ckn

My adverts on here now are all this sort of thing

At least Bradford may not get relegated...

I’m knackered and my joints are aching but it’s stress doing that going by my historical experience with it. The stress you had with your work being bum holes to you will have had you running on toxic adrenaline. That could have been what was hitting you, your body struggling with stress. But then I’m not a clinician!

HIGNFY is less funny in a working from home format than our team meetings at work.

Germany is on the same track as the rest of us, just behind us in time. See the FT’s daily charts.

The difference to me is how Spain and Italy have dealt with it. Both have been hard on lockdowns and their numbers aren’t rocketing away in terms of death increases now. Scary but stabilising and hopefully we’ll start to see them fall. The UK with some startlingly daft policies has seen a soft lockdown that may mean that reduction in increase may just not happen as quickly here. If our strategy is better than Italy’s or Spain’s then I’ll be shocked. Pleasantly shocked, but still shocked.

There are no supplies. Literally none. Private suppliers are not answering calls/emails and we’re buying stuff directly from China and other countries. We do status reports daily across our patch from GP practices and we have no practices that have more than 1 day of full kit, most have complete outages of some items, especially eye protection. Clinicians are having to make the ethical nightmare decision of using short personal protection or patients doing without appointments, being clinicians they’re overwhelmingly treating patients. 1. There was a rapid clinical assessment of PPE by PHE over last weekend and released yesterday. I linked to it yesterday, let me know and I’ll link it again if you prefer. It is fine for use but we don’t have it all AND clinicians are still dying even if they are using it properly. I have some sympathy with PHE as there would NEVER be enough of the higher FFP3 standard masks, full-sleeved aprons/boiler suits, etc this side of June/July at the expected use, even if assuming we could repurpose all companies possible today. So, what do they do? The best they can. We know it’s the best they can do but clinicians are still dying with it. 2. That’s one for the political threads and directly links that vile old thwaite Lansbury and his butchery of the NHS into bits & pieces. To smooth feathers, Hunt and now Hancock have genuinely reversed that but would be years away in fair weather of making it back to 2011 standards. Hancock especially has been tough in pushing through reversals of the idiot 2012 “reforms”. Also, see the 2nd paragraph of point 1, no point asking for perfect when we know “good” will be hard enough to source. “Live within your means” has no monetary meaning with this, it’s all entirely logistics and supply. 3. Some. They do work very closely with the NHS and are a respected body. See the second paragraphs of both 1 and 2. —— The new “e-commerce” platform comes live next week where NHS organisations can buy kit from NHS supplies and it’ll be delivered using a commercial courier company that’s lost all its normal trade. Should be fast as long as it can keep supplies up (see above!). Some weird folk are still putting prices against these things rather than just sending places what we need.

It'd undoubtedly go to the wealthy first, the ones squirrelled away and don't need it. Then it'll be "can we REALLY afford 6bn of these vaccines along with the programme to get them done?" and moral lines will start to be stretched.

Aaand back again... Here's what hospital clinicians on COVID-positive wards are being expected to wear:

Some good news on this depressing thread:

If this doesn't convince you to stay in this weekend with the predicted nicer weather, then you will be directly contributing to the death trajectory not coming down. You are putting your friends and family at risk as well as my colleagues in the NHS. Just stop.

Another:

I had a 2 hour window between meetings so took the chance to do a big shopping run. First one since February and we were out of fresh stuff. We'd only done fresh-food runs in the last month but it was long overdue to to a big one. I got bog roll AND pasta! No shortages of stuff except hand sanitiser and some brands of fancy comfy-bum bog roll. Almost civilised as well. Full decontamination at home. Any more and I'd need fullers earth to do my army decontamination!

There's a whole pile of discussion in healthcare circles of healthcare folk making their own eye protection and so on. It's proper "wartime spirit" if the Mail would care to do something positive. (NOT a Mail link)

There's a rant on many of the exploitative media sources, such as the Daily Mail, getting all angry about end-of-life discussions that some areas are having with patients. Please don't get angry or worried by this if you think you're caught by this, it's the worst sort of trolling. The NHS isn't going to throw you in a skip to die regardless of what this filth is saying. The whole message is around survivability and your dignity. No-one wants to die or be seriously hurt by this, and some patients on end-of-life pathways already would never survive hospitalisation with COVID therefore surely it's the responsible thing to discuss their wishes with them. Where would they want to die if they know they're dying anyway? In a hospital where no-one will see them, or at home in their own environment. It's all about dignity of people in distress, not abandoning people. This is NO different to the normal discussions people have in end-of-life scenarios, it happens already, it's just more important now that people already dying are consulted on their own future. Would people rather that a stressed out ambulance paramedic make decisions on the fly about their dignity and future? I f***ing hate the Daily Mail and I sincerely it gets the treatment that Liverpool gives The Sun.

Also remember the 2nd home lot who fled London to holiday homes, but actually brought the infection with them.

The wife was out clapping for the NHS. I told her bluntly that if she gives me the clap that there’d be a few blunt questions asked...

Populism gone mad!

Youngest confirmed death is a 6 month old in the US.

First game back:

For those interested, the brand new PPE standards And the primary/community care specific ones that some on here will be keen to see Importantly, this is now an INDIVIDUAL authority to wear or not, not an organisational one. You now have the authority to refuse to do certain things if you don't have the kit, here it is in the original big bold text from the document: Ultimately, where staff consider there is a risk to themselves or the individuals they are caring for they should wear a fluid repellent surgical mask with or without eye protection, as determined by the individual staff member for the episode of care or single session.

I have fairly bad tinnitus at times, made worse by silence. My hearing aid helps massively as it provides noise context for me that distracts my brain from the tinnitus. I was on calls from 0830-1430 non-stop and some were quite loud with strong opinions. I came off at 1430 into silence, I had my hearing aid out as I was using headphones and it sounded like I was in a church bell-tower ringing away.

For our clinicians, many knew the GP who died in Essex and the nurse who died was from our patch. That's changed a lot of attitudes from "let's make the best of this" to "no" when being asked to do more with less.