Good evening and Happ(ier) New Year we hope. Welcome back to my patient safety update which this week looks at COVID, NHS workforce, Israel’s fourth dose plans and has a Select Committee teaser.

COVID LATEST STATS The latest ONS survey published on New Year’s Eve for the week ending 23rd December estimated that an extraordinary 2 million people in England had the virus or 1 in 25 of the population. Just three weeks ago in our pre-Xmas update it was 1 in 60. But even though daily cases hit the 200k mark on Tuesday cases are still not translating into hospitalisations or deaths with just 14,126 covid patients in hospital on New Year’s Eve. To cheer you up here is a graph from the HSJ explaining why in London, the epicentre, hospitalisations may have peaked. Boris was probably right to hold his nerve before Christmas but it still remains a close run thing (and is not over yet).

OMICRON VS STAFF Where we’re seeing the real pressure is not on bed capacity but on the NHS workforce. Tomorrow we get the latest official figures but on Boxing Day around 25,000 acute hospital staff were absent due to covid. Shaun Lintern reported at the weekend that his had increased to 40,000 and overall, 1 in 10 NHS staff were off either with the virus or isolating because of it. NHS Confed said one Trust had 750 staff off on one day. But as I say in this thread it would be a big mistake to think of this as a temporary Omicron staffing crisis - the workforce crisis is now permanent and dangerous. Which is why Boris’s answer to my question this afternoon was so disappointing - but hey, it is January, the year is young and we will keep pressing the case for an overhaul of NHS workforce planning. The key moment will be when Baroness Cumberlege's amendment to the Health and Care Bill is debated and voted on.

JABS JABS JABS (AND JABS?) While the government boasts about 2 million jabs being available over the next week (and complains about the crazy people who don’t take them up) Israel has made a start on fourth doses for the most vulnerable. A related study states that such a dose increases antibodies fivefold and that the effect of a booster wanes after four months. This is a difficult one to wrestle with when you read Sir Andrew Pollard’s thoughtful Telegraph interview arguing we should be sorting out vaccines for developing countries but surely NHS and care staff at least need to keep their immunity boosted? With 132 million doses administered in 2021 and new data from UKHSA showing those who are unvaccinated are 8 times more likely to be hospitalised the UK can be proud that many lives have been saved, but whether or not ‘living with Covid’ means six monthly boosters is surely going to be the next difficult decision for ministers.

COVID BACKLOG Remember that? Well tomorrow the Health and Social Care Select Committee publishes its report into how best to deal with it. You won’t be surprised to hear that workforce issues are vital to dealing with the 5.8 million patients waiting for care. You’ll be able to find the report here tomorrow morning.

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Jeremy Hunt