Then and Now

A report from the Front Line

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The account below was sent in to us by a HART follower who works in a busy A&E department, comparing the workload and the treatment options in the spring of 2020 with that of 2024. Here we reproduce it in full, with some added links to previous HART articles.

“I have always wondered about the ‘noticing’ of what became known as SARS-COV-2 in April 2020.  Of course, evidence shows it was circulating for a long time before that, and that the response (in my opinion) was worse than the disease for the overwhelming majority of humans on the globe.  But I did see sick people that spring/summer (and a small minority of very sick) and always wondered why the ‘peak’ was then and not over the winter.  The views range from there being no such thing as a virus, there being no novel virus, there being an out of season virus, there being a virus which was lethal because of the response, there being a weaponised virus, through to (the least likely) that there was an easily spread killer virus which ‘the vaccine’ saved us from. Apologies if I have left out an obvious category, and I accept that combinations of the above form other views.  I have a view, but that’s not a point I’m trying to push here.

What I did notice, was that when I slowed down over last weekend from a heavy, sustained workload, and the sun appeared for the first time — when I retired from rotavating the garden — I got sick with an upper respiratory tract illness — you know the type — pounding headache, dripping sinuses, copious catarrh, painful cough and (the worst bit) agony when you laugh.  Having not slept for two nights, I ignored the advice of my better half and headed for work at 7am, only to take calls from a plethora of trainees who had decided not to show for their shifts because they were smitten with ‘feeling poorly’, ‘coughs’ etc — the most spectacular one being an e-mail that they could not come in because ‘they were absent’ (and not in the seizure sense).  One industrious trainee had managed to score an NHS swab as positive for influenza B.  I make no claim to martyr status for going in (nobody would listen in our place anyway) but it did strike me that among staff and patients there is widespread upper respiratory tract illness.  And it is April.

For those with COPD, obesity, advanced years, polypharmacy, from institutions, immunocompromised etc — it is no surprise that they are getting superimposed bacterial lower respiratory tract infections…  some even breaking through to ‘sepsis’. Thing is, I am no longer prohibited from admitting these patients and my treatment options extend beyond paracetamol, oxygen and ICU.  We have regressed back into atrocious, antiquated treatment modalities like antibiotics, non-invasive ventilatory support, nebulisers, corticosteroids. I can talk to them without PPE, they can have direct contact in nursing care, the chest physios are back in action, and their relatives can be there for support.  “Sepsis Six” is back in favour (thank you Ron Daniels) and we can resuscitate in the Resuscitation Room.  (OK, I exaggerate, we are overwhelmed and today we treated 10 admissions in ambulances and 60 in the corridors;  some into their third day. But you get the gist).

Did I mention — it is April?  I don’t know how I have practised Emergency Medicine for over 30 years and not noticed the spring/summer (viral?) URTI/LRTI ‘waves’.  Maybe because all-cause mortality has a seasonal (dark, cold, sunless) winter spike — but it is real in other seasons too.

And I feel really lousy; but better equipped to rationalise the madness of April 2020. Take my current condition, add two or three morbidities, reduce therapeutic options and pile on the FEAR — or even my current condition with just the FEAR (friends were sending me Ivermectin from India back then) and I think my condition today would not be that different from 2020.”

For those readers who like some charts, these from 2009 show that when there is a stated ‘pandemic’ and lots of ‘testing’, spring and summer waves are easily demonstrated…

Figure 1. Influenza surveillance results July 2008 to January 2011: (a)Germany (b)Netherlands (c) Eastern Europe (d) Canada

As the account above highlights, filling the population with FEAR and telling people to stay at home, avoid their general practitioner and only go to hospital when they are blue or breathless at rest, then banning their relatives, dressing all the staff in military PPE and doing a PCR test to demonstrate a ‘novel’ and dangerous pathogen which then directs the patient to a no-antibiotics, no-steroids protocol, quite easily transforms a ‘summer cold’ into a life-threatening condition. That is without the DNR notices and the Midazolam.

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