London Hospital staff speak: ‘We are not here to judge, but please get your Covid vaccinations’ | Corona Virus

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On the third floor of one of the country’s largest hospital chests, a team of intensive care professionals in visors and masks gather around a screened bay where a critically ill patient lies unconscious surrounded by cables and tubes.

The elderly man’s breathing is supported by a ventilator and connected to an arterial line to measure blood pressure. He’s fed by a gastric tube, and a close-up of six monitors provide updates on his condition, from oxygen levels to heart rate.

He is one of 14 Covid patients in the critical care ward admitted this weekend. He receives some of the best medical care in the world, but his medical team involved knows the long-term prognosis for this patient in the unit at King’s College Hospital in south London, and many like him are uncertain.

Staff who spoke to the Observer during a visit to the Covid wards said that most of these critically ill patients who were recently admitted to critical beds have not been vaccinated.

King’s medical teams are now preparing for a new influx of patients with the rapidly spreading Omicron variant. They urge people to take punches.

About a third of patients transferred to critical care beds with Covid will die, according to several studies conducted during the pandemic. Most will gradually improve over the course of a week to 10 days, and a small number will require long-term treatment—three months or more—in the unit.

Doctors and nurses say they are very concerned about the number of critically ill patients being transferred to intensive care beds who remain unvaccinated.

Michael Bartley, a critical care officer at Kings, estimated that “80 to 90%” of hospital critical care beds were not vaccinated.

He said, “We are not here to judge patients – we are here to take care of them – but this can be a scary place. If the patient is OK, we will take over the breathing, intubation and ventilation.”

The disease can affect all organs of the body, and its long-term effects can be devastating. We have a number of patients who have been with us for more than 100 days. The age of the unvaccinated is between 35 and 65 years. The message is, “Please get your vaccinations.”

The proportion of unvaccinated patients in King’s intensive care beds is particularly high compared to the rest of the country. A report by the charity’s National Center for Audit and Research on Intensive Care charity showed that the percentage of unvaccinated Covid patients admitted to critical care in England fell from 75% in May to 48% last month as more people were stabbed.

However, London has the lowest rate of vaccinated over 12 years in England. Nearly a third of Londoners are not immune – and many are now seeking urgent medical help as a new wave of the pandemic spreads in the country.

The staff at King’s say they are ready for whatever lies ahead in the coming months. Photography: Andy Hall/The Observer

Dr. Laura Jane Smith, a consultant respiratory pulmonologist who works on the Covid ward in Kings, said Friday: “I saw four new patients admitted to the ward this morning between the ages of 40 and 90. They are all unvaccinated.

I haven’t sent anyone to intensive care recently who had any vaccinations. Even if vaccinated people get sick, they don’t get sick. The people we see go home much faster and with fewer complications. It’s hard to hear very sick people say, “I wish I had the vaccine.”

Smith and her colleagues now face the prospect of another NHS winter crisis as Omicron spreads across the country. “We try to be optimistic that it can’t be as bad as last January, because that was terrible,” she said.

In the past week (the seven days through Friday 17 December), 5,538 people had a confirmed positive test result for Covid in Southwark, the hospital’s local neighborhood. This is an increase of 188% over the previous week.

On Friday, the United Kingdom announced a record number of new Covid cases for the third consecutive day, with 93,045 new cases. The number of hospital admissions in London is rising sharply as Omicron quickly takes hold.

Scientists from the London School of Hygiene and Tropical Medicine have warned that Omicron is likely to be the dominant alternative to coronavirus by the end of the month, and under the most optimistic scenario, there could be 175,000 hospitalizations and 24,700 deaths in England between 1 December and 30 April from Next year.

At 8.45 a.m. Friday in a ground floor meeting room at King’s, employees hold a daily incident coordination briefing, with 90 employees participating online from about 20 departments.

The occupancy rate of the 724-bed hospital is 97%, and according to the latest government data, of the 119 critical care beds, only five are free. Employees are getting sick or isolating at an alarming rate.

Plans are underway to double the number of intensive care beds in two units and convert other wards for Covid patients. The trust is currently caring for 142 Covid patients, compared to 773 during the peak of the second wave in January. Of those, 17 are in intensive care beds.

Leslie Bowles, head of emergency planning and clinical operations at Kings, compared intense preparedness to an “incredible moment of calm” before the tsunami.

“My job is to write the plans and put the plans in place,” she said. “And there is a point where you think: ‘Okay — we’re ready.’” Early indications were that the patients admitted were not as sick as in previous waves, Bowles said.

She said, “Last year, at Christmas and New Years, we’d see patients presenting to our emergency department who were so unwell that they were going to critical care as the first place of admission.

“What we’re seeing at the moment is patients who go to general wards for maybe 24 to 48 hours and can then go home. We’re genotyping all of our samples and we’re definitely seeing some genotyping that’s very suggestive of omicron.”

Leslie Bowles, Kings’ head of contingency planning, says its preparedness was like the calm before the tsunami. Photography: Andy Hall/The Observer

There may be many factors involved in this lower severity: they include the effect of vaccines, better drug treatments, and the potential for lower omicron severity. This is good news because it means that Covid patients can be discharged this time at the same rate as they are admitted.

The initial indications were that the fund would have the ability to cope, Bowles said, and he wanted to make sure other services were available for non-Covid patients. She said there were concerns that services might overwhelm her, but she didn’t consider that a significant risk based on the evidence she’s seen so far.

A report released last week by Imperial College London found no evidence that Omicron is less dangerous than the delta variant, but said more data is needed. She said booster vaccines will be crucial in mitigating the impact of the virus.

Whatever the severity of the Omicron variant, doctors say they are grateful for the range of treatments now available to help patients. These include the anti-inflammatory drug dexamethasone, the first drug proven to save lives in people with Covid, and antiviral drugs including remdesivir.

Hospital staff say the speed with which new vaccines and treatments have been delivered is “exceptional” and is a ray of light in the fight against the disease.

Prof Clive Kaye, chief executive of the NHS Foundation Trust at Kings College Hospital, said one of his main concerns was to ensure there were sufficient staffing levels to handle the demand. The fund employs nearly 14,000 people, but the number of employees who have been isolated or sickened by Covid has risen from 160 to 517 in just over a week, in addition to the usual absences of the workforce. There were 242 nurses who were ill, isolated, or caring for a family member last Friday.

“This means that we have to consider cutting back on some non-urgent routine activities,” Professor Kay said.

He stressed that preliminary data indicate that the latest admissions of Covid “were not sick” compared to previous waves. At the height of the first wave in the spring of last year, about one in four or five patients required critical care, compared to about one in seven or eight now, he said.

Hospital staff – whose efforts Professor Kay described as “really incredible” – are unsure of what the next few weeks and months will bring, but say they are prepared for whatever comes through the doors.

Professor Kay said: “We cannot say that we will not be able to adapt because we have no choice. We just have to adapt.”

This opinion is supported by the hospital staff, who did not have a short break. Chief Critical Care Bartley said: “We haven’t turned any patients away, and we’re very proud of that. We will respond and take care of patients to the best of our ability every time.”

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