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Second wave of Covid-19 will be 'gruelling' with increased pressure prolonged throughout winter, doctors warn

The second wave of Covid-19 will be 'gruelling' with increased pressure stretching out through winter, senior doctors have warned. 

Chief medical officers and other top health figures have written to doctors on the frontline urging them to be flexible during the crisis.

They may be required to work in clinical areas outside their usual practice in order to cope with pressures, as more coronavirus patients are admitted.

The letter, tweeted by England's chief medical officer Professor Chris Whitty, said the second wave 'may well be prolonged throughout the winter period, with wide local variation and fluctuation in cases, requiring a sustained response from the whole profession'.

It said: 'This will be gruelling professionally and personally.'

It echoes a warning at the start of the pandemic in March, when Professor Whitty told medics they will need to work 'in unfamiliar circumstances'.

The letter was tweeted by England's chief medical officer Professor Chris Whitty

The letter was tweeted by England's chief medical officer Professor Chris Whitty

Professor Whitty tweeted that the second wave will be 'challenging' but that he appreciated the work of doctors

Professor Whitty tweeted that the second wave will be 'challenging' but that he appreciated the work of doctors 

The letter added that pressure will 'inevitably be exacerbated by staff shortages' due to sickness or caring responsibilities

The letter added that pressure will 'inevitably be exacerbated by staff shortages' due to sickness or caring responsibilities

The chief medical officers of England, Scotland, Wales and Northern Ireland, the NHS, the GMC and the medical royal colleges all signed the letter

The chief medical officers of England, Scotland, Wales and Northern Ireland, the NHS, the GMC and the medical royal colleges all signed the letter

The letter comes after hospital admissions have crept up in the UK, with a current 14,200 patients being treated across the UK compared to the highs of almost 20,000 in April. 

But the average number of people being admitted per day is beginning to stabilise, Department of Health figures show. 

UK REACHES 50,000 DEATHS MILESTONE 

Britain’s official coronavirus death toll passed the grim milestone of 50,000 today after health chiefs announced another 595 victims in the highest daily count since May.

Department of Health figures show the UK's official death toll now stands at 50,365, with today's figure the highest recorded in a single day since May 12 - when there were 614 fatalities. 

Boris Johnson said the figures was a stark reminder that the UK 'was not out of the woods yet' despite promising news about a vaccine earlier this week. 

Officials say Covid fatalities will continue to rise for 'several weeks' due to high infection rates though October. 

It takes about three weeks for infected patients to become severely ill and eventually succumb to the virus. The PM labelled every death a tragedy, saying 'we mourn everybody’s who’s gone'.

But despite the gloomy warnings of thousands more deaths, the silver lining is that daily cases are down week on week. A total of 22,950 new infections were recorded today — which is 8.8 per cent lower than the 25,177 that were registered last Wednesday.

Mr Johnson said: 'Every death is a tragedy and we mourn everybody’s who’s gone. And our feelings are with their families and friends as well.'

Praising efforts develop vaccines and treatments to protect people from Covid-19 during a visit to a Tesco distribution centre in Erith, south-east London, he added: 'But I’ve got to stress that we’re not out of the woods yet, it does still require everybody to follow the guidance, to suppress the disease in the way that we all understand.'

Discussing the death figures, Professor Yvonne Doyle, medical director of Public Health England, said: 'Sadly the upward trend is likely to continue and it will be several weeks before any impact of the current measures - and the sacrifices we are all making – is seen and is reflected in the data.' 

Around 1,500 people seriously unwell with Covid-19 are being admitted into hospital every day, which is still far below the heights of 3,000 a day in April. 

It is difficult to judge how busy the NHS really is with coronavirus patients because the data is not compared to the health service's total capacity. 

A leaked document from the start of November claimed 84 per cent of all hospital beds were occupied across the country, which was lower than the 92 per cent recorded during autumn last year. 

Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade.

The only exception to this was between April and June this year, when it stood at 64 per cent because hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic. 

Regional differences in the coronavirus outbreak mean some places are feeling more strain than others – one major hospital trust in Liverpool is already treating more Covid-19 patients than it was in the spring. 

But tens of thousands of beds went unused during the peak of the first wave of Covid-19 and officials and officials say the 'available capacity' of hospitals is only around 20,000, prompting startling warnings they could run out of room by next month. 

Today's letter from senior health chiefs said that pressure in hospitals will 'inevitably be exacerbated by staff shortages' due to sickness or caring responsibilities.

The NHS went into the pandemic with an already short workforce, and sickness absences have further strained medics.   

Healthcare professionals will have to be 'flexible', which 'may entail working in unfamiliar circumstances or surroundings, or working in clinical areas outside of their usual practice', the letter said.

It added: 'This can be stressful and you may have concerns about both the professional practicalities and implications of working in such circumstances.'

Hospitals, trusts and healthcare leaders have been told to 'bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging circumstances of the epidemic'.

The letter said all doctors are expected to follow health regulator guidance in order to continue giving proper care, and hospitals, trusts and healthcare leaders 'must bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging circumstances of the epidemic'.

But it assured doctors that regulators will take into account the need for temporary changes to practice during this difficult period. 

It added that coronavirus restrictions imposed across the UK will result in the initial peak of pressure on the healthcare system being 'significantly lower' than it otherwise might have been.

The letter said: 'We all need to support one another during this time. It is, and is going to remain, hard going but mutual support makes this prolonged crisis easier to manage personally, as well as professionally.'

The chief medical officers of England, Scotland, Wales and Northern Ireland, the NHS, the GMC and the medical royal colleges all signed the letter.

A warning of a similar nature was first sent out to doctors on March 12, when the coronavirus outbreak began to gather pace in the UK.

Professor Whitty predicted then that 'if Covid-19 becomes an established significant epidemic in the UK, NHS and HSC services in primary and secondary care and public health across all four nations will be put under extreme pressure'. 

He said although a significant epidemic 'may entail working in unfamiliar circumstances or surroundings', 'we need to stick to the basic principles of being a good doctor'. 

When the coronavirus began spreading in the spring, doctors had no idea how to treat it - only its obvious symptoms such as shortness of breath.

Now, doctors have become far more acquainted with the progression of Covid-19, and have changed their treatment practises as a result.

For example, admitted patients are not immediately put on a ventilator anymore, because this can exacerbate the severity of the disease. It is now considered a last resort. 

Mortality rates have dropped partly because doctors have learnt to react to all sorts of complications, experts say, as research has highlighted the prevalence of fatal heart attacks, strokes and organ failure.   

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