Casualties of Lockdown

No one knows how many people died when the buildings in Shanghai collapsed following an earthquake, no more than we know how many actually died in Grenfell and we will never know how many have died, been left severely damaged and their lives shortened by lockdown

Lockdown led to a clearing of the NHS, so that it didn’t look a re-run of the over-run of Italy, lest we experience chinese 好面子 or miàn zi – that is loss of face. Actually one ITU was over-run (Northwick Park – weekend 20th March) and that was enough to send the politicians running for cover and to close down all non-covid services unless they involved life-threatening emergencies.

If logic, not panic had prevailed, then selected hospitals could have become Infectious Disease Hospitals, (IDH) the rest functioning as normal. If demand increased more hospitals could have become IDHs as required. This model was used for TB and even Scarlet Fever. All patients who might have Covid19 infection go to specific hospitals only. Everyone else goes to non-infectious hospitals and infection is rigorously screened out of these populations

The benefits of IDH approach
i) Services, using appropriate PPE, could have continued and patients, without covid19 could continue to receive treatment, for cancer, the diagnosis of cancer and other severely debilitating conditions
ii) Covid19 patients would have effectively been treated at ‘specialist centres’ where doctors would have quickly gained experience in managing the condition. As it was, every doctor / health care professional working in the acute centre climbed up their own individual learning curve. Expertise is best concentrated.
iii) It is possible that had expertise been concentrated, and the problems considered against a background of experience, that fewer patients would have been put on ventilators – ventilators are a two edged sword, particularly for older patients with pneumonias. Ventilation damages the lungs. CPAP, a safer alternative, might have been introduced sooner
iv) Covid19 would not have spread throughout the hospital population and it is possible that fewer infected older people would have been sent back to care homes to infect other residents. Many of the older people discharged with Covid19, are likely to have picked up their infection in hospital.

The Health Service Lockdown has in part to be the result of the severe lack of PPE. Had there been reasonable stocks of PPE, then doctors, (excluding those with other health conditions and vulnerable BAME ) could have carried on working as normal. The lack of adequate supplies of PPE would have made it difficult, however shops stayed open without offering their staff any specific protection.

Separating Covid and nonCovid patients would have significantly eased the NHS problem. Instead, all hospitals are now either shut down or infected with Covid19. Effectively six months work has been added to an already overstretched and badly run NHS.

The tragedy is, unlike earthquakes, a lot of Lockdown deaths could have been avoided with
a) intelligent leadership and management
b) appropriate stocks of PPE (ie intelligent planning)
c) concentrating medical experience in specialist centres

The NHS could have continued to function. Staff would have had something more useful to do than make YouTube videos in empty wards (notable for their lack of PPE and social distancing) and join the Thursday Night Clap

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