We need a new Covid Strategy...

[Hazelnutbean]

Suppressing Omicron, a disease that seems to be little more than a bad cold for most (having had the protection of vaccines or prior infection) seems to be so transmissible that it will be impossible to contain unless we live a permanent lockdown.

Wouldn't a better strategy be to just accept this and:
a) allow it to pass through low risk groups scrapping isolation, with people just off work if too ill;
b) bring back shielding for the CEV extending to whole households to allow proper protection, fully financially
and practically supported;

The latter would put a dent in workforce numbers, but so is all the isolation that current measures require, but the speed of Omicron transmission would mean that if it was allowed to spread exponentially in low risk groups (most of whom would only need a couple of days off if at all) it max out in a couple of weeks and burn out in a month or so, meaning these measures would only be needed for six weeks or so.

Yes, it's a bit shit for those shielding with their families, but if we carry on as we are, they'll likely have to shield anyway but for longer.

@Hazelnutbean

Even if removing the isolation for period for those with coronvirus meant people could go about normal life (and tbh I do think you're underestimating the impact of infection - for enough people to cause problems, it's not just "a cold")

It wasn't pre-vaccine admittedly .... But for most fully vaccinated under 50s, Covid is very minor, it really is. Some get it worse than others and it's equivalent to the flu, but very few in this category are properly ill.

Again, I think this is a lack of understanding

A tiny proportion of huge numbers translate to enough people impacted to cause issues.

Society cannot function if a certain proportion of the population are ill at the same time.

It would be outrageous if that were still the case.

It is still the case. I know this because I was working today wearing one.

What's more outrageous is that most clinical care for known covid positive patients is still done in surgical masks, inspite of us knowing they are insufficiently protective of clinical staff.

So where are you planning on magicing all these FFP3s from? Or the testing capacity to fit test every carer in the country?

And I repeat - have you tried working in an FFP3 with cold symptoms? Because, if you had, I think it unlikely you would be suggesting this as an option.

• @Hazelnutbean have you tried wearing an FFP3 mask with even a relatively minor cold? I have. It's bloody awful. You can't blow your own nose. You can't take a sip of water to soothe your throat. Every time you cough or sneeze you splatter the inside of the mask and your face with snot-goo, which you then can't wipe off.*

I can quite imagine it would be horrible... In such a situation that doctor/nurse probably shouldn't be in work. Even if they weren't in work, that's better than is currently the case where everyone is off regarding of symptoms, and for a full ten days at that!

Yes we do need a new Covid strategy, but your idealistic ‘living with Covid’ isn’t it.

The vaccines aren’t the saviours we hoped they would be, yes they’re helping but not enough to rely on them alone. We need better ones and ideally, an eventual complete cure.

We also don’t know how vaccines are going to work long term. Essentially we’re still ‘learning as we go’ with them, so booster immunity is still a guess, how long with boosters hold out for?

Long Covid is still a big question mark in terms of how widespread and invasive it’s going to be across society as a whole.

Omicron is effectively Delta on steroids, the next variant could be even worse. Reinfection is now a real concern so there goes the herd immunity argument.

Applying Pre-covid idealism’s to a Covid world is futile yet we still have to accept this before we can move on effectively.

You also don't realise just how much wearing full PPE impacts on patient throughput. Particularly surgical patients. It slows EVERYTHING right down. From the time to don and doff, the additional time just doing stuff takes, the additional clean down for theatres... If you wanted to come up with a strategy to delay cancer care even further, then requiring everyone to wear FFP3s for all patient contact would be a great suggestion.

I will not mention the awful impact it has on communicating with patients. And how disproportionately that effects patients who have impaired hearing, learning difficulties, autism, anxiety, dementia, speak English as a foreign language... I don't mention it because I'm sick to the back teeth in struggling through it. A day's shift trying it and you'd realise why providing all clinical care in the full shebang is going to be hugely damaging, both to individual patients and clinical capacity.

And that's before you factor in the impact of clinicians sharing their bugs with the most vulnerable.

@Motorina / @riveted1

Thank you for your replies. You've convinced me that what i was suggesting for clinical settings is unworkable....

If omicron does infect hundreds of thousands of healthcare workers in a short time frame, then those who are medically fit to go into work will have no choice but to go in as there will be literally no staff to look after the patients. As PP have mentioned this is absolutely NOT ideal but there is no other choice if that situation arises. People seem to forget that in winter, staff with heavy colds were still expected to turn up to work. Before I get flamed, I'm not comparing colds and covid, but rather pointing out that sick staff have had no choice but to work when unwell historically and no one raised an eyebrow. As the majority of CV etc are vaccinated then hopefully they will be protected. Fingers crossed that we won't have such dire staffing levels that covid + staff will have to work but people may need to be realistic about it happening.

Thank you. I'm sorry if I'm grumpy - it's been a long day, in a long week, in a long month...

I think we should look at the actual data from SA (who have not increased their restrictions and do not have vaccine mandates and passports) and stop basing our decisions on pessimistic models that have been proven time and time again to be inaccurate.

@Fluffysocks88 indeed - it happened in I think it was Belgium last winter. It is one step better than leaving patients with no care at all, but that's very different from having it as a planned strategy.

@Motorina

Thank you. I'm sorry if I'm grumpy - it's been a long day, in a long week, in a long month...

Don't worry... I've no problem with people who know what they're talking about rebuffing my arguments forcefully. It helps me understand the real issues.

Thank you for the work you do.

Vaccines (particularly with booster) do make a difference. We'd be in a much much worse position without them. Right now ICUs are full of the unvaccinated (relatively young and previously healthy btw - because the most vulnerable are too frail for invasive procedures).

Two years and yes we know more now. But there's still a lot to learn. We still don't know the origins. Was it from a lab? (and if so, was it modified?). Two years is nothing when it's a completely new disease.

There is light at the end of the long tunnel. We just have to get there - and that involves taking mitigating measures (with Vaccine Plus being a much quicker and less painful road than Vaccine Just).

For the future we'll have wider availability of the drug treatments - the antivirals and the monoclonal antibodies, more of the world vaccinated (reducing the risk of a mutation) and more knowledge.

@bumbleymummy

I think we should look at the actual data from SA (who have not increased their restrictions and do not have vaccine mandates and passports) and stop basing our decisions on pessimistic models that have been proven time and time again to be inaccurate.

We could also listen to the actual experts. Their advice, and their warnings.

You cannot have COVID+ people working in a hospital, I cannot express strongly enough how fucking awful this would be

We're probably about to find out exactly how awful this will be.

If Omnicron is anything, we'll find it's already widespread, even if we don't yet know it.

In terms of ICU outcome, we already control for staff that unknowingly harbour colds, flu, etc.. COVID is not different unless nurse/patient infection control protocols don't work. (Someone tell me it's wrong?)

The dumb thing would be to cripple the NHS by removing staff.

@Tealightsandd are only people in the U.K. considered ‘experts’ now? Or are we allowed to listen to the experts from SA?

And you are wrong about your figures for icu and people being ‘otherwise healthy’ as you are well aware.

Well it's been widely reported @bumbleymummy That icu are full of the unvaccinated.

The WHO is international btw.

www.bournemouthecho.co.uk/news/19790464.covid-patients-poole-bournemouth-icu-mainly-unvaccinated/

In America too.
www.bloomberg.com/graphics/2021-covid-surge-shows-overwhelming-cost-of-being-unvaccinated-america/

And widely corrected.

London Ambulance Service crisis

www.independent.co.uk/news/health/ambulance-service-engulfed-staff-covid-b1978091.html

Some good news before bed.

Elsewhere, new research on Friday showed that a Covid booster shot would offer around 85% protection against severe illness from Omicron.

www.bbc.co.uk/news/health-59707252

Goodnight all.

Unfortunately @IWannaWishYouANutNutsChristmas
the government has throughout the pandemic only acted when it's too late for London. Hopefully the booster campaign will help a bit.

The fact you were suggesting Covid-positive HCPs should be working in ICU took the cake really OP. Jesus wept.

Don’t underestimate Long Covid. 1/10 people will get it… Covid is a mass disabling event. I’ve suffered multiple physical and mental symptoms for over a year and I can’t even work currently. I wouldn’t wish this shitty existence on my worst enemy.

My DH is ECV. Able to fully work from home, no option at the moment any way as his work has closed all UK offices. I’m wondering exactly what fully practical support would look like for us as I would be home schooling a 5 year old, looking after a toddler and running the household. How would you ensure our physical needs (exercise) with no garden, social (no really interaction or a break for me) or medical needs (kid’s hospital appointments and routine dentists) would be meet?

I’m not saying the current plan is working at all but you can’t just lock up massive sections of society permanently.

@CrocodilesCry I think what the OP was suggesting was that in a disaster type scenario in which thousands of HCPs get sick in a short time span, it is preferable to have asymptomatic covid + staff as opposed to zero staff. Bear in mind that icu staff work in full ppe and have excellent infection control standards. Also, many of those in icu will be there because they are already infected. The handwringing needs to stop about covid + staff working in an emergency situation. No one is suggesting this is fine and dandy but if the choice comes down to being looked by covid+ staff or not receiving medical care at all as the hospital is shut due to no staffing, I can guess what most people will choose.