One of the country's top infectious disease doctors has warned that Covid-19 has not gone away and urged the public to keep wearing masks and show "respect and kindness" to vulnerable members of society.
Speaking about the second anniversary of the first national lockdown, Royal Victoria Infirmary medic Matthias Schmid told ChronicleLive he was concerned about changing attitudes to Covid - and said "Living With Covid" would mean getting used to consistent levels of the virus affecting our communities.
Dr Schmid, a consultant who treated the first Covid-19 patients in the UK in January 2020 and who heads up the infectious diseases department at the Newcastle Hospitals NHS Trust, said: "We are clearly in a situation where we are wanting to live with Covid.
"What that means is that when the Government makes a policy decision that we will live with restrictions, we will have to manage to live with that and it will mean living with an awful lot of Covid still around. Levels will go up, they will go down but they will stay at a substantial level in the community."
Dr Schmid added that the continued restrictions in hospitals like the RVI and the Freeman ought to serve as examples for how the public should take care to protect the most vulnerable groups in society.
He added: "It's clear that people feel very passionately about having to wear masks. We in hospital of course continue to do so out of concern for each other and our patients and it would be still a good idea for everyone to recognise that and wear masks. I think it would show respect and tolerance.
"If you're unwell you shouldn't be mixing with other people - and if you do have to go somewhere you should wear a mask at all times. It does reduce the chances of you spreading illness to anybody else."
Dr Schmid also said he was concerned about the future of the NHS, with staffing pressures among the issues to have been highlighted during the Covid-19 pandemic. He said it was important for both politicians and the public to "decide what sort of NHS people want".
"The big thing is the NHS is struggling," he said. "It is underfunded and needs more support in terms of staff, in terms of staff development and in terms of the environments that we practise in. I have been in the NHS for 35 years and I have to say I have seen it change so much - and I am a bit concerned about where it is going. I am not sure that there's enough support from politicians.
"It's something everyone is talking about - and staff are incredibly tired. On a personal level I have been working solidly since January 2020 when we had the first patient arrive, as has every member of my team, every member of staff.
"Everyone in Britain needs to decide what kind of NHS they want and what kind of country they want this to be."
In Newcastle, Dr Schmid has been part of a team which has been praised for its approach to containing Covid-19. Compared to many areas of the country Covid mortality rates at the Freeman and RVI have been lower, and the Trust has a strong record at minimising hospital-acquired infections.
He said this had been down to a number of factors including the early experience doctors had of the virus and the expertise already in place around highly infectious diseases. He also said the ability to bring in Covid testing for staff earlier than in much of the country - as early as late March 2020 - had given the hospitals an advantage.
Dr Schmid added: "We have had relatively low mortality rates, yes. That's been about managing patients carefully and following national guidance. We've also been able to implement research trials quickly and roll things out across our Covid wards. But I wouldn't want to reduce the sheer awful fact that we did still have high mortality rates.
"If you were admitted in April 2020, there was probably a 20 to 25% chance of death. If you were in intensive care in that very first month or two it was probably in the region of 40 to 50%. It was very very high but we managed to get that down to more acceptable levels quickly - but being admitted to hospital has always meant you're at higher risk."
Looking at the way in which Omicron has hit the country, Dr Schmid said Covid had changed - explaining: "I'd say the virus has changed somewhat. It doesn't cause as severe respiratory problems - that's positive from both a hospital and a patient point of view. But patients remain at risk.
"Covid may target their underlying conditions and exacerbate them, and that may be the reason they're admitted to hospital. That's what changed, we still have significant numbers of patients in hospitals ill with Covid but it's more about the way it's exacerbated other medical conditions."
He explained that Covid had changed, but so have treatments - though immunity from Covid-19 vaccines appears to wane quicker than some had hoped. At the moment, there are around 70 Covid-19 patients in Newcastle's hospitals - though as of March 15 there were none requiring ventilation according to the latest Government data.
"Clearly from a vaccination point of view, you have to understand that our immune response does change over time - and unfortunately over the last few months we have seen that rather than waning over six to 12 months," Dr Schmid added. "It's more in the region of three months. After three months we see that the immune system is not as capable of keeping the virus at bay.
"For the vast majority of patients if they get the virus post-vaccination it's a less severe illness, but there are significant numbers of patients who remain vulnerable. That may be patients with other medical conditions that put them into the high-risk groups or patients whose immune systems may not have been responding to
"Of course the other thing to have changes is we now have treatments we can give high-risk groups soon after they catch Covid. One is the antiviral treatments, and the other is monoclonal infusion which gives a patient passive immunity for a period of time."
Earlier this month, Health Secretary Sajid Javid delivered a speech setting out his plans to reform the NHS. In that speech, he said: "I believe in the NHS and I believe in its founding principles: and it’s for that reason I want it to thrive and be sustainable. As the custodian of the NHS, it’s my responsibility to make sure it’s fit for the times we live in and the future we face.
"So, even as we embrace the innovations of our modern age and we learn the lessons of Covid, my faith in the founding principles of the NHS has never been stronger. It’s my choice – and I believe the choice of the vast majority of the British people – to stick with our approach of world-class healthcare, free at the point of use, paid for out of general taxation."
Mr Javid added: "It’s clear that we were always going to come to a crossroads: a point where we must choose between endlessly putting in more and more money, or reforming how we do healthcare."
