LONDON—Britain’s National Health Service is bracing for the worst weeks of the pandemic as a new, more-contagious form of the coronavirus rips through the country and places hospitals under more extreme stress than in the spring.
A combination of a more infectious version of the virus, less compliance with social-distancing restrictions and changing hospital procedures have created a storm for the state-run health service as it tries to weather a surge of Covid-19 infections.
“I think this situation is really, really serious. It is deteriorating rapidly,” said Dr. Daniele Bryden, a doctor and vice dean of the Faculty of Intensive Care Medicine. “We know this is going to be a very difficult three weeks.”
The new variant—which scientists estimate is between 50% and 70% more transmissible than older versions—has combined with gatherings over Christmas to push daily new reported cases to record levels, government scientists say. New cases appear to be flattening out at high levels, but it will take time before any benefits feed through to hospitals.
There are now more people in the hospital than in any phase of the pandemic last April, with 32,300 Covid-19 patients hospitalized at present compared with around 21,700 in the spring.
The situation is particularly dire in London, where one in 30 people were estimated to have the virus this month. A leaked briefing by a top NHS official last week showed the capital’s hospitals would be short of some 2,000 acute and intensive-care beds by Jan. 19 even if the number of Covid-19 patients grew at the lowest likely estimated rate.
Several London hospitals are paring down health-care provision, including canceling urgent cancer treatments, to free up manpower and beds to deal with the surge in cases.
Some London hospitals have had to treat Covid patients in ambulances in car-parking areas, says Tom Dolphin, an anesthetic consultant in London. “That suggest to me a health-care system that is not working.”
During the first wave of the pandemic last spring, the NHS’s highly centralized structure helped it adapt quickly to ride out the crisis. Over 30,000 beds were freed up as nonurgent surgery was canceled.
Some elderly patients were sent back to care homes, often without Covid-19 tests, freeing up yet more space. Retired doctors and nurses were drafted to help treat the sick.
Britain recorded one of the highest Covid-19 death rates in Europe but the hospitals weren’t overrun. Even at the peak of demand, hospitals were still able to look after two non-Covid inpatients for every one Covid inpatient, said NHS chief executive Simon Stevens.
This time around, though, the NHS is limping into a bigger pandemic wave with less momentum. Staff morale is lower with many being forced to isolate due to the virus, says Siva Anandaciva, chief analyst at the King’s Fund, a health think tank.
“Staff have been running a marathon for nine months,” he said. “There are far greater levels of staff absence this time round.” As a result, hospitals are treating more people with fewer medics, he says. Despite this, many hospitals are also trying to provide a higher level of health-care provision than they did during the pandemic’s first wave.
The Health Foundation, a health-care charity, estimates that around 140,000 NHS workers are absent currently, compared with 100,000 during the peak of the first wave. The NHS has 1.26 million full-time employees.
A recently-introduced lockdown isn’t being adhered to as strictly as the first one in March, and it isn’t as tough. In London and Kent—two places where the new variant has taken hold—trips to stores in April were around 80% to 90% below their pre-pandemic norm and currently are 60% to 70% below that level, according to Alphabet Inc.-owned Google data.
Government officials are urging people to follow restrictions to keep the virus in check and protect the NHS. “The next few weeks are going to be the worst weeks of this pandemic in terms of numbers into the NHS,” England’s Chief Medical Officer Chris Whitty said Monday. “This is the most dangerous time we’ve really had in terms of numbers into the NHS at this point in time.”
The number of positive cases almost doubled in three days to Dec. 29, which has led to greater hospital occupancy. The number of people on mechanical ventilation almost doubled between Dec. 19 and Jan 5 in the U.K., rising 91% to 2,378. The number of patients in hospital has risen by a third in a week.
Over 81,000 people have died of the disease in the U.K., giving the country one of the highest mortality rates in the world, with more than 122 deaths per 100,000 population. That compares with 114 deaths per 100,000 people in the U.S., according to Johns Hopkins University data. Some epidemiologists predict mortality from the virus in the U.K. will pass 100,000 in coming weeks, as the effects of Christmas gatherings filter through.
Unlike in the first wave, hospitals have continued to treat non-Covid patients. Hospitals now can only discharge residents of care homes if they have a negative Covid test, or 14 days after their first positive test. Survival rates in hospitals have increased, helped by better treatments, but some patients who do survive need significant in-hospital care.
This, on top of the normal pressures that come with flu season, is “increasingly silting up the flow of patients through the hospitals,” says Nigel Edwards, chief executive of the Nuffield Trust, a think tank.
The pressure, now felt mainly in London and the southeast of England, is fast spreading across the country. Richard Cree, an intensive-care doctor at the James Cook University Hospital in Middlesbrough, in northern England, said that the number of Covid cases entering the hospital has risen in the past week. “If these don’t start to slow down then we are in serious trouble,” he said.
Already in his hospital’s intensive-care unit, nurses are being asked to care for more than one patient at a time, he said. “We are all knackered,” he said.
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