Finding our true north…

Finding our true north... NHS_Training_in_Primary_Care_General_Practice 2

It started, looking like the silhouette of the rolling Chilterns.  Within thirty days it was morphing into the 80’s skyline of London.  After a month it became New York, Dubai, Hong Kong and Kuala Lumpur, rolled into one.

Now, it’s up and down, like a fiddler’s elbow. 

I’m talking about the graph of daily-tests for Covid-19.

Finding our true north... NHS_Training_in_Primary_Care_General_Practice
Finding our true north… NHS_Training_in_Primary_Care_General_Practice

On June 17th we did fewer tests than the beginning of May.  We haven’t hit 200,000 tests since early June

Testing has dropped out of the news, the Number 10 press conferences glide-past the topic and what data there is, is… well…

…these numbers are an amalgam of; tests processed in labs, kits sent to people’s homes and others dispatched for use in test centres (lobbed in through the car window, as one correspondent described it) … but not yet analysed.  

To a layman like me, meaning; we don’t know where they are, or what might have happen to them. 

Kits sent, mailed out, couriered, piled up somewhere, stuck on the mantlepiece, used and messed up, spoiled, lost.  

What’s what?  Dunno.

What I do know is, behind the scenes there have been NHS people, struggling to stand-up a service, flaky from day one.  People have been finagled into massaging numbers to hit political targets and quietly rebuilding the system, from the inside, to make it fit for purpose.

Testing seems so fragile that we are still unable to routinely test all staff.  Something which Shadow Health Secretary, Jon Ashworth is calling for, today.

I have no idea why, when the only way out of the cul-de-sac our economy finds itself in, testing isn’t our route-one, exit.

Could it be, the infection is subsiding and there are fewer people to test?  That’s good news.

However, we are now pinning all our hopes on Track&Trace.  From what we know, from Australia, one contact can result in testing over 60 people.  So, as lockdown is relaxed, the numbers tested should be going up?

If the imperative is to get cash registers ringing and contactless pay-points beeping, shouldn’t we be antibody testing?  Well…

… the MHRA have stopped private companies offering AB-tests, on some spurious grounds that the public can’t be trusted to test themselves.  

Hospitals are AB-testing staff but the effort appears pointless.

In NHSE’s own words:

‘… the science is currently uncertain and a positive test result for antibodies only means than an individual has had COVID-19. 

There is currently no evidence to show it means someone cannot be re-infected with the virus, or pass it on to others, or have protective immunity.’

So, what’s the point of ABt?  Dunno.

I don’t know how deep we are into the CV-19 crisis.  To me, everyday feels like a Sunday, the weather has skipped spring and slipped into summer.  I have no idea where I am in the calendar.

We are weeks, months away from the start and I cannot tell how near we are to the finishing line.  

I am too old to go out and by the time someone decides it is safe for me to venture-forth, I’ll be too old to bother.

In lockdown I have acquired a black belt in Ocado, become a gold-card Amazonian, a Wizard of Zoom and a disciple of St Martin de Porres.  

But…

… not everyone is as fortunate as me.  There are people on the breadline, business at the point of collapse.  Kid’s fretting about exams.  

Corporations, pushing a bow-wave of debt into the black hole of Brexit, jettisoning staff by the thousands, like a sinking ship throws cargo, overboard.

We are nowhere near the end.  Watching suicide shoppers at Bicester Village tells me the public still haven’t grasped the gravity, the risk of a second spike and the fact, a flu season is waiting to rip the NHS apart.

Vaccine aside, our only chance and soul focus, our only hope and absolute pivot-point has to be testing, underpinning tracking and tracing and for science to stop dithering and give us an anti-body test worth a shilling. 

We are moving like explorers, into an alien world.  I sense a trembling, like the needle of a compass and without robust, routine testing, we have no hope of finding our true-north.

-oOo-

PS: 

Since writing this, news came in, from Morecambe Bay FT, that following a +tive CV-test result and in accordance with guidance, 38 members of their front-line staff, from their paediatric’s department, have gone home, to self isolate.  The inpatient’s ward is closed.

The ramifications of situations like this, for the wider NHS are obvious.  It won’t take many positive tests to end up with more staff at home, than there are on the wards.

Reliable, frequent, staff-testing is the only way to keep the NHS working. 

Prof Derek Alderson, president of the Royal College of Surgeons says; staff should be tested twice a week.

I find that hard to argue with.

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.