Three Nightingale hospitals in Manchester, Sunderland and Harrogate, have been told to mobilise, ready to take people with Covid-19 or other conditions to relieve pressure on the NHS, as the steep rise in infections results inexorably in more hospital cases and more deaths, NHS England’s medical director has said.
In a grim briefing warning that deaths and numbers of people in hospital were rising in line with soaring infections in England, Stephen Powis also said NHS staff in high-risk areas would be tested regularly, even if they did not have symptoms.
The briefing by the government’s medical advisers sets the scene for measures expected to be announced imminently by the government, involving tougher restrictions such as pub closures and bans on socialising.
Prof Jonathan Van-Tam, England’s deputy medical director, said a rise in deaths was inevitable, because of the current infection rate. “Already with the cases that we know about, we have baked in additional hospital admissions, and sadly, we also have baked in additional deaths that are now consequent upon infections that have already happened,” he said.
Van-Tam said nobody should think this was an issue only for the north of England. “This is a nationwide phenomenon. The rate are changing upwards across the UK,” he said.
While the pickup in infections had begun in the youngest adults, aged 16 to 29, it had now risen in the over-60s. The hospital admission rates have risen most in those over the age of 85, followed by the 65-84 age group.
Powis said there was no way to separate off more vulnerable older people from everyone else.
“The claim that without taking further action, the elderly can somehow just be fenced off from risk, I’m afraid, is provided proven to be wishful thinking,” he said.
The north-west of England, north-east and Yorkshire have the highest rates.
“Liverpool University hospital has the highest number of Covid-19 patients, with currently more than 250 patients with Covid in its beds. And in the last four weeks, hospitals in the north-west and the north-east have witnessed a seven-fold increase in Covid patients in the intensive care units, and infections continue to rise. In just four more weeks they could be treating more patients than they were during the peak of the first wave,” said Powis.
Van-Tam said he would not anticipate any political announcement on restrictions on social gatherings in pubs and elsewhere, but warned of the dangers.
“Unfortunately the virus thrives on what we like most, which is human contact,” said Van-Tam. In Japan, they talk of the “three Cs” – closed spaces, crowded places and close contact. But factors such as how close people were and the level of noise also made a difference, he said.
“We have increasingly strong evidence about shouting and singing as pressure points on the virus, in terms of making the expulsion of virus-laden particles go further and the transmission therefore to become more intense,” he said.
Dr Jane Egglestone, who leads the network of intensive care doctors in the north-west of England, said the region had about 40% of England’s Covid-19 cases at the moment.
“This has proven to be very challenging for us. Within Greater Manchester, we have seen a three-fold increase in the number of patients admitted to intensive care in the last five weeks, and an eight-fold increase in the number of patients admitted to our hospitals. The situation at the moment is that 30% of our critical care beds are taken up with patients with Covid. And this is starting to impact on the services that we provide for other patients,” she said.
The experts are concerned that the UK is following the pattern seen in other European countries. “In recent days, both the Netherlands and France have seen record highs in their daily figures for new infections, with France now seeing an average of 18,000 new cases per day. The Pasteur Institute … has recently said that without new restrictions, 11,000 patients could need intensive care across France by the middle of next month,” said Powis.
“Around 40% of hospital intensive care beds in Paris are now occupied by Covid patients. The Spanish government has declared a state of emergency in Madrid, with over 3,000 Covid patients currently in the capital’s hospitals, with around 500 in intensive care, meaning about 40% of the region’s ICU beds are occupied by Covid patients.
“Unfortunately, we are also starting to see similar pressures building in some parts of the United Kingdom. In fact, we now have more patients in hospital with Covid-19 than we did before the government announced restrictions of 23 Marc in the spring.”