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The focus of the second wave of covid is shifting and new areas are starting to feel the heat with rising hospital demand.

Covid admissions are surging in the North East and Yorkshire, where they are now at their highest since 1 April, and in the Midlands where pressure is being reported in areas that have not had as much covid activity as others.

Admissions are slowing in the systems covering Birmingham, Solihull and the Black Country, and falling in Nottingham and Nottinghamshire’s health system. Meanwhile, admissions are rising fast in Staffordshire and Derbyshire.

They are also seeing rising rates of bed occupancy as admitted covid patients fill more of their general and acute beds.

Greater Manchester continues to see the highest number of admissions – however this is falling, down to 844 in the week to 8 November from 935 on 29 October. Bed occupancy, however, continues to rise as patients continue to be admitted at a faster rate than they are discharged or die.

However, occupancy seems to have peaked, for now at least, in the rest of the North West as well as the South Yorkshire and Bassetlaw and Nottingham and Nottinghamshire systems.

PPE SOS

Unions say their members are “facing illness and even death” while performing procedures such as chest physiotherapy, introducing feeding tubes, and assessing whether a patient can swallow safely.

They claim that thousands of frontline workers delivering treatments where the risk of transmitting coronavirus is heightened are still being denied personal protective equipment.

Eleven organisations, including Unison and the British Association of Stroke Physicians, believe numerous procedures have been “wrongly excluded” from the list of 13 “aerosol generating procedures” that require PPE, despite the NHS now having adequate supplies.

The decision over which medical procedures require PPE is made by the government in line with guidance from Health Protection Scotland, Public Health England and the New and Emerging Respiratory Virus Threats Advisory Group.

A Department of Health Social Care spokeswoman said: “The guidance around PPE for aerosol generating procedures is kept under review by an expert body, based on the latest evidence, and is agreed between the four nations.”