Coronavirus statistical update: East Sussex hospitals under the cosh as new lockdown imposed

As the Covid-19 virus continues to spread rapidly, England has moved into a new lockdown, a major incident has been declared in Sussex and local hospitals are in danger of being overwhelmed. Report by Nick Terdre, research and graphics by Russell Hall.

The new lockdown, the third in less than a year, was announced on Monday evening by prime minister Boris Johnson and given legal effect on Wednesday. Similar regimes have been or are being introduced in the UK’s other nations.

Also on Wednesday, “in response to the high and increasing rate of infection,”  the Sussex Resilience Forum, which brings together health emergency services, local authorities and other partners, declared a major incident “to allow public services to make exceptional preparations for a potentially worsening situation.”

East Sussex Healthcare NHS Trust (ESHT) is among those feeling the heat. “Like many other NHS Trusts across the South East, our hospitals and services are incredibly busy at the moment,” chief executive Joe Chadwick-Bell told HOT.

“Our usual winter pressures have been compounded by a sharp increase in Covid-19 patients being admitted to our hospitals.This is already nearly four times the number of people we cared for at the height of the first peak.”

The return of a lockdown regime coincided with an increase in the UK’s alert level from 4 to 5 which was agreed by all four UK chief medical officers. “We are not confident that the NHS can handle a further sustained rise in cases and without further action there is a material risk of the NHS in several areas being overwhelmed over the next 21 days,” they said.

Level 5 represents the highest alert, at which there is a “risk of healthcare services being overwhelmed” and “extremely strict social distancing” is called for (these alert levels have nothing to do with the tier system).

The new variant of Covid-19, still the dominant cause of infection in the South East, was blamed by the prime minister for the boom in cases.

The prime minister attributed the need for urgent measures to the rapid increase in the incidence of the coronvirus, largely due to the effect of the new variant, which, he said, was 50-70% more transmissible than the old version. On Wednesday 62,322 cases of coronavirus, a new record, were reported nationally, along with 1,041 deaths of people who had tested positive for the coronavirus within 28 days.

Critcon 3

There are indications that the East Sussex Healthcare NHS Trust (ESHT) hospitals are among those in danger of being overwhelmed. On Sunday the status of both the Conquest and Eastbourne District General Hospital was given as Critcon 3, indicative of a trust “operating at or near maximum physical capacity,” and hospitals having to expand their critical care facilities into non critical care areas.

It is a priority for hospitals or units in Critcon 3 to make a maximum coordinated effort to avoid progressing to Critcon 4, which signifies that their facilities have been overwhelmed.

The Conquest was also listed as having staffing problems in its critical care facilities, with staff levels below the nursing ratio set by the Intensive Care Society.

Where hospitals have expanded their critical care facilities for Covid patients into other parts, their capacity for treating non Covid patients will be correspondingly reduced.

“The situation is the same at CQ and EDGH,” ESHT medical director Dr David Walker told HOT. “We were initially seeing far higher numbers of Covid admissions at Conquest, but Eastbourne has now caught up!!

“Our ICUs [critical care units] are certainly very busy at the moment but we are able to care for everyone who needs a critical care bed.

“Our staffing levels are challenged as we have a high number of staff who are unwell or self-isolating. I want to thank our teams who have not seen a let-up in pressure from Covid for 10 months. I am still astonished by the levels of compassion and high quality care that our teams provide each and every day in spite of the pressure they are working under.

“We have had to make a number of difficult decisions to allow us to provide care to people who most need it and this has meant that we have rescheduled a number of routine operations to focus on urgent and cancer surgery, and to release staff to focus on the Covid response.”

Patient numbers rising fast

Official stastistics bear out the rapid rise in the number of Covid-19 patients in ESHT hospitals over the Christmas period. From 193 on 23 December, the number increased to 284 on 30 December, up 47%, and to around 335-340 on 4 January (taken from a graph, exact number not given), up 74%.

On 30 December 19 patients were on mechanical ventilation. That is probably well within the hospitals’ capacity – in the early days of the outbreak, in April, the number of critical care beds was lifted to 40. But on the same day the occupancy of adult general and acute beds by Covid patients was 90%, and it is here that the hospitals are likely to be struggling.

Up to 5 January there were 278 confirmed deaths of Covid patients in the trust’s hospitals.

On 6 January 646 new cases of the virus were reported in East Sussex, taking the cumulative total to 18,288. Hastings and Rother no longer stand out so prominently from the other lower tier authorities – while they reported 107 and 73 cases respectively, Wealden had 158, Eastbourne 175 and Lewes 133.

Seven-day rates were Hastings 867.7 cases (down 87.4 on the previous seven-day period), Eastbourne 815.5 (up 295), Rother 697.3 (up 60.4), Wealden 662.6 (up 237.2) and Lewes 694.3 (up 269.2). The rate for East Sussex – 737 (up 169.4) – was above the England average of 606.9 (up 201.7).

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