Dear colleagues,

Before Christmas I reflected on the strength of our response to the first wave of Covid-19 and our outstanding outcomes. I also focussed on the superb work you all led in our recovery of all services and the thousands of patients who received care as a result. I explained our pre-emptive decision to make more capacity available for emergency care and Covid-19, and that this would imply standing other services down. As you will know, the Covid pandemic has changed very significantly in the last seven days and we are facing a new surge as transmission rates climb rapidly in our communities. This is thought to be caused by the new variant in circulation in the UK and elsewhere.

All of us are going through a period of rapid adjustment to the new reality of our personal and family circumstances. But at work, life is also changing, most significantly for our frontline staff who are dealing with this disease and the patients we’re admitting. The challenges are enormous. The flexibility and movement across roles and teams that we’re asking of you is unprecedented and we know how hard this is. The sheer physical, emotional and mental effort of completing a shift in this situation is draining. Please know that we are aware of how tough things are and we are doing everything in our power to manage this as best we can with your welfare at the forefront of our thoughts and plans.

Everyone at CUH is experiencing a change to their work over the coming weeks in one form or another. For our clinically extremely vulnerable and red risk staff the advice has changed to working from home once again, which I know is really frustrating. As we have done before we are determined to be kind to each other, stay ahead of the curve, use modelling to help our planning and be clear on a calm and comprehensive pandemic response that enables us to look after our staff, provide care, while also building for the future.
Modelling future admission rates

With the rapid step change in transmission we’ve revised our modelling which was previously showing a worst-case scenario of 12 admissions per day at the peak. Our current three-day average is 25 admissions per day. My thanks go to Nick Matheson and others in the infectious diseases team, and the University for supporting us to get to an updated view of how Covid-19 is likely to affect us in the coming weeks.

The modelling now predicts that we will have 300 patients with Covid-19 in our beds by the end of next week and that we should prepare for a peak somewhere between 300 and 500 cases at either the middle or end of January. There is much uncertainty in this and the next five days will give us critical information about the impact of the tier 4 restrictions, Christmas Day bubbles and the present lockdown.

Responding to rising admissions

My thanks to the surge planning group for leading rapid and decisive actions over recent days. Today we have 206 patients with Covid-19 in the hospital and 57 are in critical care. We continue to create additional red acute medical beds for Covid-19 patients and are expanding critical care capacity. The plan for the next changes to the configuration of the hospital was issued last night by Nicola Ayton, Chief Operating Officer and is available on the portal. This sets out the steps we will take to accommodate up to 400 Covid-19 patients and we are preparing further plans to take us beyond this should that be necessary.

Patient flow remains in a critical position with the emergency department experiencing long delays both for offloading ambulances and identifying beds for patients. It is vitally important that we do everything in our power to transfer patients safely and carefully to alternative settings as soon as we’re able to. Thank you for all you have been doing to help with this in recent weeks.

We continue to support the whole east of England region in our response, taking a number of patients with Covid-19 into our critical care units and acute wards to relieve pressures on harder hit hospitals. We will continue to do this in discussion with partners as appropriate going forward, and I’m proud that CUH is providing this assistance during these difficult times.

Taskforces

We now have 11 taskforces in place covering a multitude of urgent pressures resulting from this surge in the pandemic. The critical areas just now are the cohorting and configuration taskforce, which is identifying the physical spaces we can most effectively use, and the staffing and redeployment taskforce, working intensively to give us the safest staffing levels we can achieve and planning what the next few weeks will look like for our staffing numbers. The taskforces from the first wave remain in place and are continuing with their work, including ensuring we have sufficient PPE; increasing uptake of our testing programme from 4000 staff per week, and doing all we can to make all our staff feel safe and well.

Vaccination

The vaccination programme has taken off for healthcare staff now and it gives me huge joy to see CUH colleagues most at risk getting this added protection for them and their families. The hub at the Deakin Centre is doing an incredible job of switching to a staff programme almost overnight, and my thanks go to all involved in this. Before Christmas we vaccinated 4000 people; and today we will deliver our daily target of vaccinating 650 members of staff per day.
Every protected person protects us all and while we are prioritising the most at-risk staff first, we know that we will have reached all staff by the end of this month. Please do take up the vaccine and thank you in advance for bearing with any teething problems in the large scale booking system and processes that have been put together in a short space of time to deliver such a rapid campaign.

Alongside vaccination, our asymptomatic testing programme is an important part of protecting staff. It is one of the very best in the NHS and is enabling all of us who work on site to have regular access to gold-standard PCR testing. Over 4000 of you are already taking part and we are making some improvements so that you find it easier to access your swabs. With transmission rates so high in our communities, now is the time to use this service. It protects your colleagues, it protects your families and it protects you.

Building for the future

We’re on course to open the first beds in our surge centre at the end of March. The intention is to use these 20 beds, which are situated next to the children’s services admin offices, for patients who are ready to be transferred out of hospital for their onward care. A further 40 beds will also be available on our 2020 land for the region’s most significant surge capacity if it is needed and a further 60 beds will open in the early autumn, which will help us in our recovery from the current wave of the pandemic. Detailed plans are in development for staffing these units and making them operational, and these will of course be shared.

Finally

We can all be proud of the contribution Cambridge is making to research in Coronavirus. Our leadership in genomics, experimental medicine, immunity, big data and many other frontiers in medical sciences, is making a vital contribution to finding a way out of this pandemic. An ever richer understanding of the virus and how it behaves is critical to overcoming this pandemic and we’re really seeing now what a unique asset the Cambridge Biomedical Campus is in life sciences internationally.

The research, the vaccine, our plans for additional capacity and the recruitment and development of our staffing are all signalling where we can have hope for the future. The next few weeks will be our toughest yet in this pandemic, but we have every reason to be optimistic for what the rest of 2021 may bring. It is certain that the current situation will change and our cases of Covid will eventually go into retreat.

Recovering will take time and the longer term impact will be significant. By working as one team, supporting each other and using our shared intelligence, we can come through this having learned some lessons and developed a heightened respect both for each other and for the unique purpose of our work. As ever, we are immensely grateful to all our partners in the health and care system, and on the Cambridge Biomedical Campus.

My thanks to all of you. My best wishes for your families and please do everything you can to stay safe and well at this time. The resources to help you if you are struggling are available here.

Roland