Freedom Day – What does it mean for the NHS?
The 19th July 2021 had been eagerly anticipated, but also feared, in equal measure. As the Government signals a return to ‘normality’, following months of lockdowns, restrictions and isolating, we are poised to open up society. Unfortunately, this does not mean that the threat of COVID-19 is necessarily over.
To date, more than 46 million UK adults have had their first dose of either Moderna, Pfizer or the AstraZeneca vaccine, and 35 million (68%) adults have had both doses. However, over 128,000 have died from COVID-19 and currently approximately 4,000 people are in hospital, with around 150 people per day being admitted.
Daily cases are now topping 50,000 a day which is the highest number since the beginning of January 2021. Whilst many people are desperate for life to return to normal, equally, many are concerned at what the reopening of society will mean for them personally, but also for the NHS. The statistics do not lie. We are experiencing fewer deaths than we were even in January 2021.
The vaccination programme, whilst not eliminating the risk of the virus, has for most brought it under control (at least for the time being). However, the cost to the NHS has been severe. Hundreds of NHS employees have lost their lives to the virus, and if things worsen again, there will unfortunately be more deaths. The nation has continued to thank the NHS for their sacrifice and dedication.
Hospitals have had to change their priorities during the pandemic. Routine and even urgent procedures have been cancelled, and now the waiting list is 35 times higher than it was at the start of 2020. At the end of April 2021, 5.12 million people were awaiting a date to start their treatment. Realistically, and even if services returned to complete normality, it would take years to clear the backlog. However, things are not returning to normal in the NHS. There are still COVID wards in hospitals and as the number of infections rise, so too will the number of people hospitalised with COVID. Without a major injection of funds and personnel, the waiting list is more likely to grow, than shrink, in the coming months.
Another issue of growing concern is that experts are warning of an increase in other viruses in the months to come. Norovirus (a stomach bug), has already seen an increased prevalence this year and scientists are warning the seasonal flu this year is likely to be worse than in recent years. This is particularly worrying for those who are at high risk of not just COVID-19, but also from flu. These people are more likely to become extremely ill with either virus, requiring hospital treatment or dying from either virus.
Every year the NHS sees an increase in admissions during the winter months due to flu, and this year it could be even worse than usual. The decision to open up society now is in part, to avoid the double whammy of flu and COVID-19 admissions later in the year. Even if this is successful, and there is by no means consensus from the experts as to whether this will succeed; the NHS will continue to be hit hard by both COVID-19 and flu patients this year. A return to a more routine NHS schedule is unlikely to happen this year.
Workforce facing burnout
Staff burnout is another area of concern. As the summer holidays are just starting for many of us, Sunderland and South Tyneside NHS Trust asked staff to postpone holidays to cover staff absences with COVID-19. This hospital trust highlighted that they currently have 80 inpatients with COVID-19, whereas a month earlier, they only had 2. The number of staff self-isolating due to being ‘pinged’ by the NHS COVID App is putting increasing pressure on an already exhausted workforce. If the number of infections increase in the general population so too will they in the NHS workforce.
To ease the pressure on staffing in hospitals, the Government has announced that some frontline NHS staff will be allowed to continue working, despite exposure to COVID-19, where they have been double jabbed; and there are “exceptional circumstances” where their absences could lead to “significant risk of harm”. It is understood they will need a negative PCR test and to continue to take lateral flows.
Caution needed as society reopens
Caution is still needed. TV journalist Andrew Marr recently reported that he had a number of negative lateral flows before a PCR returned a positive result. The lateral flow tests are not as reliable as the PCR test. The ultimate question will be how “exceptional circumstances” and “significant risk of harm” are defined by decision makers, and whether they unwittingly infect more people with COVID-19. Already the first exemptions have been agreed.
It has been estimated that once we restart society, there will be an increase in cases. One such estimate used by the Government places this at 100,000 cases per day while other experts have placed it nearer to 200,000 per day. Assuming the same percentage of people with the virus will also end up in hospital, that could mean anywhere between approximately 8,000 and 16,000 could be hospitalised in the forthcoming months. Whilst this would thankfully be fewer than in early 2020, it would still be crippling to the NHS and its normal functioning.
Whilst many are looking forward to “Freedom Day”, the NHS is still facing an uphill battle against COVID 19. Life in the NHS will not be returning to normal, and probably will not do so for some time to come. Patients’ care will be adversely affected as procedures continue to be cancelled; visitors will still not be allowed into many hospitals and patients will continue to die, alone, with COVID 19. The NHS has been pushed to the brink once, and it could easily be pushed past its limits of coping again.