Did Public Health England trigger its own crisis?

In a typically Anglocentric piece, the Guardian suggests:

The health service is struggling to cope with record numbers of Covid cases to such an extent that some patients may be denied access to an intensive care unit or the chance to go on a mechanical ventilator, the Hospital Consultants and Specialists Association (HCSA) said on Tuesday.

There is no mention of the situation in Scotland.

The Hospital Consultants and Specialists Association warned of this on the 16th September:

HCSA calls for rethink on ‘diluted’ infection control guidelines

HCSA has called for an urgent rethink of England’s Covid-19 response in order to help prevent a second spike which could overwhelm hospitals. Recent data released by the government revealed that we are currently only a few weeks behind France and Spain, both of which have reported large increases in infection rates.  HCSA President Dr Claudia Paoloni warned that policy-makers here are currently adopting a complacent attitude towards hospital admissions, which have begun to creep up in the UK.  In recent weeks Public Health England (PHE) and NICE guidance has been released for healthcare settings which stipulate lower protections in order to try to tackle the NHS procedure backlog. 

https://www.hcsa.com/covid-19/latest-updates/2020/09/hcsa-calls-for-rethink-on-diluted-infection-control-guidelines.aspx

The infection control problems were highlighted by The Centre for Evidence-based Medicine on October 30th:

Probable Hospital Acquired infections in England remain persistently high: currently, 17.6% of COVID-19 infections fit the NHS England definition of probable healthcare-associated infections (HCAIs). These rates have been as high as 25% in the North West and continue to climb in the North East and Yorkshire.

In Scotland, the rate was 2% or less.

https://beta.isdscotland.org/find-publications-and-data/population-health/covid-19/hospital-onset-covid-19-cases-in-scotland/

The Ongoing Problem of UK Hospital Acquired Infections

There is no threat of overload in ICU in Scotland:

https://talkingupscotlandtwo.com/2020/12/29/it-is-under-control/

23 thoughts on “Did Public Health England trigger its own crisis?”

  1. Lewis Goodall
    @lewis_goodall
    ·
    11h
    “Staff are near burn out with lots of them showing signs of PTSD. I see nurses and doctors crying on the corridors before, during and after shifts.

    To anyone who says this is not real they need to be shown the inside of a Covid ITU or acute admissions ward.”

    Liked by 1 person

    1. Brenda, that is a most apt, succint answer to a question. Bang on.

      Professor Sridhar said (iirc) that Scotland could not eradicate (bring community transmission to the lowest level possible) covid19 unless England tried to do the same. Although Hancock claims that is the strategy, actions belie the words.

      We know from experience that what happens with covid in England can affect Scotland. My interest in what is happening in England with covid is, at present, for two reasons. One, empathy with the people who are getting it hard. Two, because what is happening there is likely to be a harbinger of what will happen in Scotland because of the new variant. It can’t be said that the increasing incidence of new variant causes the huge spike in cases. There is a strong association between the two.

      Dido Harding’s difficulties extend to mass testing of asymptomatic people. I put a link up yesterday to Professor Pollock’s piece in the BMJ about that. There is a twitter thread about the efficacy of mass testing at this link.

      https://twitter.com/deeksj?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

      Mass testing of asymptomatic people is planned for the return of University students and (iirc) is currently in use in Scottish care homes. When I first tried to comment on this here, John pulled the comment. Since then mass testing in Liverpool, Sheffield and Manchester has been halted.

      I didn’t expect the Spanish Inquisition. Where I live is nobody’s business but mine. That said, if one reads what I have written here in the past it is pretty obvious where I live.

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      1. ‘Two, because what is happening there is likely to be a harbinger of what will happen in Scotland’

        Perhaps but to the same extent? Different comms, different confidence, great compliance, fewer cases?

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  2. John,
    O/T The Herald today, paper edition, has a large article about Care Homes that have failed or come close to failing inspections. Lots of names named.

    I think they may have finally followed your example and read the Inspectors’ reports.

    Not sure if the article will make it onto the Herald’s web site. They are getting very selective these days about which articles in the paper make it onto the website

    Like

  3. The Tories cut NHS spending £20Billion from 2015 to 2020. The NHS needs £10Billion. The Tories have funded £4Billion. They have increased Defence spending £Billions. Spending £Billions on HS2, Hickley Point, Trident and the Brexit mess.

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  4. Being an English newspaper it is not surprising that they publish Anglocentric news.
    I would expect that to be the case in every country which has “national” titles,except of course for readers/viewers in Scotland where we can read about what is happening in the “real” world.
    Very inconvenient for the Greater English state that we Scots have our own legal system,education and health services so they have to pretend that we don’t exist.
    imagine if people in Denmark were constantly having to read about health issues in Germany.

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  5. Public Health Crisis in England. It’s so bad they are edging towards a mass roll out of a single jab of the vaccine to as many people as possible with a follow up 3 months later. In a desperate attempt to blunt the progress of the virus.
    Radio5 reporting the FA are thinking of a circuit Breaker in the League.

    Not sure of next bit (interference on MW) half of league games in England were called off last night due to Covid

    Now that’s what I call a Public Health Crisis

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  6. John, I would like to agree with you. But….the new variant becomes the dominant virus, replacing the “old” virus raising transmissibilty.

    https://uk.reuters.com/article/uk-health-coronavirus-variant/explainer-the-new-coronavirus-variant-in-britain-how-worrying-is-it-idUKKBN28V1MM

    The higher level of transmissibility makes lockdowns less effective.

    Vaccination with greater levels of transmissibility may allow further mutation to leak into the population with an unknown effect on the efficacy of vaccination.

    As to greater compliance here in Scotland (Spanish Inquisitors, note) I doubt that somewhat. When I look at Tabby the great majority of infections (still with low levels of the new variant) are all below the age of 65. Those dying are older.

    We don’t know much about the effect of the new varaiant on children but some scientists think it makes children more vulnerable to infection given the increased transmissibility that is thought to happen.

    Also, the problems with mass testing of asymptomatic people, false positives and false negatives, is likely to cause problems in Scotland in care homes and Universities which may be much enhanced by the new variant.

    I am sure you have noted everything is hedged with “may”, “might” and “likely”.

    Like

    1. sam a serious question to your “But….the new variant becomes the dominant virus, replacing the “old” virus raising transmissibilty” –
      As this variant has been detected in other countries previously, has not become the dominant variant, has not escalated levels of infection, what is it those countries have done which succeeded in suppressing it which does not persist in south and east England ?

      Like

      1. Bob, I’m no expert on this or anything. What I say is based on what I have read.

        The new variant seems to have originated in the UK, according to Patrick Vallance (probably SE/London). It has travelled from the UK across the world and to Scotland, inevitably. It has not yet had time to become the dominant variant in those places and in Scotland but it is likely that it will by virtue of its increased transmissibility.

        The bigger figures in Scotland should be a big worry at this time. We have not yet seen the effects of Christmas and Hogmanay is to come.

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  7. I should add, Bob,that I fear the UK government is not in control of the virus and may be unable to establish control. Testing is questionable (putting it mildly) as far as lateral flow tests go.

    Insufficient numbers of those in contact with a positive case (though the PCR test does not tell you if the person testing positive is or isn’t infectious) are being contacted by private contractors and this is unlikely to change – Tory ideology.

    As few as 10% of those testing positive may be isolating. Taking all of this together (and the ability of the virus to mutate further) makes me think it will be very difficult for the UK government ever to manage the new variant.

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    1. Thanks sam, I’m no expert either but you missed the relevance of the question.
      First, ONLY in England is this variant a dominant strain, ONLY in England is 70% increased infectivity being referred to, by way of explanation for the rapid increase in infections in SE England.
      Second, why would Europe lift the traffic blockade after only 48 hours if there was even the slightest possibility this variant was more dangerous, I suggest they knew it wasn’t.
      We must remain vigilant, but something is decidedly off when this variant is the UK-only apocalypse, when even the UN points back to ONLY the UK and no evidence, and the rest of Europe doesn’t bat an eyelid.

      I agree with your second point that the pandemic is now out of control in SEE, but given their public compliance, test and trace, and overall Covid strategy, I’m frankly shocked it hadn’t happen sooner.

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  8. Well, I don’t think travel restrictions have been lifted. All non-essential travel to and from the UK discouraged by EU Commission until further notice as of Dec 28.

    https://www.lexology.com/library/detail.aspx?g=7d5804e6-d7c9-4842-9a94-5423a64ab472

    Sky News was reporting on 25 Dec travel restrictions imposed on UK by 40 countries. I can’t find anything online to suggest that travel restrictions have been listed.

    “Ireland’s ban on travel to and from Britain has been extended to 31 December, as countries around the world shut their borders due to fears over a new coronavirus variant.

    The restrictions have been announced by at least 40 countries.”

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    1. I was referring specifically to lifting of the ports blockade sam, but take your point over precautionary air and rail limitations still being in place citing the new variant. An extension of that policy is highly likely given surging prevalence in the UK.
      It will be interesting to see what WHO make of this “new strain” in the coming weeks, it cannot be left as an anomaly. Mutations are fully expected, this one had already been recorded in September and no red flags, until London raised the alarm in December.
      Given Johnson’s predilection for “..chucking these rocks over the garden wall..”, I remain nervous but sceptical.
      Whereas the London etc outbreak will take months to get under control, I’m quietly optimistic the SG approach will bear fruit by mid January.
      By that time a better understanding of this “new variant” will hopefully have evolved.

      Like

      1. For the next two/three weeks, the new case figures in Scotland will tell us all more about the new variant. I am fearful and sorry to say it. I hope you are right.

        Like

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