London – Hospitals in the UK are under unprecedented stress as the rapidly spreading version of the coronavirus is tearing the country apart, with pressure rising as doctors say they are saving more lives, meaning more hospital beds are being used.
The more contagious version of the virus has led to a record number of hospitalizations and stretched the government-run National Health Service to extremes in some parts of the country. As they deal with the wave, practitioners seek to reduce deaths in a number of ways, led by the harsh lessons of spring.
They have established protocols so that elderly people carrying the virus are not sent from hospitals to nursing homes, where last spring such actions led to the spread of the virus, which kills thousands. They use improved treatments for Covid-1
In the meantime, they continued with planned operations so that people with serious diseases such as cancer could receive procedures. This also means that more hospital beds are occupied.
The downside: hospitals are even fuller and under more pressure than they were last spring.
This time there is a “perverse paradox”, said Will Ricketts, a chest consultant at Royal London Hospital in the capital, where every 30th person is now thought to be infected with the virus.
“Patients who previously did not survive a few days after admission now survive for weeks,” said Dr. Ricketts. “This is obviously good news overall, but it at least partly explains why this wave has stretched us so thin.”
The number of people hospitalized with coronavirus in the UK has risen to its highest levels in the pandemic and is now 49% higher than the previous peak in April.
“The next few weeks will be the worst weeks of this pandemic in terms of NHS numbers,” Chris Whitty, England’s chief medical officer, warned on Monday.
The number of spare hospital beds in England fell from 18,397 on Christmas to 6,516 on 5 January.
Pressure on hospitals is particularly high in London and the south-east of England, where the rapidly spreading version of the coronavirus appears to have originated in September and has since taken hold.
The option increases the huge number of infected people. It is now estimated that one in 50 people has the virus in the UK. Scientists estimate that the mutated virus, first discovered in the UK in December, is between 50% and 70% more susceptible than older versions of the pathogen.
This time, more young people get sick because it is easier to catch and more of them end up in the hospital. A quarter of all Covid-19 admissions to hospitals in England are under the age of 55, said Sir Simon Stevens, chief executive of the NHS, on Monday.
By mid-April last year, the NHS said it had vacated more than 33,000 beds, the equivalent of 50 new hospitals, in part by sending coronavirus-free patients home to prepare for an influx of viral cases.
Field hospitals that offered surge capacity that was never fully needed in the first wave were largely turned down. One of them in London is now used to deliver vaccines and is designed to become a rehabilitation center for patients with Covid-19.
Electoral procedures were restored before the virus resumed its attack. Hospitals are still trying to clear the backlog, as the drop in eligible cases began a 73% drop in April.
Concomitant damage in terms of hospital stays, deaths from other diseases and high Covid-19 deaths in nursing homes after the first phase of the pandemic prompted officials to try to keep normal health services running in 2021. , even when the new option coincides with the pressure in the winter from other respiratory diseases such as influenza.
Clinicians are now much better at treating patients with coronavirus, as well as understanding the signs that intervention is needed. Although it is too early to estimate mortality, the daily reported deaths between spring and winter peaks have increased by only 8%.
“The last nine months have generated Covid specialists,” said David Strain, a senior lecturer and consultant in the Covid-19 department at the University of Exeter Medical School in the South West of England.
“It also makes people live longer,” he said. Which means, he said, they stay in the hospital for longer periods.
“We’ve been seeing for a much longer time in both intensive care units and high-dependency wards,” said Dr. Strain.
Elderly patients living in nursing homes are no longer discharged unless tested negative for the disease or quarantined, usually in hospital, for 14 days after a positive test.
Daily hospital discharges in nursing homes in the first two weeks of March while the NHS was preparing for the pandemic were 5% to 9% higher than in the same period in 2019. Covid-19 tests were not required for discharge. .
More than 20,000 residents of old people’s homes in the UK died from Covid-19 in 2020, according to the country’s National Statistics Office, a quarter of all deaths in the country from the disease last year.
Doctors have been issued pages with guidelines for discharging patients to nursing homes and say they are now very cautious about allowing someone to leave the hospital who needs care at home or in residential care, fearing that the virus could to be spread through service workers who go from house to house.
Treatment with dexamethasone, a relatively inexpensive steroid, has also improved survival rates for patients with Covid-19 as the pandemic progresses, doctors say.
NHS data show that the average patient stay confirmed with Covid-19 before discharge or death was 12 days in July, compared with seven days in April. This means that more hospital beds take longer.
And because more critically ill patients survive the virus, they need extra care during their recovery, doctors say.
“While this is a huge and positive development, the benefit is that it increases bed pressure and the capacity of hospitals to respond during this second wave, which has not yet reached its peak,” said Tom Wingfield, a consultant and public relations specialist. health in Liverpool, in the north-west of England.
Write to Joanna Sugden at email@example.com
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