HSJ’s daily update of what our sources are telling us about the progress of the pandemic

With many parts of the NHS facing a period of the most extreme operational pressure they have ever known, Daily Insight will bring you an update on the latest developments and concerns from those leading the efforts.

The third wave of England’s coronavirus pandemic began in Kent and quickly spread to London and across the Thames estuary to south and mid Essex.

It is here that the situation remains the most critical, but across the country healthcare and other public sector leaders are sounding the alarm bells.

Trusts in the South West will soon be “hanging on by their fingernails”, we reported, while Royal Wolverhampton Trust chief executive David Loughton told the BBC that “the [infection] numbers are ramping up enormously… [and] today’s covid rate is my order book for intensive care in two weeks’ time”.

London’s failing

But it is the capital where the NHS continues to come closest to being overwhelmed, for the moment at least.

Friday brought news of 30-hour waits for urgent care patients, a 67 per cent covid occupancy rate for one London trust, and the capital’s largest provider undergoing a rapid re-organisation to give itself some “breathing space”.

On HSJ’s weekly Health Check podcast, our London correspondent explained that “Today in the capital there are around 500 people with cancer that needs treating within four weeks who don’t have NHS appointments”.

Oh yes, and there was the small matter of the city’s mayor declaring a “major incident”, though the move seems largely to be aimed at winning some more financial support from the government for London, rather than anything that will directly impact the NHS.

Moderna love

But at least we have another vaccine, although even this welcome news comes with a caveat.

The Medicines and Healthcare Products Regulatory Agency has authorised the Moderna covid vaccine, of which the UK government has bought 17 million doses. The not so good news is that “supplies will begin to be delivered to the UK from spring once Moderna expands its production capability”.

Meanwhile, those responsible for rolling out training for the vaccine’s booking system are clearly pleased. A link in an NHS England guidance document, published on Thursday, points those charged with managing appointments at vaccination centres to a training video with the cheery title of “2a. NBS- booking ‘happy path’.mp4”. This particular path to happiness guides those booking in patients over the phone through the questions in the online system.

In addition to the vaccine, there is another hope in the form of a potentially life-saving treatment that could cut stays in intensive care units by 10 days.

Clinical trial results show tocilizumab and sarilumab reduce the risk of death by 24 per cent for critically ill patients and will be available immediately, says the government.