that is ICU though so not sure 1000 sounds like a small number, but not sure. Without stating the obvious you have to be very ill to end up there. My partner had pneumonia 2 years ago and was pretty ill, and did end up in ICU for a few hours but the other 5 days on the critical care ward I think it was.
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that is ICU though so not sure 1000 sounds like a small number, but not sure. Without stating the obvious you have to be very ill to end up there. My partner had pneumonia 2 years ago and was pretty ill, and did end up in ICU for a few hours but the other 5 days on the critical care ward I think it was.
MrHullMysterious
Well-Known Member
I think it is because ITU beds are highly specialised; something like 4 highly trained staff to 1 patient etc.
And in normal times you go into ITU and recover or die relatively quickly. With covid they can be in ITU for 3 weeks to months.
So that is what makes it a game changer. Now we have more ITU beds, couple of staff to 3+ patients, and some have had only basic training for ITU.
Like you said, its staff which is the pinch point.
Probs one @Hally Can answer better.
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djedwardsmith
Active Member
Some positive news on a Sunday - although the thread talks about it being March/April until we start seeing restrictions relax, I had pretty much assumed that be the case anyway. Schools going back will be the big balancing act, as soon as they can do that safely they'll start re-opening hospitality.
spinksy123
Active Member
So following this analogy.
I type this not to cause friction at all. But to get some grasp on the conflict on this forum and probably almost everywhere else as well.
The whole country finds itself locked down.
Not because the survival rate isn't 99.5%*
Not because the average age of Covid related death hasn't been 82 years of age*
But because the NHS is woefully equipped for anything on any sort of national/International scale. Taking a very, very small percentage of cases in relation to population to reach full capacity?
Obviously the government could never come out with this and the bed statistics in terms of numbers at any press conference.
Intrigued by people's thoughts here. Or actual data.
*these 2 statistics used as they're often quoted by anti lockdown advocates
MrHullMysterious
Well-Known Member
Sort of, but remember there are a shed load of people ill with covid in wards on positive oxygen pressure masks etc, which ain't in ITU. That as far as I'm aware is pretty much reserved for people on mechanical ventilation (iirc there are over 4k on that).
Government cuts and reduced staffing over years had really got the NHS over a barrel.
Also number of normal beds has been cut by 100k over the decades, and so staffing too. Some of this is due to moves to more day surgery out patient type stuff, but a lot is cost cutting as well.
That said if it was "normal flu", they'd struggle but you wouldn't have lots of patients using an ITU bed for weeks or months. Or patients in less intensive care wards doing the same. All needing high amounts of care from staff.
Bit like gov having 2 snow plows cause it hardly ever snows, then it does heavily - for 6 months. Even if manage to buy/borrow the equipment, you've got rid of the trained drivers.
That been said. If ITU capacity was say 100,000 beds, you'd still not really want to use that as your ceiling for determining opening the country etc.
That many seriously ill people has large direct costs, long term costs and impacts on a large proportion of society. Just imagine the funeral service and so on.
Shit show, but mid March I'm hopeful will be better.
Btw, I get you're just trying to understand, no problem with that mate. It's more when someone says, "god these old people been irresponsible for been old and ill"
?
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DelMarSunset
Active Member
Why are people STILL humouring that c**t? Jesus Christ!!!!
MrHullMysterious
Well-Known Member
Middle of the road we are I guess
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spinksy123
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Sort of, but remember there are a shed load of people ill with covid in wards on positive oxygen pressure masks etc, which ain't in ITU. That as far as I'm aware is pretty much reserved for people on mechanical ventilation (iirc there are over 4k on that).
Government cuts and reduced staffing over years had really got the NHS over a barrel.
Also number of normal beds has been cut by 100k over the decades, and so staffing too. Some of this is due to moves to more day surgery out patient type stuff, but a lot is cost cutting as well.
That said if it was "normal flu", they'd struggle but you wouldn't have lots of patients using an ITU bed for weeks or months. Or patients in less intensive care wards doing the same. All needing high amounts of care from staff.
Bit like gov having 2 snow plows cause it hardly ever snows, then it does heavily - for 6 months. Even if manage to buy/borrow the equipment, you've got rid of the trained drivers.
That been said. If ITU capacity was say 100,000 beds, you'd still not really want to use that as your ceiling for determining opening the country etc.
That many seriously ill people has large direct costs, long term costs and impacts on a large proportion of society. Just imagine the funeral service and so on.
Shit show, but mid March I'm hopeful will be better.
Btw, I get you're just trying to understand, no problem with that mate. It's more when someone says, "god these old people been irresponsible for been old and ill"
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- s&o/c
I think people knowing just how dire the bed numbers are in the NHS would actually make them feel better. A lot of people genuinely believe there's another agenda with regards to lockdowns and coming out of them(or not).
The fact may actually be. The government are literally sh!thing themselves with lack of resource......
MrHullMysterious
Well-Known Member
Yeah, spot on, basically boris was thinking, 2020, brexit done. Easy life.
Now they are shitting bricks. NHS capacity breach would mean pics on news of people dying in corridors, in beds and not been discovered for hours - well this is happening , but not at scale. Yet.
Didn't help they didn't bother keeping up with the pandemic planning doc the uk wrote in early 2000s. Too expensive. Let's save 10 billion or so ?
- s&o/c
spinksy123
Active Member
Quite shocked with how low the number is. Honestly thought it'd be more....
MrHullMysterious
Well-Known Member
Yeah, but its pragmatic reality of how expensive a single ITU bed costs to run. Like £2k+ a day.
Normally you don't need many as like said, few days someone is in one, then stepped down to a ward.
Covid through that out the window. It makes the body attack itself in a long drawn out process requiring lots of medical interventions. (If watch bbc or ch4 news reports, you see the amount of equipment to keep a person going in ITU, plus the regular things like draining a persons lungs and so on)
djedwardsmith
Active Member
Yeah @MrHullMysterious makes the key point that many people are missing - it's not just about deaths. ICU capacity is obviously a huge driver, we're talking about the most critically ill people, but the majority of people being hospitalised aren't actually in ICU (as far as I am aware), nor do they end up there. But they do require hospitalisation, and that in itself eats up resources. There have been several hospital trusts who have issued emergency warnings due to oxygen shortages with the amount of people they have on CPAP's and ventilators, plus you've got nurses and doctors falling ill or having to isolate.
I would be one of the first jumping in to play politics about the chronic underfunding of the NHS in any normal time, but I do think the issues in hospitals are largely down to circumstance as much as anything else and during the first wave the mass acquisition of ventilators and licensing of CPAP machines designed and cleared at pace has meant we've headed into this winter in a far better place than first feared.
I would be one of the first jumping in to play politics about the chronic underfunding of the NHS in any normal time, but I do think the issues in hospitals are largely down to circumstance as much as anything else and during the first wave the mass acquisition of ventilators and licensing of CPAP machines designed and cleared at pace has meant we've headed into this winter in a far better place than first feared.
MrHullMysterious
Well-Known Member
To use an analogy (analogy police might turn up mind?), is if this was fires and the fire brigade.
Each tender might attend on average 1 fire a day. And perhaps 1 large multi tender fire once ever couple weeks. Major incident once or twice a year.
Then we get someone dropping incendiary bombs on us all over multiple times a day. People would be screaming "why you only have 3 fire engines for a town?!" - cause we didn't have 2 years warning we was heading into the blitz.
Ok, defo hear analogy police knocking at the door ?
Each tender might attend on average 1 fire a day. And perhaps 1 large multi tender fire once ever couple weeks. Major incident once or twice a year.
Then we get someone dropping incendiary bombs on us all over multiple times a day. People would be screaming "why you only have 3 fire engines for a town?!" - cause we didn't have 2 years warning we was heading into the blitz.
Ok, defo hear analogy police knocking at the door ?
kimajy
Well-Known Member
For any false positives you might worry about there will be thousands of undetected cases associated with people who didn't get a test. I really wouldn't worry about it too much because if the UK variant got into Holland, you can be very sure that in the absence of a lockdown your health system would be extremely challenged as it gradually took hold. Don't forget the UK didn't understand what was happening in the run up to Christmas and therefore did not take sufficient appropriate measures to control transmission because they were hanging on to their old models for policy making purposes. The result you see now in UK is the outcome of that. So just be grateful you guys got the chance to lock down before the thing really got a hold.
spinksy123
Active Member
Probably screwed no matter what. But they're definitely short even without a pandemic it would seem
.....
MrHullMysterious
Well-Known Member
Yup, it's a case of run things down to remove any "fat" and save pennies shortsighted policies. Or "outsource" to mates and provide none scalable solutions.
Same for all sorts, infrastructure and so on. Just builds up problems in future. (Se USA and problems they have with their bridges)
again - a good point. Not everyone with COVID goes to ICU, but if they have covid they can’t mix on a ward with non covid patients. So the overall logistics / planning of dealing with such an infectious disease makes it difficult as well as dealing with ‘normal’ healthcare issues in a hospital
spinksy123
Active Member
This may sound ridiculous. Furloughed workers who've had the virus with Anti-bodies and T cell immunity. Crash course in basic nursing?
I'm assuming NHS staff use the App. Probably pinging all day around the hospitals? So losing a lot of staff there too?
I'm assuming NHS staff use the App. Probably pinging all day around the hospitals? So losing a lot of staff there too?
Those in healthcare and care homes are told not to use the NHS app while working, but they do / should be getting tested regularly I think
spinksy123
Active Member
Really? Surprised by that. Maybe they do need to look at ways to give extra resource though. If anyway possible
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