it's a scenario they may have to face to
one a patient who's had a cardiac arrest
and who may have coronavirus crash team
in one room that's it so that's going
into the bin now training in personal
protective equipment in another they are
brain surgeons E&E Merces and in a
neighboring theater anesthetist here
being shown how to intubate a kovat 19
patient while minimizing their exposure
to infection they'll be using more
protective masks when it comes to it but
for now they need to preserve stocks
this is one of the highest risk areas
that we have to do we are close to the
mouth which is where the virus can be so
you'll see the team are trained in
hugely at this particular procedure to
be safe and to keep the patient safe
what did it feel like to be interfacing
in that team scenario and with all the
people you kill I thought it was gonna
need to wear yeah a specialist a glasses
wearer sat down and talked it through
okay go at donning but we'll be golfing
now and then we'll all do it again in
two weeks 600 staff will be trained like
this in this Cardiff Hospital alone
Wales's biggest critical care team is
about to get much bigger all right this
isn't going to be over in the next few
weeks this is a minimum of six to nine
months up to 12 months and it's going to
be really exhausting if we don't pace
ourselves how would you sum up what's
what's going on here right now it's
unique it's difficult it's energizing
it's worrisome but it's also something
that intensive care was made for
are you scared by what the next few
months might hold I think we always have
an outer facade of common intensive care
we arrive at scary situations we try to
instill car
in a sea of chaos and I think that's
what we're doing we put in on that
facade of calm which helps it makes a
big difference but although I'm a doctor
I'm also a dad husband a son and so the
things which concern me are not what we
do in the hospital here that's my job I
know how to do it it's the things that
happen elsewhere actually to those who
are elderly frail vulnerable all with
serious underlying health conditions we
have not forgotten about you he must be
so Matt Morgan wrote an open letter for
the British Medical Journal recently
inspired in part by thoughts of his
parents who fall into the more
vulnerable coronavirus categories the
checklist is purposely designed to be
used as a daily ward round but there are
and as he now helps circulate kovat 19
critical care video training to other
intensive care units his colleague Julie
hi filled the unit's clinical
psychologist is focusing on how to
manage the personal toll this could have
on frontline health workers we've heard
accounts from Italy of Staff having to
make terrible decisions over who to
prioritize for ventilation if that is
the truth of the situation do you think
that could happen here in your hospital
and if so how do you equip your team
psychologically for a scenario like that
I think the reality is is how can you
prepare psychologically for something
like that other than to know that it's a
risk I think it's important to know that
no matter how much we might limit the
health however we're always here giving
the care to the best of our abilities
and that's that that's the moral check
when you come back to it at the end of
the day did I do the best I can with
what I have and did I do it with
compassion again everyone can feel the
emotions in that yeah this may be a
reality it hopefully won't be but this
is something that we have to consider
going forward planning for worst-case
scenarios while they have time Julie hi
field staff well-being guidance is
being shared across the UK they are also
planning on how best to support families
of those admitted it's going to be
hugely difficult for families whose
loved ones are going to be in critical
care units because presumably that
getting close to them is going to be
difficult there are some options that we
are enabling at the moment which is
family being able to be trained and
supervised in personal protective
equipment for those end of life
situations but the reality is is that
we're not going to have lots of
opportunities to do that and lots of
equipment spare to do that and also
patients my families might be frightened
of doing that as well so they're going
to be torn do I go in and say goodbye
and feel slightly at risk myself or do I
miss that opportunity that's that's
gonna be really tricky for them I mean
it's extraordinary that these issues are
now being considered in this way oh
absolutely absolutely we have an idea
about creating a family liaison team in
our unit because what we're hoping to
enable is virtual visits so being able
to kind of Skype and FaceTime instead
because it takes away the PPE but humans
need touch and that's gonna be hard I
think my message is that we are doing
all we can we will be there for you no
matter what listen to the science listen
to the advice from experts science isn't
perfect it doesn't give us all the
answers but it's the best thing we have
and so the covert 19 training continues
at Pace soon no doubt to be rapidly
implemented as the number of deaths
linked to this virus continues to rise
we're joining me now our hashanah Mary
Ann who is an NHS surgeon and Chris
Hopson who's chief executive of NHS
providers the body which represents
hospital trusts and foundations Chris
Hopson first when you take together the
lack of ventilators the lack although
it's promised of protective clothing
masks and so on and belatedly ramping up
the testing but not enough is the NHS
ready for this crisis that is underway
now so we know that there's going to be
a big challenge here but the NHS we have
1.2 million staff who are all rallying
round to make the preparations that are
required we know for example on
ventilator capacity we'll be able to go
we think from 8,000 ventilators to
12,000 ventilators we started off with
1,500 tests a day you heard the prime
minister say that we're now targeting
25,000 tests a day we're looking at
increasing the number of intensive care
beds Sevenfold is what we're targeting
so the NHS is doing all of the
preparations that you would expect it to
and we have the advantage of the fact
that we are unlike in Italy where it
seemed to descend very quickly and be
geographically concentrated we have had
the advantage of being able to see how
others have experienced this and we've
had the chance to prepare and despite
that advantage and the time to prepare
we're hearing reports that London
paramedics are having their masks
rationed only one in a team of two
that's unacceptable isn't so nothing
could be more important than ensuring
the safety of our frontline staff on
whom we are going to rely so heavily
over the next few weeks do you think
they are safe as being stands tonight
and clearly we can see there is a level
of anxiety amongst staff about access to
personal protection equipment that's
completely understandable interesting so
effectively we
because we've had conversations today
with the national team looking after PPE
that there are protecting clearly that
there are sufficient national stocks
however there is some lumpy distribution
because effectively orders for PPE
personal protective and have gone
through the roof and the logistics are
taking a bit of time to catch up but let
me win that will catch up let me put
that to rashanna Marianne do you feel
that you are protected that you have the
right protective clothing and mastered
moment so I think it depends on what's
what part of the health service you're
in I'm hearing different reports from
different colleagues and friends I have
some colleagues for instance in the
community GPS who feel upset because
they've been given what seems to be
out-of-date equipment and they've peeled
back labels and found different dates on
them although there have been then
reassured that those have been tested
and seem to be okay they don't have
visors on their masks with which they've
been taught you know that's what's that
that's what they need so GPS are facing
one problem alternatively in the
hospitals I've got colleagues who didn't
have masks on are seeing covered
patients very frequently one of them
called me I stayed you know where I can
get an F P P three masks from I'll buy
them myself on the black market so you
know some some of this is as you say in
logistical challenge we know that it's
coming we've been reassured that it's
coming but we're trying to help the
population we're trying to help other
people's families and we need to feel
that we're going to be looked after as
well how do you respond to what you've
just heard though
well I'd completely agree so when we
talk to our trust chief executives as
we've been doing over the last 48 hours
what they've got absolutely top of their
list is the security and health and
well-being of their staff because
clearly if our staff aren't reassured
that they've got the equipment that they
need then then and and also they get ill
unnecessarily we're not going to have
the number and staff that we need so let
me just assure you this is absolutely at
the top of the list of priorities for
both trust leaders that we represent but
also national leaders and there is a
huge amount of work being
and just to reinforce the point we have
been told really clearly there are
sufficient national stocks of the
required equipment we just need to let
the logistical distribution chain catch
up because of the amount of orders that
have come in as you would expect but
then you hear about you know not having
the correct visors out-of-date equipment
well so only out-of-date equipment again
we know that to maximize the stocks we
have gone back and public health England
have tested that equipment and we know
that it's safe
so very good so you are using out today
so we're losing we are using equipment
that Phe the public health England have
tested and say is appropriate for use I
mean the visors one I had two chief
executives today who said they are
nervous about the fact that they are
potentially going to run out of visors
in the next 24-48 hours but when we then
talked to the national team they said
there is no problem in terms of there
are plenty of national stocks we clearly
just need to rush and order to you so
all I'm saying is I'm just relying on
the information that we've been given is
we recognize this is really important
because we have to reassure our
frontline staff but all I'm saying is
there are sufficient national stocks
maybe on Diouf and your colleagues feel
fearful that you're you're at risk I
seem like goes without saying really I
think you know it's not just doctors and
nurses everyone's fearful at the moment
and obviously doctors and nurses and
health care workers are in harm's way
but you know that's this is what we've
trained for and you know we're gonna do
our jobs and we're going to look after
people but we just need we need to be
looked after to in order to be able to
do our job so you know I think what's
important is communication and we're
hearing now that we do have the stocks
it's going to take a bit time to get
them to us well that's reassuring to
hear and I'm sure everybody is
incredibly grateful for the hard work
you're doing thanks both very much
they'll come into this to you