As Covid recedes its aftermath is witnessed in a system that is ‘beyond broken’…

On Nolan yesterday to talk about the latest response from the Stormont Executive to rising Covid infections. Through the various conversations it struck me how public understanding is failing to keep pace with the nature of the crisis.

One lady said she was so fed up with looking at people in masks that she preferred to sit at home rather than go out. It transpired that she’d lost her husband during the crisis and still clearly suffering from the loss and the forced isolation.

The private stressors that people are suffering because of isolation deemed necessary to curtail the disease bring real complications. The Storey funeral cut through was the fact so many have forgone normal courtesies in life and death.

The fact that so much of the population has been vaccinated creates its own logical challenges, but only if you don’t look at the wider problems in the system. It’s worth reading Maire Louise Connolly’s excellent report from the Ulster Hospital:

The nurses move around, fixing blankets and pulling curtains to protect patient dignity. At every turn, there is a sick person waiting to be seen or to be admitted onto a ward. At the peak, 134 people were waiting – in a department that originally housed 65 bedded cubicles.

Now, those are not covid patients, as Marie Louise explains further down in the piece. We are having a third wave of excess deaths, but it’s not all about Covid. Chris Giles and Sarah Neville in the FT explain (H/T Tony):

The new phase of excess deaths raises the possibility that since the summer more people have been losing their lives as a result of strains on the NHS or lack of early diagnosis of serious illness, although the interpretation of the figures is contested.

Data from the Office for National Statistics, National Records Scotland and the Northern Ireland Statistics and Research Agency have shown three distinct phases of the pandemic.

As they note, non Covid deaths “since early July have been higher than the weekly average for the five years leading up to the pandemic”. What’s going on at the moment is a bottleneck of deferred cases.

Some of them serious life ending, some covid, or other forms of respiratory disease that have been released since we eased off mask wearing thinking that we were completely in the clear.

Listening to friends who work in health service areas less stressed than Northern Ireland, most (though not all) of the most serious cases they’re dealing with in ICU are unvaccinated.

“Freedom Day” didn’t help. Nor does politicians turning a blind eye to mass breaches of regs. Current regs are fairly moderate allowing for discretion and individual freedom.

But if we just ignore them (and I’ve been guilty of this too), our freedoms will be further curtailed. If really you want to avoid another economic seizure, at the very least you can wear a fecking mask!

However chronic lack of resources long predates COVID. Miracles have been worked by medical staff not just in facing a killer disease, but in liaising with contractors to run oxygen supplies to where they were needed, often not where planned.

In my own family I had an experience of an elderly aunt who fell and broke her hip. She spent three to four days being shipped between the Downe Hospital in Downpatrick and the Ulster for an operation that took all of that time to arrange.

As it happened a younger relative, a nurse who looks after such patients in a health trust in southern England, was horrified to witness a delay that would not have been tolerated under a protocol that insisted on surgery within 24 hours.

I should say, no blame attaches to the staff. But if your resources are so short there’s nothing anything anyone on the sharp end can do. Years of procrastination and reports from Bengoa and Donaldson gathering dust on the shelves.

On the bigger issue, as our Gerry Lynch has noted on Twitter, the main Covid treatment we have (vaccines) is working:

What we are dealing with is a legacy of neglect and political timidity when faced with explaining to voters why the system doesn’t work at the capacity we need. Mask wearing will help in the short term, investment will help in the medium term.

But we also need our politicians to take the dilemma’s cast up to them by the experts whose reports they like to wave around like so many promissory notes, to stand up and explain the bigger picture and why tough decisions need making.

Putting Matrons back in charge of hospitals will help too. It’s outcomes we need to manage as well as budgets.