Concerns about Thanet people being able to gain hospital care and demands to keep primary schools closed despite government saying they should open have been raised following a revelation by The Independent newspaper yesterday (January 1) that intensive care bed occupancy at Kent hospitals stood at 137%.
This means existing ICU beds plus extra ‘surge’ capacity beds are being used. Not all ICU beds are occupied by patients with covid.
The worrying data, gained from an NHS dashboard, also showed QEQM Hospital in Margate was unable to maintain the nurse to patient staffing ratio for intensive care and had been marked as Critcon 3 – meaning the service is at full stretch.
William Harvey Hospital in Ashford is at Critcon 2 and is maintaining staff ratios. Kent & Canterbury is at level one but is not sustaining staff ratios, according to the details published from the dashboard.
What is Critcon?
The Critcon measure is for staffing and capacity in the pandemic.
Critcon 3 is when expansion into non-critical care areas (e.g. wards) and/or use of paediatric facilities for adult critical care is needed. It means the Trust is operating at or near maximum physical capacity and maximum mutual aid between Trusts – the transfer of patients and/or staff to other hospitals-, is necessary.
The prime imperative in Critcon 3 is to prevent any single trust entering Critcon 4 which is the stage where services are overwhelmed. NHS England intervention is needed to declare this level.
The Independent article said there are 114 patients in critical care, with 55 on ventilators and only 83 beds available on the adult critical care wards across Kent and Medway.
East Kent Hospitals Trust has been asked for confirmation of its figures. Last confirmed figures from the Trust were for December 29 the Trust when it was at 96 per cent of traditional capacity (existing ICU beds not extra ‘surge’ beds) and December 30 when the highest was 91 per cent in any of the ITUs but the trust has experienced 113% capacity at points this month.
Government data for East Kent Hospitals (Margate, Ashford and Canterbury) was last updated to December 30. This shows 423 patients being cared for with Covid and 29 on ventilators for that date. As of December 29 the Trust had 51 unoccupied Adult General and Acute beds.
East Kent Hospitals Trust has recorded 813 covid-related deaths to date.
The Trust has 1,161 beds in total. Of these 981 are general and acute and around 43% of these are currently in use for patients with covid.
A spokesperson for for East Kent Hospitals, said: “Our staff are working incredibly hard caring for more than three times the number of patients who have tested positive for coronavirus than we did in the first wave. Our hospitals are extremely busy.
“We are asking people to keep A&E for emergencies only and to call 111 for advice if they are not sure.
“We are incredibly grateful to everyone who is working very hard in these challenging circumstances. We urge everyone to play their part in stopping the spread of Covid-19 by staying at home as much as possible, social distancing, wearing masks and washing their hands.”
County Councillor Karen Constantine, who is one of the Ramsgate representatives, said: “The figures are very concerning. We must acknowledge that our NHS is on a knife edge. Capacity has been reached.
“It is absolutely clear that people must continue to take all the steps they can to protect themselves and their families from Covid transmission. The coming weeks are critical, with GPs predicting increased numbers of infections based on people mixing over Christmas and the New Year.
“The Government should have been clearer and firmer with their guidance. However I am aware that many people were extremely cautious. That sensible cautious approach must now continue.
“I will ask county council leader Roger Gough to fully consider the evidence pertaining to Thanet in relation to Covid.
“We are more limited in health care as we are a peninsula, once QEQM is full we are have less choice as to where we can send patients requiring specialist treatment if ICU beds are full.
“Likewise in light of these figures it’s seems unwise to allow school to return and I will be urging KCC to make a decision contrary to the Government’s current advice to open schools.
“I have presented sufficient evidence, collated from over 80 responses from teachers and parents to indicate that the rules for a return to education are incoherent and increase risk of virus transmission. That is a risk we can’t take.
“We need to delay the reopening of schools. A further Covid surge will occur due to Christmas and New Year’s Day mixing. Our hospital is at capacity for Covid. The risks are real and patients are being transferred to Oxford, Southampton and Plymouth.”
“I thank our NHS staff for their amazing work and remarkable resilience. Let’s do all we can to support them.”
Lib Dem county councillors are also calling for the full closure of schools for up to two months.
A statement from councillors Rob Bird (pictured) and Trudy Dean says: “It makes no sense to close schools in London which is in tier 4, but to keep them open in other tier 4 areas including parts of Kent.
“The Imperial College study of the new strain of the virus, UK B114, shows that it is hugely more infectious. It also shows that cases are highest in children and young people from birth to 19 years right now.
“We know that children are unlikely to suffer serious effects from the virus. But we also know that in recent weeks, despite lockdown, Kent school children have been bringing the infection from school back into their homes. This has led to cases rocketing, filling our hospitals with older and more vulnerable patients, many more of whom will die.
“All schools must close countrywide to contain the new strain as much as possible and to allow vaccination programmes to give health workers, key workers, teachers, the elderly and most vulnerable the essential protection they must have. That is likely to take two months. Education is precious. But life is more so. “
The call for a ‘fire-break’ has also been made by Independent district councillor Ruth Bailey.
She said: “Most secondary children are not returning until January 18 so why does not the same apply to primary children? There has been a u-turn resulting in all primary schools in London’s Tier 4 boroughs now remaining closed.
“The Government was insistent that the whole of Kent entered Tier 4 collectively – why doesn’t the same apply to the closure of schools?
“Parents of primary children are more involved than parents of secondary with transporting their children to and from school and more likely to mix at the school gate thus moving the virus around. There are bound to be many mixed-aged households, where some children will be in school and some won’t, so the virus will spread regardless.
“Thanet’s rates may be coming down but they still remain significantly higher than the national average. We have not yet seen the repercussions of the Christmas holidays which will put even more pressure on our already over-stretched critical NHS services.
“In my opinion we need this ‘fire break’ with all children remaining at home with remote learning and, importantly, teachers need and deserve the time to prepare for this.”
North Thanet MP Sir Roger Gale is in agreement, saying: “We need consistency in a schools re-opening policy that reflects the spread of the pandemic as it is now and not as it was before Christmas. What is right for London has to be right for East Kent. Delay the start of term and re-assess the needs of both the education and health services.Teachers’ lives matter.”
Worried parents in Thanet have also sent a group letter to Thanet MPs Craig Mackinlay and Sir Roger Gale this morning (January 2) urging them to share the rationale used to order Thanet primary schools to open on January 4 when many across the county, such as Tunbridge Wells which has lower transmission rates, will remain shut until January 18.
The seven day covid rate for Thanet as of December 28 was 484.1 per 100,000. In Tunbridge Wells the rate was 430.4.
The letter, posted on the Friends of Cliftonville Coastline facebook page, says: “While many of us face an almost impossible situation of working from home whilst trying to homeschool or supervise home learning, we simply cannot turn a blind eye to the very real Covid crisis unfolding in front of us.
“We are all increasingly worried that it is not safe for our children or the staff to be at school and we’d be very grateful if you could offer a clear rationale for the decision to reopen to allay our main concerns:”
The letter expresses concerns that the decision over schools reopening is inconsistent with Tunbridge Wells primary schools remaining shut despite the area having a lower infection rate than Thanet.
The letter highlights the U Turn on opening schools in some London Boroughs with all now remaining closed until January 18. More than 250 parents have put their signature to it.
The capacity rates for ICU in Kent are also raised with the letter saying: “Do we not run the risk of overwhelming local hospitals even further by re opening primaries? We wonder if you could tell us the plan for dealing with this situation and also give us some scientific evidence on the safety of allowing primary schools to reopen in general?
“The message from the government seems to be that schools are safe but where is the scientific evidence to say that primary school aged children don’t spread the virus?”
National Education Union
The National Education Union is calling on all primary schools to defy government and move to remote learning for the first two weeks of January except to vulnerable children and the children of key workers.
Dr Mary Bousted, Joint General Secretary of the NEU, says a longer period of online working for all primary, secondary and college students could suppress virus levels and buy time both for the roll out of the vaccine and to put in place measures that can keep schools safer.
She added: “With warnings from eminent scientists of an ‘imminent catastrophe’ unless the whole of the UK is locked down, and with more cases in hospitals than ever before and our NHS facing an enormous crisis the Secretary of State is sending the majority of primary pupils and staff back on Monday to working environments which aren’t COVID secure.
“Uniquely school and college staff are being required to work in overcrowded buildings, with no effective social distancing, no PPE and inadequate ventilation.
“Why is it that Primary age children are the second highest infected of all age groups, or that levels of infection amongst Secondary pupils have multiplied by 75 times since the start of September?
“Serious questions also have to be asked about the Government’s plans for lateral flow testing in secondary schools, in particular about the effectiveness of these tests in identifying COVID infection in young people who are highly likely to be asymptomatic, with the tests being supervised by non medically trained volunteers. We do not think it likely that these tests alone can make our schools Covid secure nor protect the communities they serve.
“We believe the Government’s steps will fail, that cases will continue to rise and that the question of school opening will have to be re-visited but in a worse situation than now.”