We’re publishing the latest update from our in-house doctor, who’s pored over the latest NHS England and ICNARC data packets so you don’t have to. Contrary to some hysterical reports in the media yesterday, it’s actually good news. Community admissions for Covid are falling in London and tailing off across England – and of those classified as being in hospital ‘due to Covid’, 40% were admitted for something else and only have Covid incidentally.
When I was a medical student, a novel called The House of God was required reading. It relates the experience of the fictional American Dr. Roy Basch in his first year as a qualified doctor. The book contained lots of good advice for surviving the junior doctor ordeal including several ‘Rules of the House’. Rule 13 states: “The delivery of good medical care is to do as much nothing as possible.”
Surprisingly often in medicine, doing nothing is the best option. One of my former mentors frequently advised me to “do as little as possible for as long as possible” – his point being that over-hasty intervention is not just unnecessary, but can be actively damaging. This transgresses a key principle of medicine Primum, non nocere – first, do no harm.
Having looked at lots of data from multiple sources over the last few weeks, I am coming to the view that the entire country would be better off in almost every way if doctors stopped ‘doing things’ for a while – particularly if they stopped testing asymptomatic people for the variant du jour.
I will discuss the available information and explain why I have arrived at that conclusion.
Firstly, the admissions from the community in London (as the leading edge of the Omicron wave).
Graph 1 shows the daily Covid admissions from the community in the blue bars vs the same time last year on the brown line. Readers will recall that Professor Sir Chris Whitty warned at the Downing St press conference on December 15th that a big increase in Covid hospital admissions after Christmas was “nailed on”.
It looks like we are waiting for Godot, because the numbers are actually falling, not rising and are currently less than a third of levels a year ago.
Graph Two shows the same metric for the whole of England. On this graph the bars represent daily admissions, the brown line the seven-day moving average. Again, admissions to hospital from the community are tailing off.
This is not really surprising as the ONS data for community infections shows that London appears to be well past the peak. The same pattern is also seen in the ZOE app reports. Other regions are now showing rising positive tests for Omicron – and it is likely that regional waves will peak and decline rapidly, as in the capital. Rather oddly, the data for Wales seem to show much higher community spread of Omicron than in England, despite far more stringent social restrictions. Could it be that Mark Drakeford’s draconian rules aren’t flattening the curve? Whatever next?
On Thursday/Friday the NHS release a weekly summary with hospital level data and the Primary Diagnosis spreadsheet. Graph Three shows the Primary diagnosis data for English hospitals – a busy graph, so I will explain it. The vertical bars represent patients testing positive for Covid (orange) and patients being ill from Covid in hospital (blue). The difference between the two is the number of patients with ‘incidental Covid’ – in other words, they’ve tested positive but that’s not the reason they’re in hospital.
It can clearly be seen that the ratio between the two on the gray line is falling quickly – in other words, only 60% of the total patients reported as in hospital ‘due to Covid’ have actually been hospitalised because they’ve got Covid. Fully 40% of the patients in the reported totals have Covid as an incidental condition. In the Midlands, 45% of patients have ‘incidental Covid’. I expect the proportion of incidental findings will increase in coming weeks. I will return to this point later in support of my contention that we need to rapidly scale back testing.
The weekly hospital update is often quite dull. Not so this week. For a few weeks now it has been apparent that hospitals in the East and South East of London have had higher admission numbers from the community than other parts of the capital. These numbers are now plateauing. However, the total Covid inpatient burden is much more evenly spread across the London hospitals. I think this indicates a serious issue with in-hospital spread of the virus (not surprising), although the significance is much less than in prior waves, because Omicron really is less severe than previous variants.
Exactly how much less severe is not possible to say because the NHS will not release key pieces of information around length of stay and oxygen utilisation in hospitals. Patients who are not very ill with Omicron do not need supplemental oxygen – it would be easy to compare current oxygen utilisation rates with those from a year ago to assess relative severity of Omicron vs the Alpha variant.
Readers may wonder why the NHS send this information daily to NHS Trust CEO’s but conceal it from the public? Readers may speculate that the NHS choses only to release information supporting the catastrophe narrative and conceals data supporting the opposite view. Readers may very well think that. I could not possibly comment.
The Spectator calculates that average length of stay has fallen from 8 days to 5 days – anecdotally I hear it is closer to 3 days. Admissions to ICU are flat and not substantially above normal for January, as are death rates. Cases of influenza, respiratory syncytial virus and community acquired pneumonia are all substantially below expected levels for this time of year.
Unfortunately, the latest ICU ICNARC report does not provide information around how many people have been admitted to ICU with Omicron vs Delta. I expect this information will emerge in time. It is certainly already known. Although absence of evidence is not evidence of absence, it is a reasonable assumption that if most of the current ICU admissions were positive for Omicron, the BBC would be broadcasting that fact on an hourly basis. So far, that dog hasn’t barked – I am not expecting to hear it.
Given all the evidence that Omicron is a variant of the common cold and that admissions of moderately unwell people seem to have peaked already in London, why is the NHS under so much pressure?
There are three main reasons. The first is the policy of sending staff home for extended periods of time based on positive lateral flow tests irrespective of whether they have symptoms.
The second is the incredible degree of ‘organisational friction’ in segregating patients on Covid wards and the arcane rules around testing prior to surgery.
The third is the difficulty discharging patients from hospital – so called ‘bed blocking’.
The first two factors are attempts to limit the spread of Omicron. The available data shows the futility of that approach. Omicron is so transmissible, eventually everyone in the country will be exposed to it – yet only a tiny proportion of people will experience serious illness – very much like the common cold. If persistent testing of asymptomatic people stopped tomorrow, a substantial number of problems currently besetting the NHS would vanish overnight. To quote Rule 10 of The House of God: “If you don’t take a temperature, you can’t find a fever.”
I have come to the view that we are making mistakes in management of the pandemic that will damage the country for years to come. Much of these mistakes stem from testing asymptomatic people for a disease which is highly unlikely to do them any harm.
I close with a well-known limerick, which contains good advice for our times: “Dr Bell fell down a well, and broke his collar bone. Doctors should attend the sick, and leave the well alone.”
Primum, non nocere.
Stop Press: Saturday’s Daily case toll fell by 20% week-on-week and Covid hospitalisations in London are 31% lower. MailOnline has more.
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It’s hard to disagree with those who say Democracy is a sham. Nobody voted for this and yet it’s foisted on us anyway. At least the pro-Pally f-wits in London are prepared to fight for the future they want. Everyone else just sits at home waiting to get shafted some more.
Actually Net Zero was in Labour and Tory manifesto’s. It is just that most people have no clue what is involved for their freedom and their prosperity. ——Most will probably think that there really is a climate crisis and all we need to do is get rid of fossil fuels and use wind and sun and everything will tick along just fine. ———-NOPE. IT WILL NOT
“London councils were the most likely to implement these charges, with responses revealing that at least 20 of the capital’s 32 boroughs have them in place.”
So, although many London councils claim to be against ULEZ they are nevertheless more than happy to screw their own people for not driving the correct car. In other words these sanctimonious so and so’s are lying barstewards who in reality are dancing to the same tune as the Khant.
Not damned bright enough to be aware of their own crude hypocrisy and lies.
A mini dump.
https://www.conservativewoman.co.uk/a-beginners-guide-to-the-great-covid-con-part-5-matt-hancocks-role/
A short but grim read.
As many of us on here have stated Hancock is bang to rights on the Care Home murders – Democide.
And here’s another worthwhile dump:
https://www.conservativewoman.co.uk/news-you-might-have-missed/
The clue is in the title.
We are being pushed, perhaps purposely, towards pitchfork time! Everyone will have to become a bladerunner!
I’ve been driving around my local area over Xmas with family guests and have noticed a significant increase in both 20 mph zones and surveillance cameras everywhere since the summer. This in a rural area with a p*ss poor bus service and mostly narrow country lanes with few or no footpaths. Oh, and fuel in these parts is 20p/litre more than guests pay at home. Democracy has died, bureaucratic totalitarianism rules.
Green = Red. ———Public policies are strangling us with regulations, mandates and impoverishment with climate the hammer that nails us to the floor. The pathetic excuse that we are in a “climate emergency” is not just a slap in the face to hard pressed families depending on their car. It is 5 uppercuts from Mike Tyson. There is no tyranny worse than the one that terrorises you for your own good as these people never sleep.
Why only concentrate on tailpipe emissions. EV’s are heavier than an equivalent ICE and produce more tyre and road wear, so instead of a clear new diesel, a filthy EV that will have to drive at least 60,000 miles before it is ‘carbon-neutral,’ will be producing micro rubber and plastics from tyres while causing greater road wear. I say penalise EV drivers for their selfish actions.
Rest assured they will have to move onto this soon enough – as more and more people are forced into EVs (or nothing) they’re obviously not going to drop parking charges just like they’re not going to give up fuel duty, so they will come up with some way of ranking EVs also or simply charge everyone sky high rates if they can’t be bothered.
They certainly won’t give up as long as the majority of those that vote tend to vote for establishment parties. No sympathy can be extended to the inconveniences and costs experienced and endured by the unthinking establishment party voter. Apart from the EU referendum the British people haven’t tried boycotting the establishment line by voting for centre Right challenger parties but it is way past time they gave it shot in 2024.
“Councils argue that such charges are need to improve air quality and encourage people to use more sustainable forms of transport”———–The first part of that is dubious and the second requires that this “sustainable transport” is available 24 hours a day to every workplace and back straight to your home which IT IS NOT. —Where is the sustainable bus at 5.30 am to take people right to their place of work? Or at midnight to get home from late shifts or start night shifts? Why are we letting these phony planet savers away with this tyranny? People go out to work and have bought vehicles in good faith with hard earned money only for these eco parasites to come along and tell them they cannot use those vehicles instead of allowing them to come to the end of their natural life and is a diabolical disgrace.