‘Covid affects all acute care – the system is bogged down’ | Nick scriven | Today Headlines

‘Covid affects all acute care – the system is bogged down’ | Nick scriven

| Latest News Headlines | Fox News

“Hospitals in the north of England are incredibly busy now, especially because of Omicron. At the hospital where I work, we’ve gone from 26 Covid inpatients on Boxing Day to 104 now.

Unlike previous waves of Covid, only four people are treated in intensive care, while in previous waves, we were at most 20 people in intensive care. This is good from a patient perspective. But it stresses out the rest of the system, including the part of the system that I work in – acute medicine.

This is because the system somehow gets dirty from the infection control procedures we need to implement to keep patients safe and separate Covid and non-Covid patients. These are especially needed at this time, given Omicron’s ease of propagation.

Covid patients should be kept in single rooms where possible or isolated in areas for them, which may reduce the number of beds for other patients. Do we have enough single rooms for everyone? Not at all. And if a non-Covid hospital patient in a four-bed bay tests positive, you can lose the other three beds because segregation is so important.

If there are not enough beds for other patients, you cannot bring in patients for an elective procedure because urgent patients have filled the elective beds. This means that we cannot bring in as many patients for elective procedures as we would like.

The number of patients we are currently treating – both Covid and non-Covid – is pretty incredible. Our acute medicine team is 45 patients, but this morning we had 62. Ten of those 62 have contracted Covid and the rest have a mix of all the medical conditions that get people to the hospital – pneumonia, accidents cerebrovascular disease, heart attacks, liver disease. My colleagues in respiratory services are the same. They are made up of 45 people and have 58. The Covid affects all acute specialties.

We have more non-Covid patients than we ever saw in the first week of January, and we have more Covid. It’s not the worst year ever, but it’s on par with it.

This is my fourth wave of Covid. Staff are mentally tired of making so many decisions all the time without interruption. But this time, my colleagues and I are not thinking “here we are again”. It’s more “we have to do this, we are going to take care of these people, it is something that we have to do”. No one is happy. Nobody takes advantage of it. But it’s kind of head down and doing all we can for these people.

You still feel a little anxious, however, coming in each morning to see how many patients are waiting for you in the emergency room, who don’t have beds. How long have they been there?

The staff sickness caused by Omicron does not affect my hospital too much. We’ve had a few young doctors on leave, but only a few consultants, and from a nursing perspective we’re doing. But I do know that parts of other hospitals in the north have been really devastated, decimated, because of a horrific staff shortage.

You know an NHS trust is in trouble when they send group texts saying ‘can someone come in and do a few hours? Many NHS staff across the country will now receive these messages from their workforce. These are messages to the doctors and nurses basically saying “can someone take a few hours to come and help?” They seek help in all front-line services – A&E, medical admissions, surgical admissions and respiratory medicine. They are the ones who are really busy and need more staff.

Are people answering the call? Most people are now too tired. Some answer and enter. Maybe they have a few days off and choose to come in, whatever the risk to themselves.

But I talk to people who say, ‘Yeah, I got the text, but I’m just too tired. My choice is either to work overtime or to do my shift tomorrow. And I will stay with my shift tomorrow ”.

* Dr Scriven is a past president of the Society for Acute Medicine, which represents physicians specializing in acute medicine and caring for patients who do not need surgery, many of whom are Covid +

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