April 15 2021

I was pleased to see a copy of a draft letter The Chelsea and Westminster Hospital Foundation Trust are planning to send to all their staff, especially aimed at those who are choosing not to be vaccinated. It says “We will take into account your occupational risk assessment – this may impact the range of duties you undertake and the environment in which you work”

As patients we have a right to be protected from staff passing preventable conditions to us and as clinical staff, that we can be protected as much as possible from our patients.

I give notice to my friends and family that I will not be prepared to go into a nursing or care home where staff are not fully protected against Covid 19 infection if the need arises.

More data available shows how these rare blood clots associated with low platelets are more likely to occur if you have the illness than if you have them in response to the first dose of OAZ vaccine.

Other figures show if 1 million people aged 60 catch Covid 19, about 2,000 would die. If 1 million 40 year olds were to catch Covid, 1,000 would die. If a million 30 year olds catch Covid a few hundred would die. If you give 1 million people a dose of OAZ vaccine 1 person might die. The risks from this vaccine remains infinitesimal compared to the benefits.

In the UK we had brought our hospital waiting lists done very considerably just before the pandemic hit us. Sadly, the waiting lists have risen very dramatically again and are far higher now than before the pandemic. The NHS is to tackle this again now as it becomes easier to undertake many of the procedures that have been paused. Some new NHS monies are to be allocated to boost the numbers of cases that can be dealt with. We have no idea how many extra deaths will come to light due to the failure of the system to detect early cancers through all the screening programmes.

I wonder just how significant immunisation technique is in improving the efficacy of the vaccine? I have not as yet heard of studies reviewing this. I suspect one of the most photographed subjects of the last year has been the giving of vaccine. Have a look at about 30 such pictures and see for your self the various techniques being used.

Leave aside the question of wearing gloves where the official policy says you do not need to wear gloves and they may interfere with the proper control of the vaccine leaving the syringe. You should wash hands between each patient.

Look at the angle the syringe is held at in relation to the skin surface, and look carefully at which sort of needle is being used. Then look how close or how far the injection site is from the point of shoulder. The deltoid muscle you are aiming for is at the top of the upper arm. Depending on how much fat you carry, there is between 0.3 cm and 4 cm of fat between the skin and muscle. The most muscle is about 5cm below the tip of the shoulder. To access the optimum spot, you must have a lose short sleeve and pull it up to expose the right site. The injection must be placed in the muscle. We know from many other studies it is not as efficient when injecting into fat. The patient will not thank you for a long needle in a small arm which hits the humerus bone under the muscle. It is normal to use a size of needle that puts the vaccine in the right place. Most needle systems in the UK are colour coded. An orange needle is fine for those with minimal fat, but will not be long enough with moderate or more fat.. A light green needle will do the job for most people provided it goes in up to the hilt. It is certainly possible that poor injection technique contributes to vaccine failure when patients are not as protected as expected and still catch it. If you think you are fatter than average make sure you indicate this to the vaccinator and have a longer needle.

In tonight’s statistics 32.44 million 1st doses and 8.51 million second doses have been given.

Covid testing has picked up again with 1,162,840 tests done yesterday with 2,672 found to be positive. This is a drop of 6.9% and the rate of positive tests is 28.4/100k. I notice over the last couple of days the rate of dropping has slowed. We must watch this carefully. Deaths are reported as 30 a drop of 2.3% over the last 7 days, reversing yesterday’s slight rise. As far as hospital are concerned, 2,393 are inpatients on 13th April, there were 201 admissions on 11 April, a drop of 11.2 % in the last week. 351 patients require a ventilator.

We remain on course but need to watch that new cases do not begin to rise again as lockdown is eased.

Stay safe everyone

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