June 16 2021

As people debate the pros and cons of delaying the removal of the remaining restrictions on our daily lives the Government float the idea of mandatory immunisation for Care Home staff. Do you remember the criticism the Government got for moving too slowly with Care Homes, leading to a high mortality? The Pandemic in the UK is now firmly set to produce a new peak of cases. There were 9,055 new cases today compared with 7,673 yesterday. Testing is now at a lower rate than it has been despite the rising case numbers. The day-to-day fluctuations are influenced by school children being tested on two weekdays but not on the other 3. There were 930k tests done yesterday compared with777k today.

The Health Care data is now beginning to rise but only slowly still. 184 people were admitted to hospital on 9th June and 173 on 10th June. The total in hospital beds is now 1,177. The number on a ventilator has doubled in the last few weeks and now stands at 206.

Deaths are still holding steady with 10 yesterday reported and 9 today. There have been 66 deaths in the last 7ays. With the number on ventilators rising, it is inevitable that some of these will fail to recover and go on to die.

The pattern of illness is changing, with a high percentage of the senior citizens fully immunised now, Covid is attacking younger and younger people and the unvaccinated elderly. The younger, fitter members of society are able to withstand this better than the elderly. We have got much better at treating the disease with alternative methods of ventilation and the use of dexamethasone and other drugs. This means the death rate should be able to be contained at a lower rate than before.

The situation with mutations seems stable at present, thank goodness. The prominent strain is the Delta variant which as we can see is much more transmissible.

The race to get everybody immunised continues. Today it is reported that 42.02million 1st doses have been given with 30.44 million 2nd doses. All those aged 22-23 were called for immunisation on Monday, today it’s the turn of the over 21s and by the end of the week everyone over 18 will have been called. Remember you have to ring 119 in England to book the slot for your immunisation. If you are late having your jab or now want one having earlier said no just ring 119 to arrange it.

Greater London, whose immunisation rates are lower than the rest of the country have set themselves a target of giving 10 million jabs by the 19th of July. That’s about 100k per day. This target is reachable with a lot of effort but on Monday only 51,892 were given. Football grounds belonging to Chelsea, Spurs, West Ham and Charlton are to be used as walk in centres. Providing the doses of Pfizer and Moderna vaccine continue to be available this campaign will make a significant difference to the total immunity in the country by 19th July. A further 813 new cases were confirmed today in Greater London.

Ireland have said that unvaccinated Brits. arriving in Southern Ireland will have to self-isolate for 10 days on arrival and have the usual negative testing from today.

The United States has just passed the dreadful figure of 600, 000 deaths now, the highest in any country in the world. Brazil from whom we hear very little, has the second highest number of deaths according to the WHO.

As I mentioned in the beginning, the Government have suggested mandatory Covid vaccine for Care Home staff and perhaps also for NHS staff. I have discussed this before, but we would all wish our loved ones to be safe from their carers passing Covid to them. There is nothing new in this approach. The only thing that is relatively new is the civil liberties movement. Back in the 1970s I worked for a few years in the NHS Occupational Health Service at a major teaching hospital. Part of my job was to ensure all the staff were protected from diseases they could be immunised against. When I first started, a booster smallpox vaccination was required every 3 years, a tuberculin test had to be positive, tetanus and polio had to be up to date. Then hepatitis B vaccine became available, and staff were required to have an immunisation or show adequate antibodies in a blood test. Annual flu vaccine was strongly encouraged. Nobody ever objected, rarely a vaccine was contra indicated. An example would be giving a smallpox vaccine to someone with eczema. It did not have to be mandatory, hospital staff expected us to do our best to protect them, as they did their best to protect patients. It was a condition of employment.

All employers have a responsibility under the Health and Safety at Work Act to do all in their power to keep employees safe as well as protect patients as fully as possible. I suspect the responsibility of Care Home staff to be fully immunised has in the past been down to the staff themselves. Many of the Care Home managers were not medical and so the issue has been overlooked in the same way as there were very limited stocks of PPE available. It makes sense that employers must now make it a condition of employment that all employed staff have an Occupational Health Assessment and are fully protected before commencing work. If there are contraindications to having Covid or other immunisations they probably should not be employed in these high-risk environments. As part of an admission procedure to a Care Home any patient found not to be fully immunised should be offered it as quickly as possible. If a planned admission, given before they arrive. If it is an urgent admission, they should stay isolated from other patients until fully covered.

If there is anyone who wants to argue there must be mandatory immunisation, or there is no need to immunise any staff at all please feel free to post it for discussion.

For now, all we can do is to ensure full compliance with the existing restrictions. We probably all know at least one vaccine refuser. Let’s try politely and calmly to persuade them to change their mind, and educate them. Make absolutely sure that the younger adults in your family make time to get their jabs. Remember the social distancing rules still apply and make sure, as we enjoy the fine weather, we do not all cram together too close. Check how many masks you have and ensure you are always able to access one quickly. You will need them for at least another month.

Stay safe everybody.

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