A senior doctor at Wales’ largest hospital has urged people to “consider postponing Christmas” in a bid to reduce the increasing flow of Covid-19 patients into A&E.
Dr Farbod Babolhavaeji, a consultant in emergency medicine at the University Hospital of Wales (UHW) in Cardiff, said the volume of patients into the emergency department on Wednesday was the most he had experienced since March.
He estimated around eight in 10 patients coming through the doors were either confirmed or suspected cases of the virus, while there was also a steady stream of non-Covid patients ranging from victims of road traffic accidents to those suffering cardiac arrests.
The 38-year-old predicted it would only be a matter of time before the Lakeside Wing – a new £33m, 400-bed medical facility treating coronavirus patients when bed capacity at the main UHW site cannot cope – was opened up.
“The rate of people turning up to the emergency department with Covid and needing medical attention has increased dramatically just in the last couple of weeks,” said Dr Babolhavaeji, who was treating the most seriously ill patients in the resuscitation area on Wednesday.
“The emergency department is very congested at the moment. People are staying in the department – and our sister ward the assessment unit – for long periods waiting for beds to open up.
“I don’t know what the criteria is for opening up the new ‘surge’ wing for Covid patients but I wouldn’t be surprised if we were going that way very soon.”
Dr Babolhavaeji, who became unwell with the virus himself towards the start of the pandemic, said he was deeply concerned by projected infection rates in Cardiff over the coming weeks.
He made the bold admission that this winter was probably going to be the hardest in the entire history of the NHS.
“This whole Christmas period is going to be rife for transmission,” he added.
“The more people who transmit Covid, the more likely it is that it will reach the most elderly and vulnerable who are most at risk of significant harm.”
The experienced medic said he has become used to the “chaotic, information-sparse environment” of A&E and is simply getting on with the job at hand.
“We have an attitude in emergency medicine that you can ‘only do as much as you can do’ and you can’t take your work home with you – particularly if things aren’t going well,” he said.
“When I get out of the hospital I wipe my slate clean as much as I can. However I know some people are struggling with the day-to-day grind of it all at the moment.
“But we deal with this pressure every winter. Covid is just another burden to bear.”
The dad-of-three, who lives in Miskin, Pontyclun, urged people to be “sensible” during the five-day Christmas period between December 23 and 27 when three households can meet up as part of an extended “bubble”.
“It’s not for me to say what people should or shouldn’t do in wider society, but looking at the projected rates of transmission being three to four times higher than in the first wave, I believe we may struggle to manage the number of patients who get this disease,” he added.
“If people can postpone Christmas this year then consider it. I don’t want to be the type of person who says ‘no you can’t have your Christmas’, and I know people have struggled this year with isolation and everything that goes with it, but I think this five-day period with three households mixing is potentially going to cause a really significant increase in rates of infection at a critical time for the NHS.
“If I’m going to be completely cold and pragmatic about it, it’s just another five days in the calendar. Christmas means a lot to me too as my middle daughter was born on Christmas Day, but we’ve made the decision not to have family here because we think the risk is too great.”
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On Tuesday, Dr Babolhavaeji was one of the first people globally to receive the Covid-19 vaccination at Cardiff and Vale Therapy Centre in Splott.
But he warned that it will be “many months” before the Welsh Government could even contemplate easing restrictions on our everyday lives.
“Vaccines won’t necessarily stop you from catching the disease. All it does is prime your immune system to fight it off very rapidly so that you hopefully don’t become symptomatic,” he explained.
“In that short period from when you catch the disease to your immune system fully eliminating it, you’re still potentially able to transmit the disease.
“But if the person you transmit it to has also been vaccinated, then it should break the chain of transmission so that they don’t pass it onto someone else.
“You need to have a critical mass of people taking the vaccine for it to [lead to] herd immunity. It’s only at that point we can start thinking about returning to life as we knew it. This vaccine is a gift for next Christmas, not this one.”
NHS workers in Wales were among the first people in the world to get the approved vaccine:
His comments come following a joint statement from nine unions representing frontline healthcare workers in Wales.
They have joined forces to highlight the impact the rise in coronavirus cases is having on the staff providing care and to urge the public to do all they can to protect the NHS.
BMA Cymru Wales, the British Association of Occupational Therapists, the Chartered Society of Physiotherapy, GMB, Royal College of Midwives, Royal College of Nursing Wales, Society of Radiographers, Unison and Unite say staff are “beyond exhausted” and they have significant concerns regarding the impact of the five-day Christmas period on infection rates.
A statement from the Joint Health Trade Unions said: “If pressure on the service continues to increase we must be realistic about what it will mean for patients in hospitals where every bed is full – making treatment difficult and waiting lists longer.
“We are not seeking to change the decision that has been made about Christmas but we have a responsibility to help minimise any impact on the health service and its staff and patients.
“Staff are truly exhausted, mentally and physically, and they are extremely concerned about what January will bring.
“All we ask, as we have done throughout the pandemic, is that when you make your choices about Christmas you take the risk seriously and minimise contact as much as possible. Covid-19 has not gone away.”
Latest NHS Wales figures show there were 1,936 Covid-19 patients in hospital beds on Wednesday, which was 153 more patients than the week before. These patients make up about 24% of all patients in hospital which compares with about 18% at the end of May – but the proportion has been slowly increasing.
In a statement on Thursday, Welsh health minister Vaughan Gething said the rate of Covid-19 transmission continues to rise across communities in Wales at “an alarming rate” despite best efforts to contain it.
He said: “As transmission rises it becomes increasingly difficult to maintain the fragile balance between providing care to those who require hospitalisation because of Covid-19 and the delivery of essential non-Covid services.
“There are now more patients being treated with or recovering from Covid-19 in our hospitals than ever before. Difficult choices will have to be made as services and our workforce start to be stretched beyond the levels that we would normally see at this time of year.
“NHS organisations will need to take action to ensure they stand ready to face increasing levels of Covid-19 in the coming weeks and in the run-up to Christmas. My priority remains to save lives and to minimise harm.”
He concluded: “To be clear – if rates of Covid-19 transmission in communities continue to rise, and pressures on the health and care system continue to increase, Welsh ministers may need to consider what further urgent actions and restrictions are necessary.”