Is this to protect the NHS?

[suitsnot]

I assume this has been discussed before. I’ve not checked all the posts.

Does anyone have a clear answer on why this virus is taking precedence over quite literally every other illness and destroying the economy simultaneously? I don’t mean to sound facetious. Is it simply that the NHS will collapse if we don’t manage it? I can sort of see that but then again, so much else is collapsing that is causing slower health problems...mental health being key. I know of two suicides and lots more struggling mentally. Others who have not had treatment they should have had for ongoing health problems. A friend has ME and her health has declined terribly as she is not able to go to regular appointments. I know first hand that plenty of doctors have been quieter this year than ever - of course not including those in intensive care with high levels of patients. But generally across the board.

Is this concern about covid solely about making sure cases are managed so that the nhs isn’t overwhelmed? It seems like such a strange approach.

It’s not strange if you imagine trying to call an ambulance for a child with breathing difficulties for example - or any other possible scenario you can imagine for any age group- and there being no ambulances available. That is the reality we will face if we don’t keep the virus under control. It’s very scary. Or there being no beds or specialists available in hospital because they are all taken up with treating COVID.

Agree with you OP. There are huge numbers of ppl dying unnecessarily of treatable conditions as their hospital treatments have been cancelled. COVID is not the only or even the worse disease out there.

So far though it hasn’t been overwhelmed and yet GPs and minor surgeries unrelated to covid are not taking place. These staff can’t treat covid patients as they are not trained to do so but then they are also not carrying out normal services such as surgeries and physio. It doesn’t seem right.

It’s not rocket science. If the NHS collapses there will be even more deaths. Heart attacks, strokes,
road accidents, cancer, sepsis etc etc!! It makes every single one of us vulnerable. This is a pandemic. If you don’t understand the basics by now I don’t think you ever will.

It’s easy for me to say as I’m low risk but how long do we neglect everyone under age 70?

Even if beds are overwhelmed, why is a physio session cancelled? That is essential to some people. A physiotherapist can’t treat covid so it’s no loss there.

@BaileyBoos people are already dying because of this pandemic and unrelated to covid. It’s worth considering the strategy.

Yeah exactly it's not about protecting the nhs for covid patients its about its ability to do any usual business if there are thousands of covid patients in hospital. The nhs is stretched at the best of times particularly in winter, it hasn't got capacity for the extra work, we all need to be able to call an ambulance and it arrive, have a surgery if we need one or access to emergency diagnostics and treatment.

Most routine stuff is still happening but a lot of it on tel or video, there are risks currently associated in going physically to routine appointments. Some will be delayed due to staff sickness, isolation or redeployment.

This is not correct. Physics are redeployed into covid wards and covid recovery to work with patients.
So are speach and language therapists etc.
The NHS has been underfunded for years.
There are not enough trained staff at the best of times and posts can't be filled.

Physiotherapists absolutely treat Covid, they don’t just treat sports injuries or backache

In our health board they have just paused some routine appointments because the workforce is so depleted and there are very few ITU beds left. Surgeons can’t do operations if there is nowhere for the patient to go post op. Nurses have been redeployed to other areas, we can’t just magic up ITU nurses to care for all of the Covid patients, they need to come from other services. Then there’s all the pressure to vaccinate as many people as possible with a vaccine that takes 15 minutes and 2 qualified staff to prepare and administer.

No one cuts services lightly and none of us want to be in this position. I can’t believe people are still asking this question!

@BaileyBoos

It’s not rocket science. If the NHS collapses there will be even more deaths. Heart attacks, strokes, road accidents, cancer, sepsis etc etc!! It makes every single one of us vulnerable. This is a pandemic. If you don’t understand the basics by now I don’t think you ever will.

The NHS is going to collapse in a couple of years when there is no money to fund it any further. There will be no money because few people will have jobs and pay the taxes they have done for many years. Instead they will be reliant on state support, which, guess what? Costs even more money. Why can’t anyone see this?

There is always money if the government wants it

Millionaires are getting richer through all this. Fairer taxation could solve a lot

The nhs survived much higher unemployment than we have now

“Even if beds are overwhelmed, why is a physio session cancelled? That is essential to some people. A physiotherapist can’t treat covid so it’s no loss there”

But perhaps all the physios are now needed on covid wards to rehabilitate elderly covid patients to a point where they can be discharged to free up beds.

OP, did you not see the news footage from Italy in the Spring, with patients dying in corridors, overflowing mortuaries, doctors having to turn patients away from full ITUs? Is that really what you would like here? Because that’s what you will get if we don’t limit the spread of Covid.
It is now a race to the wire between the vaccine roll out and the spread of the (more infectious) new mutation. It is worth suffering some restrictions for a few more months, surely?

In my hospitals , we are delivering the vast majority of our pre covid activity, yes some had moved to virtual or telephone, but when patients need to be seen for a scan, a physio appt, a consultant Outpatient clinic, or whatever, all of these services are running, including routine surgery.

We are finding it increasingly tough to staff all of our services which results inevitable in cancellations and disruptions to services. We are further constrained by the guidance implemented to keep patients, staff and the public safe, which essentially reduces the number of patients we can manage at any one time.

I know with a certainty, if we fail to take these strict measures to reduce transmission now, our services will fall over. You will see the Nightengales open, and it will be field medicine not quality care. It was reported this week that some California hospitals are now in the awful position of choosing which patients to treat. We do not want to be in a position where we are denying care to people based on their age or their comorbidities. We will be unable to prevent hospital acquired outbreaks (already a massive problem), and will need to stand down elective activity to redeploy staff to provide acute and emergency care. Waiting lists will be even longer, cancers will go undiagnosed, and more people will die.

The efforts to recover from the shutdown of services during the first wave are herculean, and if we don't act now it will have been for naught.

I work in the NHS and it is to protect the NHS. But I hear you.

I had a baby in July, I'm still bleeding. I've got a gynae appt for March. MARCH!

@SillyUnMurphy

They can see it however the vaccine is imminent. You’re right, the NHS is fucked. Underfunded, obliterated etc. It’s just LESS fucked this way.

Things will be brighter at Easter re covid but to stop the NHS collapsing right now at this very moment, these restrictions need to take place. I’m not sure what alternative strategy you would have in mind?

A physio can be redeployed to Respiratory wards or ICU to treat Covid patients. So yes they can treat themZ

@suitsnot

It’s easy for me to say as I’m low risk but how long do we neglect everyone under age 70?

Even if beds are overwhelmed, why is a physio session cancelled? That is essential to some people. A physiotherapist can’t treat covid so it’s no loss there.

Physios play a very crucial role in treating covid both in itu, on wards and in the community.

So far though it [NHS] hasn’t been overwhelmed

That's because we've had lockdowns.

What do you think would have happened if we hadn't had lockdowns?

Oops cross post with all the others

You make many good points. It’s been badly managed. It was always going to be tough to manage, but shorter sharper lockdowns, not jumping in and out of tiers etc would have managed it better.

Protecting NHS from collapse is the goal, trouble is it’s on verge of collapse anyway.

I think if a vaccine wasn’t on the horizon we’d have to rethink, but since it is (please god) I don’t think the basic management will change.

And then we’ll have brexit. So economically it is not looking good, no.

Is it simply that the NHS will collapse if we don’t manage it?
People have misunderstood what “protecting the NHS” means. The number of people with Covid who need a hospital bed can not exceed the number of beds available, otherwise the excess people will die. It’s about keeping the numbers down so the NHS is able to provide treatment for all Covid patients who need it.

This had been endlessly explained before

1. Do you really think a GP can't treat a COVID patient? They are generalist Drs and COVID 'treatment' isn't rocket science. Some were already redeployed to A&E when things were bad and they will be again as it gets bad again. Same with physios

As the regular staff all go off sick with COVID redeployments will be required so other services have to shut to allow this. There is not an endless supply of extra staff to cover business as usual plus Covid.

1. The other reason non Covid services are shut or reduced is to stop people catching COVID in hospital or at the GP surgery. Loads of people did at the start and it's still happening. When cases are very high it's likely the benefit of going to hospital for a routine OPC is outweighed by the risk of catching COVID whilst you are there. Even where services have now reopened capacity is reduced because of social distancing, room airing and extra cleaning so less patients can be seen.

Everyone wants things back to normal. Obviously we don't want to work like this. I hate video consultations but you can't give someone COVID over videolink.

I have been slagged off as being lazy for doing a care home visit over video instead of going there. Well guess what 2 days later I tested positive for Covid. Now do you want me to examine your frail 90yr old parent? I mean we could assume the paper mask and plastic pinny would have stopped me circulating my COVID round that care home but what if it didn't? 1/5 of them would die and that's on my conscience.

If we let Covid "loose" and our emergency services all catch it then everybody's fucked. Cancer and strokes aren't contagious where as Covid is and we can't magic up extra trained staff. (We could employ staff from other countries but other countries need the staff and with Brexit, immigration is a sticky topic)

Of course the answer is more long term investment so it's not easily overwhelmed but I'm assuming that somebody at the treasury has worked out it's cheaper to give the NHS extra money for a year or two until Covid is more under control than commit to increased investment forever.

Everyone knows we are storing up long term issues. No-one is denying that. But we have to deal with the short term issue of Covid and try to keep whatever minimal service we can going for everything else. That's all we have the resources to do right now.

Over the summer when cases were lower services did open back up and a big attempt was made to catch up but in my area now operations are getting cancelled again mainly due to staff all being off with COVID or self isolating. Hospital admissions lag cases by a couple of weeks so there is an intense feeling of dread now because we know that in 2 weeks the tsunami will hit from this latest case surge.
Revisit this thread in 2 weeks and I hope you do not find out what happens when the NHS is overwhelmed.
Do you not remember those scenes from Italy and New York? Iran and China didn't allow much footage out but colleagues who have family there were weeping at the level of devastation and terrified of it happening here.

On top of that who do you think is going to do the vaccinating? Maybe the NHS??
Right now the issue is vaccine supply. We hardly have any. The supplies of Pfizer are a drop in the ocean
When Oxford gets approved we'll have plenty of vaccine and the limiting factor will be staff to get it into people.
So yes other stuff will get cancelled again in favour of vaccine clinics. Every member of staff that can safely wield a needle is going to be needed for a mass vaccination effort. Maybe including physios. I can't see why not they know anatomy.
Would you rather someone had a physio session or a COVID vaccine. You can't have both there are not enough staff to do usual work plus handle Covid and it is impossible to train more in the time available.