Nearly a third of England’s hospital trusts have exceeded their first-wave peak of Covid patients undergoing treatment, as scientists warned that relaxing or scrapping the three-tier system too quickly could further hamper the NHS.
Ashley Kirk www.theguardian.com
Hospitals trusts in South Somerset and Devon treated more than twice as many Covid patients on at least one day last week as they did at the peak of the first wave in spring, Guardian analysis shows. However, because tier decisions are based on a range of data, both areas will go into tier 2 from Thursday.
Conversely, Manchester Universities hospital trust last week treated 31% fewer Covid patients than it did in the busiest week of the first wave (295 compared with 428). The whole of Greater Manchester will go into the strictest tier 3 this week.
Although much of south-west England has avoided tier 3, more than half of acute NHS trusts in the region treated more Covid patients on at least one day last week than at their first wave peak. The same was true for half the trusts in the north-west and north-east, and a third of those in the Midlands – almost all of which are in tier 3.
The data comes amid a row over Michael Gove’s warning that the health service, including the emergency Nightingale hospitals, risked becoming “physically overwhelmed”.
The Cabinet Office minister intervened ahead of a Commons vote on the new three-tier system that triggered a backlash from Tory MPs, many of whom claim their constituencies will be subject to overly draconian measures despite low, stable or falling infection rates.
In an attempt to calm the rebellion, Boris Johnson signalled that some areas could be moved into lower tiers after a review on 16 December, if there was “robust evidence” that coronavirus was in sustained decline, with the tiers system potentially shelved in nine weeks unless MPs vote to keep it.
But his confidence in reducing infection numbers within weeks has been questioned by senior scientists and health leaders, while the Guardian’s hospital admissions data analysis points to the risks to the NHS in certain areas.
In the East Riding of Yorkshire, for example, some residents were angered to find themselves in tier 3 despite a lower infection rate (287 per 100,000) in the week to 21 November than several London boroughs, which will be in tier 2 (Havering, for example, had 338 per 100,000 in the same period).
Yet the area’s hospitals are now treating far more Covid patients than in spring. Northern Lincolnshire and Goole NHS foundation trust had 185 Covid patients in the week to 24 November, compared with 75 in its busiest week of the first wave.
Dr Layla McCay, a director at the NHS Confederation, warned: “The national lockdown might be coming to an end but NHS leaders are telling us that they are still facing the triple whammy of treating Covid patients, providing broader care services and preparing for winter.
“While hospital stays because of the virus continue to present massive challenges, this terrible disease is also stretching other parts of the NHS, including primary, mental health and community care, very thin.”
Dr Chaand Nagpaul, the chair of the British Medical Association, said it would be a mistake to relax restrictions too early. “If we are to prevent the NHS being overwhelmed this winter and left unable to provide both critical and wider care to all who need it, we must do everything we can to bring the spread of the virus back under control,” he said.
“We don’t know where we’ll be in two weeks’ time, let alone nine weeks, but whatever decisions are made at that time must be based on the most up-to-date data on infection levels and pressure on the NHS.”
Nagpaul described the previous tiers system, introduced in October, as inadequate and ineffective at stopping the rise in infections and warned that without tougher measures this time, another national lockdown would follow.
Scientists echoed the warning. Dr Simon Clarke, an associate professor in cellular microbiology at Reading University, and Peter Openshaw, a professor of experimental medicine at Imperial College London, said they did not expect enough data to have emerged by 16 December for restrictions to be relaxed.
Clarke said that relaxing tier curbs would be more of a political decision than a science-based one. “It is inevitable that it will lead to an increase in the number of new infections. January and February are the worst months for respiratory infections anyway, regardless of the current pandemic. These factors combined will, inevitably, translate into more hospital admissions and fatalities,” he said.
Openshaw said: “We scientists are very concerned indeed about relaxation of precautions at this stage. The rates are still too high, there’s too many cases coming into hospitals, too many people dying. And if we take the brakes off at this stage, just when the end is in sight, I think we would be making a huge mistake,” he told the BBC.
An NHS spokeswoman said: “The number of hospitalisations for Covid-19 varies significantly across the country and while the national volume of patients in the second wave has not yet exceeded the first, some hospitals in certain areas of the country are indeed treating more Covid patients than they did in the spring.”