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Hospitals will be forced to cancel routine operations in England due to pressures from Covid’s resurgence despite new lockdown measures, medical leaders warned.
The NHS faces potentially “impossible” lawsuits in the coming months and hospitals around the world would soon have to follow the lead of those in the North of England and the Midlands by canceling non-essential surgeries, against the wishes of bosses and NHS ministers.
Medical leaders also said the new lockdown in England was necessary and unavoidable, but warned that tens of thousands of NHS vacancies across the service would make it difficult to staff Nightingale field hospitals during a surge in Covid patients.
“Things are going to get worse in the NHS before they get better, even with the closure, because people who have been infected need time to get sick and come to hospital. So the impact on changes in transmission rates of blockage will take a while to show up, ”said Dr Tom Dolphin, consultant anesthetist and board member of the British Medical Association.
Dr. Claudia Paoloni, president of the Association of Hospital Consultants and Specialists, said: “It is difficult to predict if this [lockdown] It will be enough, to be implemented so late and to miss the opportunity for mid-term school closings, especially since it is a modified and not complete closure, with schools, universities and manufacturing open.
“While this can certainly reduce the infection rate, if it is fully met, if you can get the R rate [the average number of people each case infects] below 1 and keeping the capacity of the NHS at a manageable level will require close monitoring. “
Hospitals will find it difficult to treat both Covid patients and those with other illnesses unless the public strictly follows Thursday’s new rules, warned Dr. Alison Pittard, dean of the College of Intensive Care Medicine. “The NHS will not collapse, but patients with diseases not associated with Covid will suffer if we do not control transmission and more people will die,” he said.
“Intensive care units have seen a steady increase in the number of Covid cases. Staff have returned with full personal protective equipment, working in response capacity, non-ICU staff are helping. Routine operations are being canceled to accommodate Covid patients. It all feels like deja vu but with the added burden of trying to maintain as many non-Covid activities as possible. “
NHS England and Boris Johnson want normal NHS care, especially surgery, to continue during the second wave, as opposed to the spring, when it was mostly suspended. But Dr. Sue Crossland, president of the Society for Acute Medicine, said that was unlikely to be possible and that the needs of people in need of life-or-death care due to Covid should take priority.
“A second blockade was inevitable given the exponential increase in cases. We are now at a point where we have to minimize the risk between caring for Covid patients and ensuring that other patients awaiting treatment are also seen in a timely manner. It is difficult, if not impossible, to square this circle, ”he said.
“The tough decisions that scientific evidence and SAGE advise us are not easy, but we must ensure that we protect the vulnerable and keep the NHS working for those who need it most.”
BMA’s Dolphin agreed. “You can’t walk away Covid patients who are septic, out of breath and sick at the front door. You have to admit them. [But] so you don’t have beds to admit people due to other conditions ”, he said.
Senior doctors are divided over what role Nightingale’s seven field hospitals could play this time around. The first to open, in London, was the only one to see patients in the spring.
Paoloni said: “The NHS has one of the lowest hospital bed bases in Europe. There are 246 beds per 100,000 inhabitants in the UK, compared to 800 per 100,000 in Germany. [Given that] I suspect the Nightingales will have to be used, but staffing levels will restrict what they can be used for. ”The Nightingales of Manchester, Harrogate and Sunderland have been put on hold.
Dolphin warned that the more than 100,000 vacancies in the NHS make staffing difficult for field hospitals. “A lot of people are saying ‘the nightingales will save us.’ But I’m not convinced that they are necessarily the answer to everything. They are physically there and have beds and equipment you need, like fans. But who is going to hire them? There are no more doctors or nurses sitting there doing nothing, waiting to be called to the Nightingales. “
