having to working differently and at a reduced capacity, and we are now doing it facing the thought of a second peak. In reality that means that for all must the sickest of patients your care is either going to be different, delayed or both.
Believe me we in the NHS do not want this to be the case. We want as much as you do for things to go back to how they were before but our hands are tied right now.[/quote]
Well this is explained 100% better than the GP surgery did (over the phone) as their answers have very much been along the lines of 'because covid'! There seems to be multiple health areas that have not started functionig yet. Your post explains why this might/will be, of course others who had stuff cancelled and are worse would get priority. I understand there are a lot in worse pain than me. People more in need of a hip replacement than my family member, and so on. However, when speaking among multiple friends and family, it appears to be very rare (for here) to be able to get any medical treatment at all. Presciptions if on repeat, yes. Thats about it seemingly.

So no, no bullshit sadly. I wish it was. I have moaned a bit in private but do understand everythings running slowly. To the average patient though, especially when the GP are actively blaming covid when contacted..it does indeed look like everything has just shut down and not reopened at all.

MIL is much much more ill than me, and has been unable to even get a call with the GP on multiple occasions over the months. 3 of these times, she tried for a few days, and then it got to the stage where she had to go to A&E for treatment as her pain was so intense (oesteoarthritus, I thik its called. Her spine is basically crumbling), which in turn, puts even more pressure on A&E, and makes both staff and patients more at risk when people are going there that probably wouldn't have had to go had they been seen beforehand. A couple of times, her meds have not been done (busy, covid) which has made her have to seek A&E again, for both pain levels, and the fact that they put her off again and again, telling her 'it will be done by the end of the day' on a Friday, then not doing it, so she is expected to go the whole weekend without the morphine her body needs. Shes on a very high amount per day too, and as I understand it, cold turkey is very very dangerous.

So yeah, maybe wrote a bit much there. I really appreciate the explanation. And of course it makes sense. Others are prioritized, however, to those not prioritized, and actively being told its because of covid (even when covid was at very very low numbers indeed, here anyway), well they will obviously see it as..stuff cancelled because of covid.

Shitty shitty situation for everyone. Please don't think I was blaming NHS staff for this, thats not what I meant. But it really does seem that either our area has massively crappy luck, or some other areas have amazing luck (or a hell of a lot extra staff/equipment/rooms at least!)

In response to the original OP.

What do you mean by imminent? I don't think anyone really believed there would be a thoroughly tested vaccine by Christmas, did they? To my way of thought, anytime in the first half of 2021 is 'imminent' in vaccine timescales. And that is not off the table.

So it's too soon to say 'we've come this far and it's far enough' IMO. Given the very bleak options that are ethically unacceptable to anyone who has really experienced an ICU ward. (Please don't tell me lockdowns are somehow preventing non-Covid patients; they're doing the opposite).

preventing non-Covid patients from having treatment

A small point, but we need to stop wasting so many tests on healthy, often asymptomatic or only very mildly symptomatic university students. I taught a Zoom class today in which two students had Covid (both well), one had a cold (obviously somewhat unwell, negative Covid test) and two people left early or arrived late (both well) for a test. Almost all were self-isolating.

Their unhappiness and anxiety was visible, not because they were ill, but because their first couple of weeks of living away from home had become a process of solitary imprisonment in their small, underfurnished new rooms. Given that they're basically not allowed to leave the university accommodation anyway, there seems to me no point in testing students unless they become properly ill (more ill than with a cold). This would save, even in one part of one university, hundreds of tests a day which could be used much more sensibly in the wider community if university resources were shared.