//Health care provision in a pandemic

Health care provision in a pandemic

UK, Medicines and Healthcare products Regulatory Agency (MHRA)

Negative test, 72 hours before travel, South Africa variant, next Wednesday

London

Major incident

Virus out of control

UK, 1 in 50

London, 1 in 30 infected

Firefighters driving ambulances, police soon

Friday prayers taking place today

Daily admissions, 800

Younger people being admitted to ICU

Pan London crisis

https://covid.joinzoe.com/data#levels-over-time

https://coronavirus.data.gov.uk/details/cases

Data, 8th Jan 2021

Cases, 60,916 + 62,322 + 52,618 = 2,889,419

Full lockdown announced, Monday 4th legal from midnight Tuesday 5th

Hospitalised, + 3,600 = 30,370 (ventilated, 2,821)

Deaths, + 830 + 1,041 + 1,162 = 78,508

NHS hospital beds in England

https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers

General and acute, mental illness, learning disability, maternity and day-only beds, 141,000 in 2018/9

General and acute beds, 101,000

Critical care beds, 5,900, 2019/20

Beds in private patient units, 1,140, (UK) 2016

Acute bed occupancy

In 2018/19,

Overnight general and acute bed occupancy

averaged 90.2 per cent

Regularly exceeded 95 per cent in winter

Hospital capacity (NHS Journal)

https://www.hsj.co.uk/acute-care/exclusive-london-will-be-overwhelmed-by-covid-in-a-fortnight-says-leaked-nhs-england-briefing/7029264.article

NHS in London, acute and intensive care beds shortfall by 19 January

Best, 4% daily increase, shortfall 1,500

Average, 5% daily increase, shortfall 2,900

Worst, 6% daily increase, shortfall 4,400

Accounts for the impact of planned measures to mitigate demand and increase capacity.

United States

CDC trends

https:/covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases

https://covidtracking.com

Cases, + 214,378 + 243,346 + 266,197 = 21,070,137

Up 8% in 7 days

Testing, + 1,605,799 + 1,914,839

Up 4.6% in past 7 days

Hospitalizations, 132,370 (23,821) (7,900)

Deaths, 356,229

At Methodist Hospital in Arcadia, Los Angeles

Crisis care guidelines

Delivering the best care possible under the circumstances, forcing choices that may pose risk to patients

Methodist Hospital, triage team

Doctors, community members, a bioethics specialist and spiritual care providers

make the difficult, but necessary decisions about allocating limited resources

Three other hospitals in California Department of Public Health, approaching or entering that stage

B117

Connecticut, Pennsylvania, California, Colorado, Florida, Georgia, New York

https://www.washingtonpost.com/health/2021/01/07/covid-death-record/