I am speaking regularly with Angie Smithson the Chief Executive of Chesterfield Royal Hospital, and am writing this to provide an update on the local Coronavirus situation from a health perspective.
When I spoke to Angie Smithson six days ago we had 11 Coronavirus cases in the Royal Hospital, there are now 62 confirmed cases, and sadly 15 people have died. This escalation is in line with the projected figures but shows how rapidly it is spreading. It is too early to tell what impact the social distancing measures enacted in the partial lockdown announced by the Prime Minister a week last Monday have had. It is currently projected that the peak of virus cases here will start over the Easter weekend.
Currently six ventilated beds are in use, and capacity to care for 22 patients right now, with plans for another 10 to be in place when required. Beyond that, there is not the pipe capacity for more oxygen for further ventilators, although additional alternatives to ventilators are being investigated as is increasing capacity at other neighbouring hospitals. There are also plans being investigated for a temporary Nightingale hospital being set up in the East Midlands along similar lines to those set up in Manchester though on a smaller scale.
If the numbers continue to escalate in line with projections, the local demand on the Royal Hospital is likely to exceed the available beds and ventilator capacity and it is very likely that priority will have to be given to those whose life expectancy beyond the virus is greatest, so the need to continue shielding our elderly and more vulnerable residents remains critical and immediate.
The virus is also having a significant effect on staffing at the Royal. 500 staff are absent due to the Coronavirus either because they are shielding in line with public health advice, isolating with the household or because they are actually ill. The need for increased testing capacity is urgent. Many of the 500 staff members currently absent could return to work if they knew that they were not currently infected. It is likely that many of them will not currently have the virus.
Testing has been slow to get up to capacity and is a couple of weeks behind where it should have been but recent steps have seen a welcome increase in testing capacity. Currently around 15 tests can be done on staff members everyday, but with 500 absent and around 4,000 employees employed in the trust it is a long way below the ideal amount. In addition to the 500 absent related to Coronavirus, another 200 or so are absent for other reasons, meaning around 13% of the Trust’s employees are currently absent from work.
There has finally been clear guidance provided from Government about which PPE is appropriate for each individual setting. The PPE provided to staff treating patients known to have Coronavirus is different to that provided to staff in less exposed areas. All staff have the PPE that the guidance suggests is necessary, but it is often arriving very shortly before it is needed and nationally there are limited stocks. So far, it has always arrived in line with when it is needed, although low stocks understandably increase staff anxiety.
Unsurprisingly, there has been a reduction in demand for non-Coronavirus related work, which has enabled the Trust to cover some of the staff absences with staff who would otherwise have been busy in other areas. There are two wards currently closed due to there not being patients in them.
The Trust recognise the huge workload that staff are facing, and the fact that the worst is yet to come. They are taking all steps possible to push for more testing availability and are happy that more testing capacity is now arriving.
There should be no doubt that the demands on the Royal will continue to increase and the demands on the NHS staff that remain on the front line will continue to grow. Every step that every local resident can take to reduce their likelihood of contracting Coronavirus is genuinely a step towards saving someone else’s life.
We also discussed the safeguards that have been put in place within the Maternity department, but the Royal are continuing to allow a birth partner for births from the moment a midwife suggests that labour has started, although post-natal visitors are restricted along with all visiting across the Hospital.
It is clear that the national issues- testing, PPE, ventilators and staff absences due to lack of testing are also affecting us locally. It is also clear that many frontline NHS workers are showing amazing dedication, that their workload will only increase and that most likely the next few weeks will be physically, emotionally and professionally exhausting for all of them. The government must do all it can to alleviate the issues they face, and we must respond be staying home and stopping the spread of the Coronavirus.
I will continue to interact regularly, and update people whenever I am able.