Even NHS chiefs back cutting self-isolation period to five days

53

View
comments

An NHS leader today revealed he would support slashing Covid self-isolation to five days amid an escalating staffing crisis that has engulfed hospitals and led some to cancel routine operations. 

Matthew Taylor, head of the NHS Confederation — an organisation which represents trusts, said two more days should be shaved off the period as long as it was backed up by the science.

He told BBC Radio 4’s Today programme the situation was ‘desperate’ and any way of getting staff back into work was a ‘good thing’.

But he said it would be ‘completely counterproductive’ to have infectious staff return to wards because it would exacerbate the spread of Omicron.

Last month ministers cut the self-isolation period to seven days, providing someone tested negative using a lateral flow on days six and seven. But pressure is mounting on Boris Johnson to follow the US, which has squeezed quarantine to only five days for anyone without symptoms. 

One in ten NHS employees are currently thought to be off sick or self-isolating, and Boris Johnson yesterday revealed plans are being drawn up to call in the Army if the crisis continues to worsen. 

One ambulance trust began asking patients with life-threatening heart attacks and strokes to get a lift to hospital because it did not have enough paramedics.  

Meanwhile, around a dozen hospital trusts have declared ‘critical incidents’ in recent days, signalling that they may struggle to deliver vital care to patients in the coming weeks because so many medics are off isolating. 

And last night it emerged that 17 hospitals scattered across Greater Manchester have had to start pausing non-urgent surgeries. Up to 15 per cent of staff are off sick with the virus in the worst-hit hospitals.

At the same time, the number of Covid-infected patients being hospitalised is rising. 

Health minister Gillian Keegan today admitted that the Government knew this was to be one of the most ‘pressurised winters’ yet. But she praised doctors and nurses for doing an ‘amazing job’, despite the spiralling pressures.  

Asked if he could support such a change to self-isolation rules, Mr Taylor told BBC Radio 4: ‘As long as it is based on the science.

‘Because on the one hand we do need to try to get staff back to work as soon as possible.

‘Hospitals who have declared critical incidents, for example, are essentially reaching out to staff who are on leave, on rest days or even recently retired and asking them to come back to wards, so the situation is desperate — any way of getting staff back into hospital is a good thing.

‘But on the other hand, if staff come back into hospital and are infectious, that’s completely counterproductive because that is going to mean more sickness in the hospital and for staff, so this can’t be led by politics or blind hope — it has to be led by the science.

‘If the science says it is possible for people to go back to work earlier, then of course NHS leaders will want that to be possible.’

He suggested that people in quarantine could test themselves on days three, four and five, and come out of isolation on day five if they test negative. 

The UK Health Security Agency recommended the reduction in self-isolation to seven days last month after finding it posed no greater risk of spreading the virus than completing the full ten days.

Scientists at the agency fear a further reduction could be ‘counterproductive’ because it could lead to staff returning to work while they are still infectious, and spreading it to other employees.

But evidence showing most people who catch the virus are not infectious from five days after symptoms develop has been available for months. 

University of St Andrews’ scientists found in November 2020 that the vast majority of transmission occurs in the first five days after symptoms develop.

And last summer Oxford University’s Pathogen Dynamics Group said just two per cent of transmission occurred five days after symptoms developed.

Ministers today eased testing requirements so that people who test positive using a lateral flow no longer need to get a confirmatory PCR.  

It comes as a staffing crisis sparked by the spread of Covid left hospital leaders in Greater Manchester no choice but to cancel some operations. 

A spokesman said the cancellations were ‘temporary’, although cancer and heart surgery would be protected.

Chief executive of Bolton NHS Foundation Trust, Fiona Noden, said the cancellation was done ‘so we can keep people safe, can maintain the very best infection control measures, can make sure we deploy staff to where they’re needed most and can keep looking after people who need urgent and emergency care’.

The North West — where the hospitals are based — has seen the number of Covid patients in its wards surge 94 per cent over the last seven days to 2,618.

A GP in Oldham, one of the areas affected, warned today that the decision will lead to ‘more suffering’.

Dr Zahid Chauhan, who is also a Labour councillor for the area, told BBC Radio 4: ‘A non-urgent operation might be non-urgent for a hospital administrator or the state, but they are not non-urgent for the patient.

‘If you are waiting for a hip replacement, that means you are in pain, so it might be non-urgent for someone, but for the person who is suffering that is not non-urgent for them.’

Yesterday Morecambe Bay NHS Foundation Trust in neighbouring Lancashire also declared a critical incident.

And there are mounting concerns that hospital trusts in Cumbria could also hit the panic button in response to rising pressures.

Colin Henderson, public health director for the county, said it ‘seems very likely’ that trusts in Cumbria will start to shelve non-urgent operations.

He said: ‘We always knew that January was going to be a tough month.

‘The case rates that we’ve seen so far with the rising hospitalisation rates and the large staff absences and the pressure on social care… are coming together to create a really difficult time for our health and care services.’

Several hospital trusts across the country have already declared critical incidents in response to pressures.

A critical incident allows them to start working with neighbouring NHS trusts to share the workload and avoid becoming overwhelmed. 

Asked about the pressures faced by trusts, Ms Keegan said: ‘Right now, they are under extreme pressure with the Omicron variant, with the number of positive cases and the increase in hospitalisations, and at this point in time when they always have extreme pressure.

‘We knew that and we actually knew that going into this period — that’s why we’ve put an extra £5.4billion of investment to try and get extra staff, get some extra capacity to be able to put virtual wards in place, extra beds and extra capacity with the Nightingales, etc, all of which we anticipated, that this was going to be really difficult.

‘We’ve had two years of a pandemic, there is a build-up of people who haven’t come forward who need electives — there is a backlog we need to deal with — and then you have got the unknown of Covid — we now know we have Omicron — and also flu was a big unknown as well, how much flu we would have this year.

‘We always knew that this was going to be one of the most pressurised winters and they are doing an absolutely amazing job.

‘Part of one of the procedures we have with our NHS contingency and resilience plans is actually to declare this critical state, and then they will work with NHS regional colleagues and the local resilience forums to make sure that mutual aid is provided, or whatever support is required, so it is part of the escalation process.

‘These are tried and tested plans, we have these plans in place every winter.’  

Truth about hospitalisation figures revealed: Number of Covid patients on intensive care wards is HALF its peak level 12 months ago, data shows

By Eleanor Hayward for the Daily Mail

Intensive care admissions are half the levels of previous peaks – with Boris Johnson insisting this means he is ‘confident’ the NHS will not be overwhelmed. 

Despite record cases and soaring admissions, the number of patients in intensive care units has remained flat since Omicron arrived in the UK. 

Just five per cent of patients in hospital with Covid-19 are on mechanical ventilators, compared with 11 per cent at the peak of the pandemic last January. 

The Prime Minister said Omicron is ‘milder than previous variants’ and ‘keeps people in hospital for a shorter period’. 

He told a Downing Street press conference yesterday: ‘While hospital admissions are rising quickly, this is not yet thankfully translating into the same numbers needing intensive care that we saw in previous waves.’ 

Mr Johnson said the next few weeks would be ‘a difficult period for our NHS’, but added: ‘I’m also confident that we can get through it. 

‘Although Omicron does cause lots of hospitalisations, it is pretty clearly resulting in fewer people in ICU, and certainly less mortality than we’ve seen from other variants.’

He added it was ‘absolutely crazy’ that people were ending up in intensive care with Covid because they were refusing the vaccine, with the latest figures showing 61 per cent of patients on ventilators are unvaccinated. 

Professor Sir Chris Whitty, chief medical officer, stressed that booster jabs provided 88 per cent protection against hospitalisation and ‘even greater protection against mortality’. 

He added that Omicron was not leading to a surge in deaths, after another 48 were recorded yesterday. 

But Mr Whitty warned hospital admissions and deaths could keep increasing in the coming weeks as the variant spread to older and more vulnerable age groups. 

He said: ‘In London it does look as if the numbers in younger adults are falling… But rates in older people are still going up and these are the people who are much more likely to be hospitalised.’ 

The number of Covid patients in England’s hospitals has doubled in the past fortnight and there are currently 15,055 patients receiving treatment. But only 797 are on ventilators – fewer than two months ago when cases were significantly lower. 

At the peak last January, there were 34,336 patients in England’s hospitals, including 3,736 in intensive care. And the proportion of patients with Covid in hospital who end up in intensive care has plummeted compared with the numbers in April. 

Health chiefs say hospitalisations are plateauing in London and they are hopeful this could soon be replicated across the whole of the country. 

Another 1,881 people were admitted with coronavirus in England yesterday, down from 2,370 on December 29. 

Chris Hopson, chief executive of NHS Providers, said there had not yet been a major increase in the number of seriously ill older people needing critical care and mechanical ventilation. 

Mr Hopson added: ‘There are a number of chief executives who are saying, if we were going to see that surge, we probably would have seen the beginnings of it up to now, so there are glimmers of hope.’ 

Research by the UK Health Security Agency shows that patients with Omicron are between 50 and 70 per cent less likely to need hospital treatment than previous variants. 

And the proportion of patients admitted ‘with’ Covid rather than ‘because’ of it has increased. 

Latest data shows a significant rise in so-called ‘incidental’ admissions, when for example someone breaks their leg and happens to test positive when arriving at hospital. 

Just 67 per cent of Covid patients are being treated primarily for the virus – compared to 73 per cent a month ago. 

Almost half of those admitted to hospitals in London last week were admitted ‘with’ not ‘for’ Covid, figures suggest.