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Plea to unvaccinated to act now as cancer delays mount

Frustration is mounting among medics in Birmingham and the Black Country as unvaccinated Covid patients continue to fill intensive care beds – forcing doctors to make ‘distressing’ decisions to cancel surgery for other sick people.

Cancer ops and other vital surgery are being axed, often at the 11th hour, because of ITU bed shortages – with around one in five of those beds taken by a critically ill Covid patient who has not been vaccinated.

Out of 93 patients in UHB’s intensive care beds yesterday (Saturday), 27 were Covid-positive. Most were unvaccinated.

One doctor who works in the city, consultant neurologist Dr David Nicholl, representing Doctors Association UK, described the situation as an ‘avoidable’ pressure on the NHS that was forcing difficult decisions.

Read more: The worst is yet to come – Black Country and West Birmingham hospital chiefs braced for January peak

“For every unvaccinated person with Covid in intensive care, there’s someone else who may well be struggling to get access to a life-saving bed,” said Dr Nicholl.

He cited a recent case of having to beg for a bed for a deteriorating patient after learning there were no ITU beds free locally.

A fresh plea has now gone out to the staggering numbers of people locally who have still not had a single dose, urging them to resist the ‘lies’ of anti-vaxxers and trust in the scientific and medical community over vaccine safety.

Birmingham and Solihull health chiefs are encouraging people to get their jabs in the run up to Christmas – using suitably festive encouragement

Take up of first doses is still below 60% in around a third of Birmingham (22 areas out of 69). Mistrust of authorities, misinformation spread by anti-vaxxers, cultural opposition to medical and vaccine interventions and access issues are widely cited as reasons for continued hesitancy.

Resistance is greatest in areas of the city that have faced the highest case rates through the pandemic, and largely in the most deprived areas.

But even among hospital staff, there is resistance – a situation that leaves colleagues baffled.

Vaccine take up among staff at Sandwell and West Birmingham Hospitals NHS Trust is 84%, for example.

“It is very frustrating. I don’t blame people individually – we have to keep engaging with them – but nearly 20% of my trust have yet to be vaccinated and that reflects the community we work in,” said Dr Nicholl.

“The booster programme is absolutely appropriate but we need to work on those who have not had the vaccine yet as well”.

Frustrated voices from the frontline on vaccines

Liz Green, a senior nurse who managed the sickle cell and thalassaemia centre at City Hospital through the pandemic, said it was “immensely frustrating” to see protective measures against Covid, particularly the vaccines, not used.

“There are even large numbers of our cohort of patients, all highly vulnerable, who have decided not to have the vaccine, which I find baffling and upsetting, because I know they would benefit from it,” she said.

Sickle cell and thalassaemia are inherited blood disorders that especially impact people of Black and Asian origin and leave patients very vulnerable to infection.

Senior nurse Liz Green, inside the sickle cell and thalassaemia centre at City Hospital
Senior nurse Liz Green, inside the sickle cell and thalassaemia centre at City Hospital

“I don’t really understand why you would not take something that could help protect you, especially if you are vulnerable.

“We are doing lots of things to try to address that, by answering lots of questions, talking to them about their concerns, and trying to overcome the resistance,” she added.

She spent time on a Covid ward during the pandemic’s peak as part of a mass redeployment of staff across the NHS – and said it was an unforgettable and harrowing experience. “I would hate any of my patients to endure the awful things I witnessed.”

City Hospital A&E junior doctor Dr Ahmed Rabie, 28, said it was ‘heartbreaking’ to see people arrive in hospital short of breath, desperately worried and uncertain what the future holds.

“I get to meet people who did not take the vaccine who have become ill and are full of regret. I have seen people who go on to become extremely unwell, and who die; and those who recover but suffer lung fibrosis, or symptoms of long Covid, and it is life changing for them.

“We cannot control everything, there is much about Covid we are still learning about, but the vaccine is a very powerful protection, the best we have.

-Dr Ahmed Rabie, A&E doctor at City Hospital
Dr Ahmed Rabie, A&E doctor at City Hospital

“I also see the impact on people who have not got Covid but who are not able to get the treatment they need, or procedures and surgery they need.

“We are seeing patients now who have been waiting months for treatment and sometimes again we have to say ‘we are sorry, you must still wait, we don’t have a bed for you.'”

He said the ‘most heartbreaking’ was the sight of heavily pregnant women with Covid-19, who were the most difficult to treat if their infection worsened.

The ability to prone (a treatment that involves placing a breathless Covid patient on their front to expand their lung capacity) and to give certain drugs is limited by their pregnancy, he said.

BirminghamLive is supporting the vaccination rollout – vaccines have been vigorously tested and are recognised as the only way to protect our region from Covid-19 and get all our businesses open again safely.

But you may have questions still. You can ask your doctor and also dedicated websites have been set up by Birmingham and Solihull Clinical Commissioning Group and its partner CCG in Black Country and West Birmingham with everything you might want to ask about the local vaccination rollout.

If you want to book a vaccine appointment, visit the NHS vaccines website here.

We hope these other useful links will help you make health decisions for you and your family.

“Always the mum’s concern is not for herself but for her baby. The baby is already named, is already part of their family, and the mum is struggling to breathe – it is very difficult to see,” he said.

“Pregnancy is a risk factor – being pregnant and having Covid-19 should be avoided at all costs, and the best way to do that is to get vaccinated.”

Dr Nicholl said of his direct experience of the pressures on ITU beds: “Recently, I had to plead to get a young man whose health had deteriorated back into the Intensive Therapy Unit.

“I knew at the time I asked there were no beds – literally there was ‘no room at the inn’. I had to go to ITU to look at one of my most trusted colleagues in the eye to beg and plead my patient’s case.

“We all loathe those conversations. It may mean another ventilated patient being moved to another hospital miles away, or, as has happened previously, closing an entire operating theatre to ventilate a patient. That in itself means another patient could be delayed life-saving surgery.”

He added: “These kinds of decisions are being made every day. The stresses on all concerned, staff, patients and families are excruciating. That day, my patient was lucky and a bed was found. But will we be tomorrow?

Dr David Nicholl, representing the Doctors Association UK
Dr David Nicholl, representing the Doctors Association UK

“This has been this way for months. It’s depressing as the vaccines have saved literally thousands of lives, yet some still won’t see sense and take it. Even now as scientists champion the new, life-saving booster program, there are still those who refuse to even get a single dose.”

A recent review of NHS data showed that 84% of patients admitted to hospital with covid-19 had not been vaccinated. Only three per cent had been fully vaccinated.

Lisa McNally, director of public health in Sandwell, said: “It’s clear that if we get vaccinated then we’re not just protecting ourselves, but also the NHS.

“We’re helping avoid NHS staff being diverted away from other patients who really need treatment.”

She also urged people who had so far not come forward for their jabs not to fret, and added it was important not to shame people for their decisions, especially given how much misinformation was being spread.

“Anti-vax campaigners are playing games with people’s lives. They are twisting the truth, telling lies and manipulating people. They have even targeted children outside local schools.

“Luckily, people are increasingly seeing through their nonsense.”

Birmingham’s QE hospital is the biggest single ITU department in the country, with more than 100 beds.

The presence of high numbers of Covid-positive patients in ITU beds limits the availability of beds for other patients in two ways.

BrumWish 2021 aims to get thousands of Christmas gifts to young children in need across our city – the homeless, the vulnerable, kids in care and kids who have little.

This year’s appeal is bigger and better than ever – because we have teamed up with our partners at #Toys4Birmingham, including Thrive Together Birmingham, the Birmingham Playcare Network, the Edgbaston Foundation and Birmingham Forward Steps.

Also involved are Birmingham Community Healthcare NHS Trust, Barnardo’s, Spurgeon’s children’s charity, the Springfield project in Sparkhill, St Paul’s Community Development Trust and Your Local Pantry, which runs food hubs in 12 locations across Birmingham and the Black Country.

You can buy a gift from the #Brumwish Amazon Wishlist here.

Or you can collect and drop off donations of new and nearly new toys and gifts to special donation days at Edgbaston Stadium, B5 7QU, on Saturday November 27, Friday December 3 and Saturday December 4, from 11am to 3pm, where volunteers will be waiting to see you.

Brand new or nearly new, unwrapped gifts, books and toys for all ages will be accepted.

You can also donate cash, which will go into a fund held by a charity partner to use to plug gaps or buy specialist toys for children with additional needs. This is the link to make a donation.

The need to distance between patients, additional cleaning regimes and other measures limits overall capacity; while a typical patient with Covid-19 in ITU will likely require critical care for significantly longer than a typical post-operative or emergency patient, reducing turnaround.

Doctors need to be certain that a bed will be ready in ITU for a patient after a serious operation – when that can’t be guaranteed, a postponement can sometimes be the only option.

The Department of Health & Social Care and NHS England are taking steps to address the increasing backlogs and waiting times, with an extra £8 billion announced for hospital trusts in September.

It has also announced an extra £13.8 million for new wards at University Hospitals Birmingham, delivering an expected 164 additional adult inpatient beds across the trust to help it tackle waiting lists.

Data in detail – how we know hospitalisation and death risks are lower for the vaccinated

An NHS study of all hospital admissions nationally between Monday 16 August and Sunday 12 September showed the rate of hospital admissions of over 80s was 50.5 per 100,000 in the fully vaccinated; and 143.9 per 100,000 in the unvaccinated. Deaths were 45.5 and 145.4 per 100,000, respectively.

These trends were seen across the board. For example, for 60-69 year olds the hospital admission rates were 13.5 per 100,000 in the fully vaccinated; and 74.3 per 100,000 in the unvaccinated; deaths were 4.1 and 24.3 per 100,000, respectively.

Before you go: Join our campaign to show how much little Arthur is loved, the boy killed by those who were meant to protect him

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