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  • Memorial of Health & Social Care Workers taken by COVID-19 Moving and interactive a digital tribute and memorial by Nursing Notes to the dedicated members of our health and social care family who gave their lives during the fight against Coronavirus (SARS-CoV-2 / COVID-19).
    NursingNotes is committed to planting a new tree in a protected forest for every single health and social care worker who loses their lives because of the COVID-19 pandemic.

  • (16 Jan 2022) Better sick pay, testing and ventilation: Labour’s Covid plan to keep UK open Guardian January 16:
    “Labour will today announce ambitious plans to create a country that can “live well with Covid” without the need for future harsh restrictions, as it seeks to prevent Boris Johnson claiming credit for his record on the virus.
    “Keir Starmer said he wanted people to be able to “live their lives as normal” and never again face “tough restrictions on our lives, our livelihoods and our liberties”.
    “Shadow health secretary Wes Streeting’s 10-point plan includes measures to raise sick pay, improve testing, share vaccines worldwide and transform social care.”

  • (15 Jan 2022) BHRUT chief: Winter at trust’s hospitals ‘not notably worse’ than pre-Covid Romford Recorder January 15 with a shocking quote from the new boss of the worst-performing A&E in England, with less than 30% pf patients treated and admitted or discharged within 4 hours -- and army staff propping up its ICU.
    If this is not worse than usual what level of failure would get him upset? What must his staff think of this?
    "Matthew Trainer, chief executive at Barking, Havering and Redbridge Universities NHS Trust (BHRUT), made the comment during his report to the trust’s board on Tuesday, January 11.
    "He told the board while there were a “significant number” of Covid-19 patients at the hospital, many were “incidental Covid” patients – meaning they are being treated for other things in addition to Covid.
    "Mr Trainer also said the use of oxygen was lower than 12 months ago.
    "Additionally, latest figures from the two hospitals showed the rise in Covid-19 hospitalisations was slowing."
    Which raises the question -- why, then, is the Trust's A&E performance by far the worst in England?

  • (14 Jan 2022) Recognising how big a problem we currently have in the NHS is the beginning of trying to solve it Jan 14 BMJ article by President of the excellent Royal College of Emergency Medicine, once more trying to inject some common sense into the debate over plunging A&E performance:
    “This is not just about long waits for patients with a broken finger or minor illness. The patients who have been most adversely affected are those waiting for hospital admission.
    “There has been a huge rise in those staying for over 12 hours (NHS England persists in publishing Decision to Admit plus 12 hours despite collecting the data from arrival, but even so the November figures of 10 600 was a new record).
    “The underlying bed capacity and workforce problems are clear for everyone to see.
    “There are no quick solutions, but ambulance delays and long waits in emergency departments have consequences for morbidity and mortality, just as delayed cancer surgery or heart surgery have consequences.”

  • (14 Jan 2022) I’m a Longtime Union Organizer. But I Had Never Seen Anything Like This New York Times Guest Essay from Oregon January 14 on why staff in long-term care facilities can't take it any more.
    Last winter, workers at a memory care facility in Oregon decided they were done watching the residents suffer. The story of a lousy employer, a barbaric care home, and a brave but unsuccessful strike, in which only the strikers kept their dignity, by former union organiser Vanessa Veselka.
    “I have often wondered what makes people fight when they suspect they aren’t going to win. Here, I knew. It was for the residents.
    “I wish I could say that the Rawlin workers got their union, but they didn’t. The strike lasted for 14 days, after which many of the workers who were on strike decided to quit together. About 12 employees marched over to the facility and handed in their resignation letters in person.”

  • (14 Jan 2022) Sajid Javid signs off £1 billion private health windfall as MPs sound alarm Byline Times January 14 on the latest big bung of scarce NHS cash to private hospitals - again without and obligation on the private hospitals to treat a single patient:
    “… both the chair of the Public Accounts Committee, Labour MP Meg Hillier, and her Conservative deputy, Geoffrey Clifton-Brown, were furious about having not been informed about this decision sooner.
    “Quizzing Sir Chris Wormald, Permanent Secretary at the Department for Health and Social Care, Clifton-Brown made his scepticism clear.
    “I do not have the papers in front of me as they only just emerged this afternoon, but as I understood it from what the chair was asking, the NHS has contracted with the private sector for £75 million a month – that is £1 billion a year – before a single service is even given by the private sector. That sounds like a very expensive insurance policy, doesn’t it?” he asked, rhetorically.
    “Hillier, meanwhile, asked why plans had not already been formulated for NHS bed capacity in the event of a new variant, and why the Government had been forced to rush to the private sector.”

  • (13 Jan 2022) Bristol's Nightingale 'surge hub' ready to be kitted out The intro line of this Jan 13 Bristol Post article, with a picture of a vast empty marquee in Southmead Hospital car park says it all really: “Hospital bosses hope it will never be needed as questions continue about who will staff it.”
    The article takes up the same theme:
    “The day after the ‘Nightingale surge hub’ announcements, Dr Azeem Majeed said it will be difficult to find enough staff to run the temporary NHS hubs set up for overspill patients amid rising coronavirus admissions. Speaking on Times Radio, the head of primary care and public health at Imperial College London said: “It’s going to be very difficult.
    … “Hopefully those won’t be needed, but if we do need those extra beds it will be a struggle to find the staff to deal with those patients – I’m not quite sure where those staff will come from given the fact hospitals are struggling now with their current workload,” he added.”

  • (13 Jan 2022) NHS guarantees private sector at least £225m to reserve capacity in case of new covid surge HSJ Jan 13 on Sajid Javid’s instruction to NHS England to waste tens of millions by putting private hospitals “on call”:
    NHS England has guaranteed to pay independent providers around £225m between now and March to reserve capacity in case of a covid admissions surge – but the figure could rise to up to £525m if the capacity needs to be fully utilised.
    The monthly payments under the new national deal, detailed in a letter published late yesterday, will be between £75m and £90m each month until April to reserve the capacity. But if a major surge occurs and the capacity has to be released, the payments are likely to double to £175m a month.
    Both scenarios would leave the NHS “exposed financially”, NHSE chief executive Amanda Pritchard has warned, and the arrangement creates “a material risk that the NHS pays for activity that is not performed”.

  • (13 Jan 2022) Sending out an SOS for our NHS Labour Outlook January 13 article by HCT Editor John Lister
    “A powerful new alliance of campaigners and trade unions has launched the SOSNHS campaign, demanding an immediate injection of another £20 billion in capital and revenue to help put England’s crisis-ridden NHS back on its feet.
    “… £20 billion sounds like – and is – a lot of money: but after more than a decade of real terms freeze or cuts in NHS funding it would only be a down payment to address some of the most pressing problems. Much more investment will be needed – not least to fulfil government promises of building 48 new hospitals, expanding the workforce, and fixing social care.
    “To put £20bn in context we also need to remember the huge sums of money Rishi Sunak threw at the private sector with little or no accountability during the Covid pandemic.
    “£48bn was shelled out on ‘bounce back loans’: the National Audit Office has found that that at least 37% of loans (£17.3bn) will not be repaid, and that 11%, worth (£4.9bn) were fraudulent.
    “Billions more were squandered on dodgy deals for overpriced or useless PPE and equipment. Billions more were wasted on the disastrous privatised test and trace system.”

  • (13 Jan 2022) Peak of viral shedding is later with omicron variant, Japanese data suggest BMJ January 13 article warning that moves to cut Covid isoloation from 7 days to 5 could result in further spread of the virus:
    “Patients with the omicron variant of covid-19 shed virus for longer after symptoms emerge, show data from Japan, potentially jeopardising hopes that the period of isolation for people testing positive could be shortened.
    “Preliminary data from the National Institute of Infectious Diseases—which conducts disease surveillance in Japan—suggest that the amount of viral RNA is highest three to six days after diagnosis or symptom onset.
    “The isolation period for people testing positive for covid-19 was recently cut from 10 days to seven in England if two lateral flow tests returned negative results on days six and seven. …
    “Staff absences because of isolation have caused severe workforce shortages for critical services, including the NHS, schools, and transport, leading to calls for the UK to follow the US and cut the isolation period to five days.”

  • (12 Jan 2022) The NHS won’t ‘collapse’ Pulse Editor Jaimie Kaffash January 12 on the normalisation of NHS crisis:
    “… every year, the NHS comes out the other side, leading some commentators to claim that the NHS has coped fine – that NHS staff are the Boys Who Cried Wolf.
    “But let’s think about what this actually means. What is meant by health services ‘collapsing’ (or imploding, or anything similar)?
    “… The effects are not obvious for those of us not affected directly, and they don’t make for a great 10pm news piece. Instead, it is patients who could have been treated in time deteriorating, care being rationed so you just need to learn to deal with your condition (or go private) or staff who are unable to cope having to go through the motions because there is no one else to provide care.
    “The fact that this is part of everyday life is a tragedy that is so long in the making that it no longer feels like a tragedy, and the general public becomes desensitised to the latest shocking headlines.”

  • (12 Jan 2022) Twelve-hour A&E waits average over 400 a day, leak reveals HSJ report January 12 uses leaked data and gives comment from the Royal College of Emergency Medicine on the developing problems in A&E performance:
    “The number of ‘trolley waits’ of more than 12 hours has continued to rise into January, as senior medics warn of ‘appalling crowding’ in emergency departments.
    “Internal operational data submitted to NHS England, and seen by HSJ, suggests the number of patients who waited 12 hours or more in an emergency department, from decision to admit to being given a ward bed, increased by around 15 per cent in December, compared to the previous month.
    “The leaked data is from “situation reports” from NHS trusts, but is unvalidated. It reliably reflects the trend in 12-hour waits, but the final validated figures for December, due on Thursday, are expected to be even higher.”

  • (10 Jan 2022) Tory private health deal branded waste of money as experts fear no help for NHS Mirror report Jan 10, quoting HCT editor John Lister
    “Critics condemned the three-month arrangement with 10 health care firms which is intended to offer cancer surgery and urgent care to NHS trusts if they are overwhelmed by Covid cases.
    “Experts, campaigners and trade unions believe the new deal, backed by undisclosed amounts of taxpayers’ cash, will line multinational firms’ pockets and care for very few NHS patients.
    “They say private hospitals can only take on extra patients by poaching medics from the NHS, which needs 100,000 more staff.
    “Campaigner Dr John Lister … said: “Tory ministers now prefer to squander more millions on short-term stop-gap deals with profit-seeking private hospitals than invest in reopening thousands of NHS beds.”

  • (10 Jan 2022) NHS England strikes private hospitals deal to fight Omicron surge Guardian Jan 10:
    “Hospitals in England will be able to use private hospitals and staff under a deal with the NHS to maintain services as Omicron cases surge, avoiding delays in treatment for patients with illnesses such as cancer.
    “The move comes as hospitals have also been told to find extra beds in gyms and education centres owing to rising numbers of Covid patients.
    “The three-month agreement means private healthcare staff and facilities will be on standby to support the NHS if required and to maintain services for patients who can be referred, including some of those waiting for cancer surgery.”

  • (9 Jan 2022) Free lateral flow tests are reportedly being scrapped by the government – and people are furious Indy report Jan 9:
    "News of the UK Government reportedly planning to stop free lateral flow tests except for a number of “high-risk” settings has outraged members of the public, who have described the possible move as “reckless” and “completely and utterly dangerous”.
    "In a report which suggests the government are more interested in testing our patience than testing for coronavirus, The Sunday Times said the proposals for free tests to be limited to places such as care homes, schools and hospitals are set to be announced by Boris Johnson “within weeks”.
    "A senior Whitehall source told the outlet: “I don’t think we are in a world where we can continue to hand out free lateral flow tests to everybody forevermore. It’s likely we will move to a scenario where there is less testing but we have a capacity to ramp it up if necessary.”

  • (9 Jan 2022) Nadhim Zahawi Says There Are No Plans To Scrap Free Lateral Flow Tests Politics Home article Jan 9 gives the official denial which lends credibility to the Sunday Times story on the end of free access to lateral flow tests:
    “The government has no immediate plans to scrap free lateral flow tests, according to Nadhim Zahawi, the Secretary of State for Education.
    “Zahawi on Sunday told Sky News he was "puzzled" by a story published by The Sunday Times claiming that lateral flow tests will be scaled back as part of plans to live with the coronavirus.
    “The report said Boris Johnson would confirm the decision in the coming weeks and quoted a senior Whitehall source as saying the UK would soon move to scenario whereby there is "less testing".
    “They told the newspaper: "I don’t think we are in a world where we can continue to hand out free lateral flow tests to everybody for evermore. It’s likely we will move to a scenario where there is less testing but where we have a capacity to ramp it up if necessary, such as in the winter.”
    “Zahawi said he did not "recognise" the story.”

  • (8 Jan 2022) NHS leaders accused of ‘bullying’ hospitals into silence over scale of Covid crisis Independent Exclusive Jan 8 begins:
    "NHS leaders have been accused of downplaying the impact of the Covid crisis and putting hospitals under scrutiny for declaring critical incidents and postponing surgeries.
    "A leaked email urges hospitals to use the “correct terminology” and make NHS leaders aware when declaring their status.
    "Sources said the message was a “thinly veiled threat” and that there was “subtle pressure” amid the rapid spread of Omicron.
    "At least 24 trusts have declared critical incidents this week, including one in Northamptonshire on Friday afternoon, while new figures show a 59 per cent rise in staff absences in just seven days.
    "Trusts in London were told hospitals will be scrutinised for declaring a critical incident if there is “doubt” over the decision, according to an internal email sent from NHS England on Wednesday."

  • (8 Jan 2022) Is this NHS crisis really worse than ones before? Dreadful BBC News January 8 summary that ignores the record 6m and rising waiting list, the loss of almost 5,000 beds in 2020 for infection control, the cumulative pressure on staff with 93,000 vacancies after almost 2 years of crisis, and the inadequate funding locked in to 2025. It concludes:
    “Traditionally winter would see around 1,000 admissions a day for all types of respiratory infections. Currently the NHS is seeing more than double that for Covid alone - although a chunk admittedly are people who are ill with something else, such as broken arms, strokes and cancer for example, and may well have come in anyway.
    “But even if you discount these patients, you are still well above the 1,000 threshold.
    “However, the NHS has been helped by lower pressures elsewhere. Flu is at rock-bottom levels. There are fewer than 50 patients in hospital with the virus in England.
    “So what can we conclude? The challenges are certainly worse and that is translating into poorer quality services. But this is not the first year care has been compromised. What matters now is when Covid infections peak - that will determine just how bad this winter will be.”

  • (6 Jan 2022) Delayed surgery fears and PM faces fresh pressure on tax hikes Independent Premium report Jan 6:
    “Health leaders are warning government ministers that urgent operations such as cardiac and cancer treatments are being delayed in hospitals as the PM confirmed in a statement to MPs in the Commons that England would continue with plan B restrictions.
    “We are hearing from our members that virtually all intensive care units are under strain primarily because of staffing constraints and this is resulting in many having to limit access for patients having urgent operations,” Dr Stephen Webb, president of the Intensive Care Society, told The Independent. “Staff isolation and staff illness due to Covid restricts our ability to care for other patients.”
    “Dr Webb’s comments came as a further 194,747 Covid cases were recorded in the latest 24 hour period and rules on Covid testing domestically and on travels entering England were relaxed.”

  • (6 Jan 2022) 'Unquantifiable challenge': Plans to tackle NHS backlog could be derailed by lack of staff, MPs warn ITV News report Jan 6:
    “The “catastrophic impact” of the Covid pandemic on patients waiting for NHS treatment is clear, but plans to tackle it could be derailed by emergency care demands and a lack of staff, MPs have said.
    “The record number of people on the waiting list for planned care in England – almost six million – is likely to grow but, at the same time, the NHS is also dealing with a record number of 999 calls and long waits to be seen in A&E.
    “In its new report, the cross-party Health and Social Care Committee said that tackling the wider backlog caused by the pandemic is a major and “unquantifiable” challenge as it includes all the people who have yet to come forward for care.
    “It calls for a broad national health and care recovery plan embracing emergency care, mental health, GPs, community care and social care.”

  • (5 Jan 2022) Cuba’s vaccine success story sails past mark set by rich world’s Covid efforts Guardian report January 5:
    “This downtrodden island struggles to keep the lights on, but has now vaccinated more of its citizens against Covid-19 than any of the world’s major nations.
    “More than 90% of the population has been vaccinated with at least one dose of Cuba’s homegrown vaccines, while 83% have been fully inoculated. Of countries with populations of over a million, only the United Arab Emirates has a stronger vaccination record.
    “Cuba is a victim of magical realism,” said John Kirk, professor emeritus of Latin American studies at Dalhousie University, Canada. “The idea that Cuba, with only 11 million people, and limited income, could be a biotech power, might be incomprehensible for someone working at Pfizer, but for Cuba it is possible.”

  • (5 Jan 2022) NHS staff 'in tears as unable to deliver care for patients' due to Covid shortages Mirror report Jan 5:
    “Staff shortages continue to mount as Covid cases surge in the UK with a further 218,724 people testing positive in yet another daily record. Now RCN director for England, Patricia Marquis, has said the government needs to be "honest" with the public about the pressure being put on the health service and that patient care is being impacted.
    … Ms Marquis said:
    "… Many nursing staff are going into work with only half the number of staff that are needed but with still the same number of patients to look after. They are being spread thinner and thinner and we are hearing of many being reduced to tears because they are not able to deliver the care to their patients."
    Many public services are resorting to emergency plans to tackle shortages, with some hospital trusts declaring critical incidents, where priority services may be under threat.

  • (5 Jan 2022) Critical incidents declared over staff shortages BBC News report Jan 5:
    “Norfolk and Waveney's care system, covering three hospitals, the ambulance service, community and social services, has declared a critical incident.
    “Hospital trusts elsewhere have also declared critical incidents amid staff shortages and pressures from Covid-19.
    “University Hospitals of Morecambe Bay NHS Trust, Blackpool Teaching Hospitals and Great Western Hospitals in Wiltshire have all raised the alarm.
    Derriford hospital in Plymouth has problems offloading ambulances, and has recorded nearly 500 staff absences.
    … “In a statement, Norgfolk & Norwich University Hospital medical director Erika Denton said: "Our hospital is extremely busy and it is an incredibly pressured time for everyone working in health and social care.
    "The hospital is full and we have already taken steps to increase bed capacity in response to high emergency demand and a record number of Covid-19 infections that has led to a surge in admissions."

  • (5 Jan 2022) Two more NHS trusts declare critical incidents over staff Covid absences MSN report Jan 5:
    “Morecambe Bay NHS trust, which operates three hospitals across north Lancashire and southern Cumbria, made its move on Monday evening, and the trust that runs Blackpool Victoria hospital followed suit on Tuesday morning, saying its beds were at full capacity.
    “They join at least six other trusts that are understood to have issued alerts over “internal critical incidents” in recent days, including United Lincolnshire hospitals NHS trust.
    “In an internal memo, Morecambe Bay’s chief executive, Aaron Cummins, said “relentless and sustained pressure” caused by “unprecedented staff absences” would lead to operations and appointments being cancelled and staff being redeployed to allow the hospitals to maintain safe services for patients.
    “The trust operates three sites: Furness general hospital in Barrow-in-Furness, the Royal Lancaster Infirmary, and Westmorland general hospital in Kendal. Barrow-in-Furness has the highest Covid infection rate of any local authority area in England, at 2,439.8 cases per 100,000 population.”

  • (5 Jan 2022) Private providers making the most of the pandemic January 5 Pulse magazine round-up on privatisation from the GP point of view. It notes:
    “The new framework has wider implications. Dr Jackie Applebee, a GP in Tower Hamlets, east London, says one of the key issues with the private sector taking on NHS work to help clear the backlog is they don’t offer the full range of NHS services, and this can lead to patients waiting for months only to find they won’t be treated.
    … “She adds: ‘The [private hospital] bounced pregnant women back before, and someone who was HIV positive but was very well controlled, on medication and whose viral load was really low. They won’t deal with anybody with a high BMI. Anything slightly complex and they will bounce it back.’
    “There might be a positive outlook for private providers as waiting lists rise. But it seems GPs and the wider NHS will continue to provide the safety net.”

  • (4 Jan 2022) ‘Get a lift to hospital,’ ambulance trust tells patients with suspected heart attacks HSJ report Jan 4:
    “Ambulance trusts have begun asking patients with heart attacks and strokes to get a lift to hospital with family or friends instead of waiting for an ambulance, because of high covid absences and ‘unprecedented’ surges in demand, HSJ has learned.
    “An internal note at North East Ambulance Service Foundation Trust said that where there was likely to be a risk from the delay in an ambulance reaching a patient, call handlers should “consider asking the patient to be transported by friends or family”.
    “This applies to calls including category two, which covers suspected strokes and heart attacks, according to the note seen by HSJ. It said call handlers should “consider all forms of alternative transport” for patients.
    “The note from medical director Mathew Beattie gives the example of a person with chest pain who would normally get a category 2 response – with a target of reaching them within 18 minutes – but where the ambulance response time would be two hours.”

  • (4 Jan 2022) Heart attack patients told to make own way to hospital as Covid surge hits northern England Guardian report Jan 4:
    "“NHS pressures in the north-east have become so intense that ambulance workers in the area have begun asking patients with suspected heart attacks and strokes to get a lift to hospital with family or friends instead of waiting for an ambulance, amid high staff absences and an “unprecedented” surge in demand, it emerged on Tuesday.
    “An internal note at North East ambulance service NHS foundation trust said that where there was likely to be a risk from the delay in an ambulance reaching a patient, call handlers should “consider asking the patient to be transported by friends or family”, the Health Service Journal reported.
    “The second-fastest growth rate in hospital Covid occupancy is in the north-west, which recorded a rise of 94% in the last seven days. It means all parts of northern England have more than double the growth rate experienced in London, which was 46% between 27 December and 3 January.”

  • (3 Jan 2022) NHS trusts in England declare critical incidents amid Covid staff crisis Guardian report January 3, again tacitly raising the question of how bad the situation in the NHS needs to get for the government to brave its right wing extremists and take action:
    “Multiple NHS trusts across England have declared “critical incidents” amid soaring staff absences caused by Covid-19, with health leaders saying many parts of the service are now “in a state of crisis”.
    “Boris Johnson on Monday ruled out the introduction of new curbs “for now” but said he recognised that the pressure on the NHS and its hospitals, was “going to be considerable in the course of the next couple of weeks, and maybe more”.
    “More than half a dozen trusts have issued alerts over “internal critical incidents” in recent days, it is understood, as concerns mount that some may be unable to deliver vital care to patients.
    “Health leaders said the “rapidly increasing” number of absent NHS staff was piling “very serious” pressure on hospitals already struggling to cope with increasing Covid admissions and “huge wider pressure” on urgent and emergency services.”

  • (2 Jan 2022) The Vaccine Centre Is the Latest Tory Privatisation Disaster Tribune article Jan 2 by HCT editor John Lister:
    “The ‘offloading’ of the Centre marks a major about-turn by government. Back in May 2020, then chief executive of UK Research and Innovation Professor Mark Walport, welcoming fresh government investment to expand VMIC’s capacity, said it was ‘an essential new weapon in the UK’s arsenal against diseases and other biological threats.’
    “In December 2020 the UK Vaccine Taskforce’s document ‘2020 Achievements and Future Strategy’ also insisted on its long-term importance: ‘We have worked with VMIC to increase VMIC’s delivery capability… to 70 million doses of pandemic vaccine… This is a permanent facility, with government step-in rights during a crisis.’
    “… This short-sighted decision to prioritise cash, profits, and corporations over health is consistent with the Johnson government’s instinctive turn to the private sector rather than investing in the NHS or other public services.
    “This has led to the disastrous squandering of up to £37 billion on a dysfunctional test and trace system, billions more on dodgy deals for PPE with firms owned by cronies and donors rather than established companies, and up to £12 billion more on treating NHS patients in private hospital beds rather than investing in remodelling NHS hospitals to reopen thousands of closed beds.”

  • (2 Jan 2022) COVID, Capitalism, and Collapse: A Roundtable Discussion with NYC Nurses and Teachers The Strike Wave Jan 2: Labor journalist and NewsGuild organizer Chris Brooks sat down with a group of New York City nurses and teachers to talk about how the institutions they work for are collapsing and what labor activists can do about it. A nurse explains:
    “We are two years into the pandemic and there is still a testing shortage. Twenty City MD locations have closed so they can maintain a bare bones staff at their remaining locations. Lines for testing centers run on for blocks and blocks.
    “The failure to provide adequate care where it is needed leads to increased reliance on the one place that everyone knows they can turn to if they are desperate: the emergency room. Our hospital has a public testing center and the line is so crazy that people give up and just come to the ER to get tested. In the ER, it’s still a five hour wait.
    “The acuity is really high in the Bronx and the pandemic has only made it worse. Everyone we see in the ER is now sicker than they were a few years ago, because fewer people have access to the medications they need, many have lost their jobs and health insurance and hold off on getting care until it’s an emergency.
    “The baseline for everything we see is getting worse while the system continues to be flooded with COVID patients and nurses are quitting.”

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