a break in the clouds

​The end of last week seemed to finally see a visible drop not only in the number of infections and deaths from covid, but in the numbers in our own hospital beds. After my two colleagues were turned away from helping on ITU on Tuesday, by Thursday my consultant colleagues who went for their usual morning on the wards came back by the afternoon and said that there were only 2 covid patients on their ward, which had previously been full of these patients. A truly encouraging sign!

But the angst they now had was in having to manage patients with all sorts of other general medical conditions such as fast Atrial Fibrillation (irregular heartbeat), Parkinson's, elderly patients who had had falls, and this was no longer a place where they felt safe to practice-it had gone beyond feeling out of their comfort zone, and now that the apparent crisis was abating on our wards, it seemed time to come back the specialty they knew and could make a difference in, and to leave the medical patients to the medics better honed to treat these patients in their daily work.

So as we continued our afternoon skin cancer meeting and team meeting, on zoom and distancing in our offices, another glimmer of future hope appeared as we began to talk of planning ahead to resume opening some more normal clinical activity and more skin cancer procedures-perhaps in May. I was beaming at the thought of going back to doing some hands on again, and of course would be somewhat dependent on the government's advice by that time, as the next lockdown review would be 7th May. But unsurprisingly, with the idea of seeing more patients and having more foot fall in the department, rose the subject of PPE once more. The virus is still invisible, and always will be, so how can we be sure that it isn't still around us come May, or ever?

The excellent channel 4 panel discussion I saw on Wednesday evening, called Can Science beat the Virus, was the most informative I have seen yet-no politicians, only a panel of eminent virologists, doctors, and professors from such places and The Crick Institute, Imperial, and Oxford, that latter two of which are looking into a vaccine against Covid. In their own words they still at this time feel it is too early to know everything about this virus, its virulence, its behaviour in different individuals, its treatment, the length of time someone gets immunity after infection, the most accurate antigen and antibody tests, and how we manage releasing lockdown, and anticipating further peaks and waves of infection. Contemplative viewing in one sense, but informative and to the point in another sense. And from the people who are looking at it every day in the kind of detail that enables more knowledge into this freak killer.

As numbers dropped from 821 on 22nd April, to 763 and 638 on the following 2 days, this seemed to support the downward trend. Then on Saturday 25th we saw another spike at 813. This was disappointing to see this weekend. But the numbers yesterday and today were down to 413 and 350-the lowest seen yet on the decline, and so encouraging again. But reaching over 20,000 deaths in the Uk this weekend is stark so hard to fathom I’m such a short time.

The peaks may well be a reflection of the amazing weather, with all these sunny days (which have passed me by except for my daily exercise), the Mothers Day and Easter weekends, which may all have contributed, but of greater concern has still been the seeming apathy to the lockdown and the rebelling at the lack of usual freedom that appears to be sweeping around. Whilst such sad and pointless deaths continue, in hospitals, and in nursing homes, it is angering many that people are continuing to flaunt the lockdown advice and remaining a risk to themselves and to others. As has been said before, and again, the longer the rules are maintained, the sooner we will see ourselves out of the lockdown, but this isn't computing with some people still! And seeing Boris back at number 10 today, and recovered from covid, his message was clear, that whilst we see the numbers dropping, we aren't out of the woods yet, and just need to push on a little bit longer... hard for the economy and people's livelihoods of course, but that would be nothing if you didn't survive covid infection.

But as we finally seem to be over the worst of it, may the sun keep shining on us all as we hope for an end to this pandemic and a return to some normality, albeit slowly and safely.