NHS facing third wave with 10-20 times more covid patients than September

This raises the prospect of the service being overwhelmed during the January-February “winter pressures” period and having to once again halt elective and non-urgent work in many areas.

The second wave began in early September with 425 covid patients in English hospitals. The number peaked at 13,767 on 23 November.

The latest data from 6 December shows this has fallen to 12,241, a fall of 1,526 over the intervening 13 days. Should the rate of decline continue at this rate, the number of covid positive patients would drop by around 3,000 to approximately 9,000 on 31 December.

Even an acceleration to the faster rate of decline seen during the first wave would still see the English NHS end the year with approximately 6,000 covid patients.

HSJ understands national NHS leaders are concerned that anything over 5,000 covid patients in hospital by the year end would leave the service vulnerable to being overwhelmed.

Their concerns are based on the fact that the second wave added 13,000 hospitalised covid patients at peak. During the first wave, covid hospitalisation peaked at just over 17,000, and in order to prepare for it the NHS cancelled most elective and non-urgent work.

If a third wave had a similar impact to the second then, if this were added to any more than 4,000 covid patients already in hospital in the wake of the second wave, total covid occupied beds may exceed that in the first wave.

NHS Providers chief executive Chirs Hopson said: ”Given the NHS’s bed base has been reduced by nine per cent through covid infection control measures, if there is anything like five to seven thousand covid patients at the end of the year that is going to be a major problem for the service.”

Nuffield Trust chief executive Nigel Edwards said that even in past years if the service did not clear as many beds as possible before Christmas it would experience problems in January.

He pointed out that any third wave caused by the loosening of social distancing restrictions in December and, especially, over the Christmas period, could combine with norovirus outbreaks, cold weather and increased staff absence to put significant pressure on the service.

“Quite a lot of things need to happen [in the service’s favour] for it not to have a problem,” he said.

Asked what the service could do to mitigate the problem, Mr Edwards mentioned the increased use of virtual wards and the home monitoring of covid patients. However, he admitted that trusts that were not already well advanced in implementing these ideas were unlikely to be able to do so during the remaining weeks of December.

He also pointed out that pressures on beds were likely to vary very significantly across and within regions.

The number of covid patients peaked in the North West and North East and Yorkshire regions on 16 November and have fallen consistently ever since.

The Midlands and London peaked on 23 November, and the South West a day later. They have declined at a slower rate than the northern regions. Both the Midlands and London saw increases over the period 4-6 December.

The number of covid patients in the South East and Eastern region are still climbing. Both regions have the same number of covid patients as they did at the end of April.

Hospitalisation in the South East is largely driven by outbreaks in the northern part of Kent, while the rises in the east are being powered by infection levels on the northern side of the Thames estuary and elsewhere in Essex.