With existing pressures on the NHS, will the health service be able to cope with increased cases of the highly contagious virus?
The UK is braced for an epidemic of Coronavirus cases, with health officials warning that widespread transmission is now “highly likely”. If this happens, many will need hospital treatment and concerns are being raised that the Government is adopting a laissez faire approach to the global health crisis.
Dr Bharat Pankhania, Senior Clinical Lecturer at the University of Exeter Medical School and an expert practitioner in communicable and infectious disease control, believes that the Government must continue with its containment plans to reduce the number of new cases of Coronavirus.
“Containment strategy for any serious outbreak is important,” he said. “No matter what phase of the outbreak we are in, all possible actions must be taken, at all times, to reduce the number of new cases. At a time when we may have a huge peak in demand for hospital care, we need to also be aware that the NHS has had its bed capacity reduced over many years and that it now has one of the lowest number of hospital beds for a given population and comparable economy. This has put tremendous pressure upon all the healthcare staff and services. In an emergency, it is very difficult to suddenly increase bed capacity.”
When one considers the looming healthcare threat of Coronavirus, Britain has a ticking time bomb problem of demand and supply with the NHS.
Out of the G7 countries, the UK’s health spending per person is now the second lowest, significantly behind France and Germany. England currently has one of the worst hospital beds per 1,000 people ratio – 2.3 – according to the Organisation for Economic Co-operation and Development, which has also shown that the UK has fewer doctors and nurses per head than almost any developed country. The UK ranks second worst, with 2.8 doctors and 7.9 nurses per 1,000 population – both well below the average for the 21 countries that it analysed.
Most of the people who have tested positive for the Coronavirus so far are being treated at the five main specialist centres in England: the Royal Free Hospital and St Thomas’ Hospital in London, and sites in Liverpool, Sheffield and Newcastle. Between them, they can care for more than 100 patients at any one time. Two Devon residents recently diagnosed with Coronavirus have had to be treated 400 miles away in Newcastle.
Italian doctors have warned medics across Europe to “get ready” in a letter revealing that up to 10% of all those infected with the Coronavirus need intensive care, with hospitals becoming overwhelmed.
Due to the already stretched resources of the NHS, there is a risk that many hospitals will start cancelling routine treatments and setting aside extra beds for Coronavirus patients, once the number of cases starts rising. There are more than 4,000 intensive care beds across the UK – but about four-fifths are currently occupied, according to the latest figures.
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Most cases of the Coronavirus will be mild, although the evidence suggests that one in five people may need hospital treatment, with one in 10 needing critical care. That would certainly put the NHS under strain, even if the proportion of cases is half the worst-case projections. And the health service itself is also bound to be affected by staff being off work. Indeed, the Government’s action plan suggested that as many as a fifth of workers could be absent during this period.
The Government has said it plans to introduce legislation in the coming weeks to allow recently retired doctors and nurses to be brought back into the NHS, but the Royal College of Nursing has questioned whether this would work, pointing out that they would need close supervision which hard-pressed senior staff would struggle to provide.
The World Health Organisation-China joint mission report commended China’s approach to the Coronavirus and, although the country has an authoritarian political regime that is far removed from Western societies, there are lessons that other countries can learn from its handling of the crisis. The signs are that those lessons are not being learnt in the UK. If the Government’s ‘business as usual’ approach to containing the spread of the virus continues, we could arguably end up finding ourselves in a similar predicament to the current lockdown of 16 million people in northern Italy.
The medical journal The Lancet has recommended more urgent action on containing the spread of the virus before it is too late. “National governments have all released guidance for healthcare professionals, but published advice alone is insufficient,” it said in an editorial. “Guidance on how to manage patients with COVID-19 must be delivered urgently to healthcare workers in the form of workshops, online teaching, smart phone engagement, and peer-to-peer education. Equipment such as personal protective equipment, ventilators, oxygen and testing kits must be made available and supply chains strengthened.
“So far, evidence suggests that the colossal public health efforts of the Chinese Government have saved thousands of lives. High-income countries, now facing their own outbreaks, must take reasoned risks and act more decisively. They must abandon their fears of the negative short-term public and economic consequences that may follow from restricting public freedoms as part of more assertive infection control measures.”
The Government’s approach, which seems to consist of simply crossing its fingers and hoping for the best, isn’t good enough. As the Coronavirus continues to spread, we now have limited time to take decisive, bold, brave decisions.