Critical Care with Covid-19: Tier 4FS.

Photo by Bermix Studio on Unsplash

I'm starting to feel like a harbinger of doom. Everytime I say 'I'm scared that...' it happens. The only thing that hasn't happened yet is people fainting in their PPE, thank goodness. But late presentation of very sick people, check. Relaxed too far and got a nice second wave, check. And now we're on for wave three. I live in the south east, which looks to be heading into exponential growth right now. So we have just received the news that we are entering Tier 4. Which was not a thing until yesterday. We now have tier 1 - medium risk, tier 2 - high risk, tier 3 - very high risk, and tier 4 - what? Extremely high risk? Bolt the doors and hide? I think tier 4 f*** sake has a nice ring to it.

In all seriousness though, this is scary as you like. They announced that there has been a new variant of Covid found, which is up to 70% more transmissible. That means way more contagious. And considering that covid is very contagious to start with...uh-oh. This is not totally unexpected, mutation of viruses is a thing - that's why flu jabs are yearly. And it doesn't look like it makes you more sick, the government said mortality (the number of people who die from it) is about the same as regular covid. But it does cause further problems for health services. I heard at work this week that they were predicting a large peak in the next few weeks and that up to 90% of our inpatients could be Covid patients. Their last projections for the winter peak were pretty much bang on. That was before restrictions were tightened, so hopefully that will stop things getting as bad...but still. Eek.

On the plus side - vaccination has begun! I'm super lucky that my trust has been one of the first able to offer it to staff (I understand it comes down to cold storage capacity among other things), and I've already had my first dose. I'd urge anyone who's offered it to take it. I understand that people are a little nervous about it coming into being so swiftly. But the reason vaccinations usually take ages to be approved is because 1) bureaucracy and 2) recruitment. The reason that this one has managed to happen so quickly is because the whole world has a vested interest in its existence! So a lot of money and political pressure has pushed it to the top of everyone's agenda - no more waiting for it to get to the top of the pile, it’s already there! Problem No. 2, recruitment, again the whole world wants a vaccine. That means a lot more people aware and willing to participate in trials. The Pfizer vaccine trial involved 41,000 people and there were no safety concerns raised. That seems like a reasonable number to me.

I know Christmas is going to be different this year. If the government had had the balls to keep restrictions tight over Christmas all along, it wouldn't feel so crap, because now hopes were up and plans were made. What can I say? Christmas is not cancelled, we'll just have to make the best of it.



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Kat Hargraves

Critical Care Sister, MSc Advanced Practice, Really not a morning person.