Coronavirus: NHS will have to prioritise younger patients with ‘better chance of survival’

This problem is all the more alarming as Italy has a relatively high number of critical care beds per population for a European country. There are much fewer critical care beds in Ireland, Netherlands, Finland, Greece, Sweden, Scotland, Wales, Northern Ireland and Portugal. The Italian state of Lombardy has already multiplied its ICUs and is far more prepared than the rest of the country.

According to New York Times investigative correspondent for the UK Jane Bradley: “If Italy is already having to prioritise younger patients with a better chance of survival because demand is outstripping available beds, this could be a major incoming problem for the UK and our greatly overstretched NHS.”

One British doctor admitted to the Independent that fighting the contagion “will be tough” after Italian experts warn one in 10 of those infected need intensive care.

Italian doctors have warned medics across Europe to “get ready” for coronavirus in a letter revealing up to 10 percent of all those infected with coronavirus need intensive care, with hospitals becoming overwhelmed.

A note was sent to the European Society of Intensive Care Medicine, critical care experts Professor Maurizio Cecconi, Professor Antonio Pesenti and Professor Giacomo Grasselli, from the University of Milan.

It revealed how difficult it had been to treat coronavirus patients.

It said: “We are seeing a high percentage of positive cases being admitted to our intensive care units (ICUs), in the range of 10 per cent of all positive patients.

“We wish to convey a strong message: Get ready!”

They said hospitals across the UK and Europe needed to prepare for a surge in admissions and cautioned against working “in silos”.

They said it was vital hospitals had equipment to protect staff and that staff were trained in wearing the kit.

They added: “Increase your total ICU capacity.

“Identify early hospitals that can manage the initial surge in a safe way. Get ready to prepare ICU areas where to cohort Covid-19 patients, in every hospital if necessary.”

There have been concerns the NHS will struggle to cope in the event of a sustained coronavirus outbreak where large numbers of patients require intensive care. The UK’s chief medical officer Professor Chris Whitty has said critical care units may struggle.

Latest figures show NHS intensive care units were running at around 80 percent capacity at the start of March.

Overall the NHS has one of the lowest ratios of hospital beds per head of population in Europe.

UK hospitals are already discussing how they will need to ration care to those most likely to survive in the event there are not enough beds, ventilators or staff to care for the numbers infected if the worst case scenario predictions prove accurate.

He said: “It will be tough. It’s going to be hard. My worry is staffing. If a lot of doctors and nurses become sick that will be the crunch. If a third of staff are self-isolating that is the time when we stop being able to cope.”

He added that while the NHS was as prepared as it could be for the virus patients could suffer.

“What I am more worried about is if the intensive care unit is full and we don’t have enough nurses, the anaesthetists will be called on to look after patients outside of the ICU in theatre and recovery areas.

“If that happens we won’t have the capacity for patients who need urgent surgery for appendicitis, blood clots etc and that’s when patients will start getting worse care as a result. These are the people who will die unnecessarily.

“The big challenge will be keeping the anaesthetic service going.

“Anaesthetic staff are most at risk because we deal with patients airways.”

In a separate note, Italian intensive care doctor Giuseppe Nattino, from the Lecco province in northern Italy, has shared a clinical summary of the patients his unit has been treating, which doctors described as “frightening” in terms of what it could mean for the UK.

The technical note spells out how patients with coronavirus experience a severe infection in all of their lungs, requiring major ventilation support.

It also reveals the effect of the virus, which affects blood pressure, the heart, kidneys and liver with patients needing sustained treatment.

Source: Read Full Article