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Opinion and Editorial

UK's health system is feeling the strain

Euan Reedie
Filed on April 3, 2020
National Health Service, United Kingdom, Boris Johnson, Michael Gove, Matt Hancock
Boris Johnson government hopes that lockdown and social distancing measures will reap rich dividends.


The biggest worry for NHS workers is that there is serious shortage of protective equipment, such as masks, gowns and gloves, to keep staff free from infection.

We have never needed and valued our National Health Service (NHS), and its acclaimed free primary care system, more in the United Kingdom than we do now in the midst of one of the most deadly pandemics in history.

No wonder people all over the country came out of their houses at 8pm on Thursday, March 26 and again on Thursday, April 2 to give rousing rounds of applause to our heroic healthcare workers. 

The task facing the NHS, which was founded in 1948 and helped breathe life into Britain's post-war rebuilding programme, is a Herculean one. And that's putting it mildly.

The UK government is braced for 80 per cent of the population, 53 million people, to contract the coronavirus in a worst-case scenario.

Up to 5 per cent of those to get it could be critical cases, which represents 2.6 million people.

Covid-19 are cases are surging daily, with the UK death toll standing at 2,352 on Wednesday, to put a massive burden on Intensive Care Units. British ministers are therefore for ever reiterating the mantra of 'Stay Home. Protect the NHS. Save lives' at every daily briefing.

Two weeks ago, UK had just over 4,000 intensive care beds, 2.1 per 1,000 people, much lower than Germany and France. Around four in five of these beds were occupied, although strenuous efforts have been made to increase supply.

Most critically ill patients will require ventilators, but there were just 5,000 available at the beginning of March. There are currently around 8,000 ventilators in use.

The first batch of British-made ventilators will be rolled out to the NHS next week, Cabinet Office minister Michael Gove, said on Tuesday. He also said that ventilators have been bought in from abroad to tackle the pandemic.

How they will be manned remains uncertain, however.

Non-intensive care specialists are to join forces with specialists in a relaxation of staffing regulations, and staff-to-patient ratios may also need to be diminished.


Non-emergency operations are being cancelled 

All routine operations, such as hip and knee replacements, are being cancelled for three months from April.

Many patients who do not require urgent medical attention are being discharged from hospital.

Last Friday, the head of the NHS in England, Sir Simon Stevens, said: "We have reconfigured hospital services so that 33,000 hospital beds are available to treat further coronavirus patients."


Retired staff and volunteers mobilised

Some 20,000 former NHS staff, most of whom had retired, have answered desperate pleas to return to work.

More than 18,700 student nurses and 5,500 final year medics will also galvanise the NHS workforce.

Us Brits are an altruistic bunch in a crisis and this was exemplified earlier this month after Health Secretary, Matt Hancock, urged 250,000 NHS volunteers to deliver food and medicines. 

Within days, 750,000 people had offered their services.


Voluntary endeavours, which began this week, will focus on supporting the 1.5 million highly vulnerable people who have been told to self-isolate.

Field hospitals are being rapidly built to cope with the incessant rise in coronavirus cases.

One such, at the ExCeL Centre in east London, opened on April 3 after being transformed into a hospital in an astonishing nine days. 

Named the Nightingale Hospital after nursing pioneer Florence Nightingale who tended to British soldiers in the Crimean War, NHS medics and the military will staff the temporary base. 

The exhibition arena, which has been used for events like the international dog show Crufts, will eventually house up to 4,000 patients.

Several other temporary field hospitals are being set up across the UK.

Work is already under way at sites in Wales, Cumbria, Scotland and the Midlands, while several venues in Northern Ireland are being considered.

Significant issues and challenges remain for the NHS, though. Many healthcare staff are self-isolating at home because they fear they have the virus, or a member of their household does. 

They are also having trouble getting tested. The government's testing strategy has focused on screening gravely ill patients in hospital with coronavirus symptoms.

The government is aiming to carry out 100,000 coronavirus tests a day in England by the end of April, Mr Hancock said on Thursday, as he announced a "five-pillar" testing plan.

The government has come in for fierce criticism in the UK for not increasing the number of tests more quickly.

Currently, there are around 10,000 tests being carried out a day.

The new target includes swab tests, which are already in use, and blood tests, which are yet to be rolled out.


Lack of protective equipment a major issue 

Perhaps the biggest worry for NHS workers is that there is serious shortage of protective equipment, such as masks, gowns and gloves, to keep staff free from infection.

Thousands of frontline NHS staff have written to Prime Minister Boris Johnson pleading for equipment. This comes after two nurses in their 30s died from coronavirus, while two consultants were put on ventilators after contracting the disease from infected patients.

A national supply team, bolstered by the armed forces, has therefore been working tirelessly to deliver equipment, including 170 million masks, 42 million gloves, 13 million aprons, 182,000 gowns and 2.3 million pairs of eye protectors.

Television medical dramas Casualty and Holby City have even had to prepare to give real doctors their medical provisions.


Can the NHS cope? 

Fears remain that "a tsunami" of coronavirus cases will overwhelm this great British bastion in the weeks to come, although the government hopes that its recently introduced lockdown and social distancing measures will reap rich dividends.

"There are some signs, as a result of people observing social distancing, that we may be able to flatten the spread of the infection," Gove said this week.

Whatever happens, the cacophonous clapping afforded to those battling to save lives in the UK should become a regular, celebratory event rather than just an occasional occurrence.

- Euan Reedie is a freelance journalist and editor in the United Kingdom


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