Coronavirus: NHS warns of critical care beds shortage as UK cases exceed 100

That was the warning from England’s Chief Medical Officer as the UK confirmed its first death and the number of coronavirus cases exceeded 100 for the first time - as the Herald reports.

The person who died was an “older patient” from Berkshire with underlying health conditions.

The Royal Berkshire NHS Trust said they had been “in and out of hospital for non-coronavirus reasons”.

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A total of 116 cases of the new Covid-19 strain have now been confirmed in the UK, including six in Scotland.

Greater Glasgow and Clyde and Forth Valley reported their first positive tests, with patients also being treated in Ayrshire, Tayside and two in Grampian. None are seriously ill.

First Minister Nicola Sturgeon said it was “looking increasingly unlikely” that the virus will be contained.

Describing the situation as “very serious”, Ms Sturgeon said: “I would expect that to rise - possibly very rapidly - in the days to come.”

She confirmed that it was likely that the government would have to escalate its action plan from the containment to delay phase “escalate from the contain to the delay phase of the “reasonably soon”.

This could include measures such as school closures, banning large public gatherings, discouraging travel by public transport, and asking people who can to work from home.

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However, Ms Sturgeon stressed that the public could still help to slow the virus’ spread with regular handwashing.

She added: “We may not be able to contain the virus indefinitely, but every day we manage that and every week that we manage that, taking a future peak out of the winter period and into spring and summer, then we help to reduce the impact.”

Ms Sturgeon also said she is confident Scotland’s two coronavirus testing facilities in Glasgow and Edinburgh would be able to cope with the rising demand, although discussions are ongoing about opening a further site in Tayside.

The First Minister also confirmed work is under way to identify recently retired NHS staff as part of “contingency plans to encourage and ask those who have recently retired from the National Health Service to come back if that is required”.

Asked about plans that could see the number of NHS laundries serving mainland Scotland cut from eight to four, the First Minister said the final decision would lie with ministers - and the “current and emerging situation with coronavirus will be very much a factor” in this.

She told MSPs: “There will be no plans approved by the Scottish Government that we think in any way puts at risk the steps we have to take to deal with this situation.”

It came as Prime Minister Boris Johnson said authorities had to “strike a balance” between protecting public health and the economy.

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He said: “One of the theories is perhaps you could take it on the chin, take it all in one go and allow the disease to move through the population without really taking as many draconian measures.”

However, England’s Chief Medical Officer Professor Chris Whitty said officials hoped to be able to delay peak infection rates for two to three months to lessen the impact on the NHS.

He said: “Depending on how high the peak, this could be anywhere from a rather bad winter for the NHS - but in spring or summer - through to huge numbers way overtopping the ability of the NHS realistically to put everyone in beds, and that obviously would have big pressures on the service.”

Half of all coronavirus cases in the UK are most likely to occur in just a three-week period, with 95 per cent of them over a nine-week period, he said.

In worst-case scenario, he said “the ratio of doctors to patients and nurses to patients would inevitably go down very sharply for a short period of time, that’s a mathematical reality”. However, he said steps could possibly be taken to mitigate that.

He added: “The bit of the system which will come under pressure first will be those conditions that require people to have oxygen and particularly to have critical care beds, and that bit, I think, will come under pressure at quite an early stage if we have a high-end-of-the-range epidemic for this.

“Wider general services will be much less affected. And children’s services - because children seem to be relatively spared from this disease - I think will be relatively much less affected.”

Prof Whitty said he had a “reasonably high degree of confidence” that 1% is at the “upper limit” of mortality from coronavirus, although the latest estimate from the World Health Organisation is 3.4%.

Mortality is likely to vary depending on individual countries healthcare systems.

In Italy, which has closed schools and universities amid spiralling incidence and deaths from the disease, medics have described hospitals buckling under a “tsunami” of extra workload and shifts of up to 80 hours.

Cases of pneumonia - a common complication in the most seriously ill coronavirus patients - have spiked. Cremona hospital, near Milan, normally deals with 250 cases of pneumonia a year but has reported 180 in the space of just 15 days.

Its intensive care units which typically handle eight patients at a time are now caring for 15.

On many criteria Italy’s healthcare system is better placed to deal with the crisis than the UK would be.

According to the latest OECD survey, Italy four doctors for every 1000 people compared to 2.5 per 1000 in the UK. It also has more hospital beds - 3.2 per 1000 people compared to the UK’s 2.5 per 1000. The EU average is five per 1000.

Intensive care unit (ICU) capacity in the UK also falls short of most of our European neighbours. In Scotland, there were a maximum of 275 ICU beds according to the most recent audit of critical care, published in December 2019. That equates to around five per 100,000 people in Scotland, whereas Italy has around 12 ICU beds per 100,000.

Intensive care units will be at the sharp end as coronavirus cases climb and demand for ventilators increases. Oxygen therapy is the main treatment for critically ill victims of the virus.

Although Scotland has the lowest occupancy rates for intensive care in the UK, averaging around 84% in a normal year, the audit warned of “increasing evidence that some areas of the country lack sufficient numbers of intensive care beds”.

Meanwhile there were warnings that the crisis could scupper the conclusion of Scotland’s football season. SPFL chief executive Neil Doncaster said the league was preparing to play matches behind closed doors, or even cancel fixtures.

He said: “If the outbreak affects the first team of even one SPFL club, it could make completing the SPFL season very difficult, so first team players and staff should be extremely vigilant.”

He said there could be “dire financial consequences” for some clubs unable to generate revenue from ticket sales.