We are now in disaster mode

[lovelemoncurd]

“We are now in disaster medicine mode,” it said.
“We are no longer providing high-standard critical care, because we cannot. While this is far from ideal, it’s the way things are, and the way they have to be for now.”

I see that this means rationing medical care. So those who would have previously been given a chance will now not.

This is really significant!

@throwa which trust do you work in? Genuinely curious where you are getting your they are prioritising beds for 20 and 30s information from.

Mr friend's 83 year old mother had a stroke on Tuesday, and she was admitted to and is being treated at St Georges, their local hospital.

@Fembot123

What’s ‘Three wise men’

It’s when a small group of senior consultants decide options, which can depart from normal triage (where you treat the sickest first)

It’s different from battlefield reverse triage (where you clear the decks by treating the least sick first)

It’s a more rounded approach - still assumes you deal with the most unwell first, but not when it’s likely to be hopeless (an extension of ordinary decision making about likelihood of surviving ICU which is part of normal admission criteria)

@BIWI

Have you never had the experience where the Royal Mail doesn't bother knocking, but just shoves a card through the door?!

Standard

Very interesting ☺️ Thank you @iVampire

@screamingfemale

well *@tokenbalm* vitamin D has a far longer history of being beneficial to health than the vaccine does, and a much better safety profile. Anyway the vaccine won't stop you from getting or transmitting Coronavirus, it just means you're less likely to have severe symptoms, much like having a good immune system will do for you. Not sure whats up with society that everyone has succumbed to the billion dollar marketing budgets of big pharma, begging for synthetic, untested chemicals when a good diet and fresh air is provably as effective at keeping your immune system strong.

@screamingfemale

Because, as you can plainly see, the NHS in some areas of the country is under untenable pressure. So to try and avoid this spreading further we are in a National lockdown which is causing huge damage to both the economy and education.

Sadly there is no evidence VitD and a good diet, useful though they are, are going to be as effective in reducing spread as a vaccine, thus people are quite keen on said vaccine.

I think a little more reading around the subject might be in order for you. Perhaps watching or reading a news source every couple of days and a sub to New Scientist would be a good place to start...

As happens every winter. Anyone who thinks that medics haven't always had to make "difficult decisions" has clearly never spent time on a gerontology ward - I pick gerontology because that's where I've spent most time, but such "decisions" are of course made across clinical disciplines - that's why there are NICE guidelines.
The government can, and will, hide behind Covid, and that narrative is being swallowed wholesale it seems, but things are only in reality marginally different from normal - it's just that many, it appears, were too ignorant about health and death to care before the last March.

vitamin D has a far longer history of being beneficial to health than the vaccine does, and a much better safety profile.

I take Vitamin D already and am planning to have the vaccine. I’m not aware that one causes an allergic reaction to the other.

I am not sure that locking down is helping. We have all these cases despite closing schools, not having full commuter trains or busy offices, not allowing mass gatherings.

Well it's stopping things being even worse I suppose

So it is helping then?

My area was one that was in tier 4 for Christmas, rising cases etc. Infection rates are flattening, our hospitals are ok so far. I am grateful the majority seem to be following the stay at home advice. My dad and SIL (different areas) have both had hospital appointments cancelled. One is for MS and I feel so sorry for her, she is getting worse and not getting much help. But that is the reality of the situation right now.

@ComesAsTheEnd

Yesterday I took my 84 year old mother for her Covid vaccination. It was in another town, so altogether including me collecting her then travelling to the vaccination centre an approx 12 mile journey. Throughout the drive the roads were packed out - it was like a bank holiday with traffic everywhere (and no, most weren’t headed to the vaccination centre). I thought we were meant to be in lockdown but obviously not for a lot of people. During the original March lockdown the roads were deserted. People need to stay home when they can.

Completely agree. I normally get public transport to work (hospital) but decided to drive as was going to be working late and wanted to avoid the chin mask wearers on public transport . The traffic is off the scale! I remember how eerily quiet the roads were in lockdown 1 and yet, this is more infectious, numbers at their highest and the london is pootling about. In part would blame government for not realising how their messaging is being perceived.

In Scotland with a curve behind London, locking down earlier in the curve was beneficial to us last time so hoping we don’t get as bad as London is now.

For people asking why it is worse time I can say locally we have many more non covid patients and only the worse hit hospitals are cancelling elective cases so everywhere else is juggling a massive work load whilst following social distancing and covid measures - the cleaning and changing PPE is endless. Also people are being treated at home with steroids and assessments for admissions and discharges are finely tuned now so those admissions you see are usually very ill.

@nhsblue

Thanks for your reply. Please look after yourselves too. I firmly hope the government will make the necessary changes to support the work, finances and physical and mental health of NHS staff, now and once this pandemic eases. If there's any support I can lend to this through the ballot box or petitions etc I'll give it. Sorry I can't do more

@thefallthroughtheair

As happens every winter. Anyone who thinks that medics haven't always had to make "difficult decisions" has clearly never spent time on a gerontology ward - I pick gerontology because that's where I've spent most time, but such "decisions" are of course made across clinical disciplines - that's why there are NICE guidelines. The government can, and will, hide behind Covid, and that narrative is being swallowed wholesale it seems, but things are only in reality marginally different from normal - it's just that many, it appears, were too ignorant about health and death to care before the last March.

Are you a health care worker ? I have not seen a single statement from a health care worker stating that this is only marginally different. Where are you getting your information from ?

All those working for the NHS directly involved in Covid cases, I'd like to ask you a question.

Do you see a trend amongst these patients? Is there something that links them all or many of them or are the patients background, age, circumstances all random.

I don't ask this to be goady. I ask this because if there is a common link e.g. overweight or unfit or smoker then people need to act on that info NOW along with staying in and keeping away from others.

@thefallthrroughtheair
Sorry I didn’t word that well. You do say you have worked on wards. I think everyone is aware that difficult decisions are always made but your statement does not tally with people currently working through this crisis.

It’s strange, when I’ve been taking my vitamin D (100 mcg/4000 iU, after I discovered I was still deficient on a quarter of that dose), I must have missed the bit which said “If you take this, you are not allowed a vaccine.”

I thoroughly recommend people to take vitamin D - I currently have Covid, it’s relatively mild, God knows what it might have been like if I wasn’t taking the vitamin D. But a vaccine would have been much more effective at stopping me getting it. I’ll be taking it when offered - even though I will probably be immune anyway - because, why wouldn’t you?

Am surprised at those commenting about traffic, I normally catch public transport to work as to drive would take a minimum of 90 mins, that would be a good day. Currently I drive as the roads are quiet and it takes me 40 mins! Loads of parking available too as clearly people are staying home

It’s terribly scary and I am sorry to read some of the horrible situations on here. I could add some too which is why I am frightened. Perhaps the key worker children who AREN’T really key worker children could be made to stay at home as some threads seem to suggest there are quite a lot of children still in schools. I’m not worried about the health of the children attending (from Covid anyway) but I am worried about my colleagues, community transmission and the fact there will be limited healthcare for any condition.

nhsblue

“I work in the NHS and don't say this lightly but I'm frightened for the coming weeks.”

Heartfelt thank you to you and your colleagues.
We all have to do everything our personal circumstances allow to comply with the regulations, take personal responsibility and relieve unnecessary additional pressure.

@TwentyTwentyOne I work in ICU although currently recovering from covid so haven't been in since start of december. Patients were all shapes and sizes, not all obese smokers and a variety of ages. Many had comorbidities like asthma, hypertension and diabetes but presumably had many years of life expectancy ahead of them. One thing that was apparent was the number of bame patients, asian as well as afro caribean. Don't know whether that was a trend noticed anywhere else and obviously I've not been at work for a while so don't know whether things have changed.

@TwentyTwentyOne

All those working for the NHS directly involved in Covid cases, I'd like to ask you a question.

Do you see a trend amongst these patients? Is there something that links them all or many of them or are the patients background, age, circumstances all random.

I don't ask this to be goady. I ask this because if there is a common link e.g. overweight or unfit or smoker then people need to act on that info NOW along with staying in and keeping away from others.

@TwentyTwentyOne, we know already that being overweight/obese, diabetic or a smoker increases the risk of ending up in hospital.

Which why I fully agree that lifestyle changes are crucial. I just don’t believe they are crucial just for covid

Yep BAME are also. Much more affected as well as people from poorer backgrounds

The only bit I find reassuring is the significant drop in new infections reported yesterday. It's too early to be the vaccine so, fingers crossed, the majority of people will behave themselves and stay at home during this lockdown. Deaths are increasing sharply though.

It feels like we're so close to getting out of this but yes, you can see it getting a lot worse over the next month. I can't believe there are still idiots out there that think you can cure this with supplements and fresh air 🤦‍♀️