People Without Covid Are Being Treated On The Same Wards As Infected Patients Because Hospitals Are Overwhelmed
7 min read
A critical care doctor has told PoliticsHome that patients are being put at risk of catching the coronavirus in hospital because wards are overrun with patients infected with Covid-19.
The frontline medic warned that a surge in serious coronavirus cases meant some hospitals were so full of Covid patients that there was now not enough bed capacity to have entirely Covid-free wards, putting people who had been hospitalised for other critical conditions at risk of infection.
Under the current system, patients admitted to hospital are classified based on their Covid status, with green patients testing negative for the virus, amber for those who are awaiting results, and red for confirmed cases.
But the doctor, who wished to remain anonymous for fear of repercussions from their NHS Trust, warned that the recent surge in cases had meant it was now impossible for critically ill patients in some hospitals to be placed in entirely covid-negative green wards.
Instead, they said staff were trying to group patients together in separate green-only bays within wards where coronavirus patients were also being treated, in an effort to protect them from infections.
Another senior NHS medic said depending on each individual hospital, a bay could range from an entirely distinct room to a series of beds divided by a simple screen barrier.
Patients can share the same nursing and medical staff, increasing the chances of in-hospital transmission.
Several medics PoliticsHome spoke to said they were seeing an increase in the number of wards treating Covid patients as infections continue to surge in the UK.
On Friday the UK reported its highest daily death toll since the start of the pandemic, with 1,325 people losing their lives within 28 days of testing positive for Covid-19. Latest figures published by the government show that up to 7 January, 32,294 people being treated in hopsital for the virus, with 4,066 admitted in a single day on 5 January.
"It has been increasing over the last few weeks now, and I feel it escalating more and more rapidly," the frontline doctor said.
They continued: "There's no non-Covid wards which has a knock-on effect that we now need to discharge or step down [patients] from ICU into the hospital, and we have to send them on to red wards where some of these patients will not do well if they catch the infection when post-intensive care, when they are in a frail physical state.
"We did have one or two green patients, and we have had to step them down into Covid positive or Covid risk wards, and we do see evidence of this in hospital Covid infections."
They added: "Testing is overwhelmed and everyone's got Covid. And so even if you're coming in with a non-Covid related problem there's nowhere else to put you but in a ward that may have at least a positive Covid patient on it, or one that's pending and we haven't ruled out to Covid."
While they said efforts were made to put critical patients in green bays in wards with other Covid-free patients, it wasn't always possible.
"They might be lumped in with amber patients, but these aren't properly ventilated wards," the doctor said.
"There's only so much that opening windows on wards can do to extract the virus."
They believed there could have been transmission between patients as a result of these practices, as well as via staff working in overrun hospitals.
"Certain patients in the hospital have had negative swabs and then later it turned into a positive swab so we get the impression that this is staff transmission of the virus... and that's because there are so many patients coming in," they continued.
"There's just really no free space and staff to keep green wards open and with enough bed space to take in new patients."
The warning comes as Mayor of London Sadiq Khan declared a "major incident" in the capital after a major surge in infections threatened to overwhelm hospitals.
Mr Khan said he was "declaring a major incident because the threat this virus poses to our city is at crisis point".
"If we do not take immediate action now, our NHS could be overwhelmed and more people will die.
"Londoners continue to make huge sacrifices and I am today imploring them to please stay at home unless it is absolutely necessary for you to leave."
New figures published by City Hall show the number of people on mechanical ventilators in London hospitals had risen from 640 to 908 - a 42% increase - in the week up to 6 January.
Speaking of the situation in London's hospitals, Mr Khan told Sky News: "It's like a theatre of war... Unless we reduce the spread, the NHS will run out of beds.
"I've never been more concerned that I am now."
Prime Minister Boris Johnson announced a nationwide lockdown last week after the Chief Medical Officers of Scotland, England, Wales and Northern Ireland made the decision to increase the Covid alert level to its highest point.
In a statement announcing the change, the group said: "We are not confident that the NHS can handle a further sustained rise in cases and without further action there is a material risk of the NHS in several areas being overwhelmed over the next 21 days."
But the critical care doctor said they were concerned that most hospitals were going to be facing "very serious situations" in the coming weeks with some Intensive Care Units already running low on some basic supplies.
"I'm really scared, genuinely scared about this. We’ve stopped all elective operations and redeployed staff which I think is ultimately appropriate and we're doing what we need to do, but I think we're probably going to be getting in the Christmas spike now," the frontline medic said.
"I think this lockdown is absolutely essential. But I feel we should have locked down a long time ago.
"I would love to think that maybe some won’t [be overwhelmed] but I’m very concerned that most hospitals are going to be facing very serious situations, including reduced levels of care throughout the country in the coming weeks, months or even days. Even in my hospital, the ICU is running short of even basic things."
The medic warned the pressure on resources could have a major impact on patients needing emergency treatment.
"I don't think the NHS is just on its knees, or on the brink of disaster, I think we are in the middle of a full blown disaster. We are on a full war footing," they said.
"I am genuinely scared for the next couple of weeks or months. And I think it’s important we express the vaccine is not going to be the [ultimate cure].
"We still need to remain vigilant. And I think people need to be aware that we are so stretched that even regular mundane things, like having a car crash, having an allergic reaction or a fall, things where you would almost certainly have survived if we were in non-Covid times, well we might just not have a bed for you now.
"We’ve got the best intentions in the world, but we can only make do with what we’ve got."
Meanwhile, Dr Dale Gardiner, a board member of the Faculty of Intensive Care Medicine, said: "The situation in Intensive Care Units, particularly in London and the South East, is deteriorating rapidly.
"The NHS is introducing plans for mutual aid where we move patients from the most stretched Intensive Care Units.
"Within hospitals, Intensive Care Units are being supported by staff from other areas so that more patients can be treated.
"At this crucial time we need everyone to respect the lockdown but be reassured that we are doing everything possible to treat all those who might benefit from intensive care."
An NHS England spokesperson said: "These claims are based on anonymous accounts, without even identifying which hospitals - making it impossible to verify, but the fact is that all hospitals are asked to rigorously follow regularly updated PHE guidance on infection prevention.
"It is obvious that the NHS is under severe pressure which is why it is so important that the public play their part by observing social distancing and the hands, face, space advice."
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