memo to staff seen by Channel four News
it shows the level of pressure some
hospitals across the country are already
under the memo says there has been a
significant rise and the numbers of
patients being admitted and also how
sick they are I think I should be honest
with you all in saying that this has
been a distressing weekend for many of
our staff on the front line as people
have been coming in through the door
sick and have deteriorated at an
alarming rate whilst it's fair to say
that most of the patients who have died
probably would have died from the flu or
any other major infective illness the
volume of patients in the situation is
unprecedented
today's all the highest jump and deaths
so far much of it still centered on
London between Friday and today 21 were
at London Northwest Trust which includes
north work park the hospital that last
week declared a critical alert after
running out of beds and intensive care
specialists in the north of England told
us today that they were watching and
waiting lists we forget this is the
winter and patients are also ill with
other conditions wails illustrating this
forty-five percent of their critical
care units are occupied 15 percent of
the patients are suspected or confirmed
covered 19 cases a survey by the hsj
Journal reveals that 13 trusts in
England have warned they will run out of
intensive care beds next week this trust
said huge surge in London and we will
run out of staff because of self
isolation plus some staff now sick we
will run out of ventilators later and on
personal protection equipment a Midlands
hospital said PPE shortages fitful and
inconsistent delivery combined with a
near revolt amongst my clinical staff
about the national guidance on use of
surgical masks for non errors
generating work these pictures show the
army delivering equipment this morning
and the health secretary promising more
to come later having the protective
equipment for the staff on the front
line especially in the NHS and social
care but also in other frontline
services is very important
we are moving heaven and earth as he
asks and the military involvement is
ramping up the delivery of that of that
equipment the race is on to find a track
nap they were used in China and can help
with contact tracing who you've been in
touch with if you've been infected
today King's College launched their own
app I'm not feeling quite right and then
it goes down through not just the
persistent cough but unusual fatigue
unusual shortness of breath loss of
smell tastes unusually hoarse voice
unusual chest pain or tightness the aim
is to fill in what many see as a
critical gap and the knowledge of
covered 19 how many people don't ever
have symptoms if they do what are those
symptoms precisely and how many people
have already been infected well joining
me now via the internet is Hugh
Montgomery who's professor of intensive
care medicine at University College
London professor we've seen the highest
UK deaths in a single day do you fear
that we're heading for the kind of scale
of suffering that we've seen in Italy
regrettably the answer has to be yes and
the reason for that is the simple
mathematics of doubling and this has
been explained before but if you assume
the worst case that every person with
the disease can infect three more by the
time each of those is infected people
and gone out to ninth or tenth cycle
you're knocking somewhere in the region
of upwards of fifty five sixty thousand
people infected and people were socially
engaged with each other until only
yesterday with the lockdown we still saw
these completely crazy mass gatherings
the weekend
six days of incubation six to ten days
before people hit intensive care units
and then time on intensive care units
before they die
so this death rate is going to go up
steeply intensive care bed use is going
to go up steeply and it's going to
follow the same trajectory as the
disease infection rate did ten days or
so ago when it suddenly took the Arctic
well you work in intensive care at a
hospital in North London we've had this
warning from 13 trusts that they'll run
out of intensive care capacity next week
how are you doing well at the moment
we're doing well and have to say the NHS
you know particularly people who work in
critical care emergency medicine and so
forth are cut of a cloth that it makes
them somewhat more resilient than others
perhaps there because they've chosen
that path we've done our best these are
extraordinary times and we are certainly
coping at the moment with the patients
we have but I have no doubt at all that
we will be unable to cope and that's not
because people haven't tried or because
government hasn't tried it's just the
mathematics of the speed of the rise so
I would expect we're seeing doublings of
cases which means we're now seeing
doubling of ITU admissions and if you
can do your own maths if you imagine
there might be more than a couple of
hundred people on ventilators now or in
intensive care in Britain I don't know
the precise number this evening will be
somewhere upwards of two three hundred I
guess if you imagine that doubles in two
days and then that doubles again in two
days and that doubles again in two days
and it will keep doing that until these
impacts of social isolation bite and
start flattening this curve flattening
the rise so we're in Kherson army of
cases in the next fortnight and so when
at what point do you estimate that you
will run out of capacity at your
hospital the Whittington we've had a
benign rise at the moment I probably
inappropriate of me to tell you quite
where we are clinically we're better
than some in London maybe that's because
people associate I say to more I don't
know that either way we're slightly
better off but at the moment and the
doubling rate
we would be likely like many other
trusts actually in London to be out of
beds by the end of the weekend I mean
that's very soon that's extraordinarily
management plans that convert helps
mitigate perhaps help mitigates people
coming to intensive care it's also the
first thing which sounds harsh but is
not meant to be it's just the
conversations with your frail and
elderly family or if that is you about
what is appropriate for you when you
become critically unwell and this is
something we'd planned as a intensive
care Society nationally is to have a
conversation with people nationally this
year about it it's not just about
coronavirus but it does bring it into
focus
that's not rationing that's not the
question of saying if you're old we're
not interested in you not at all but
it's just to say if life is coming to an
end naturally anyway maybe the way that
your life ends shouldn't be on an
intensive care unit the second thing
though is that we're trying to learn
from our colleagues in Italy and China
and elsewhere about the best ways to
manage people without going onto
ventilators and there are some tricks of
the trade that seem to be effective and
we have care pathways to try to do that
too but no I mean this we've never been
here before and people are going to have
to be inventive and the work is going to
be very very hard does this new Excel
centre you know opening up 4,000 beds
that the health secretary has been
talking about does that give you hope I
don't know
and being on it I don't think there's
any any option except to do that because
we are going to run out of beds so
unless we create massive capacity
somewhere somehow we're not going to be
able to cope with the patients it makes
sense to me to put those people in one
place as much as one can because perhaps
cohorting patients allows more effective
use of staff and more efficiency but
this is a matter of an enormous scale I
mean a hospital require
staff accommodation food beds drugs
pharmacies oxygen ventilators this is an
industrial scale to achieve I do know
one or two of the people were involved
in the clinical leadership of us and
they are exceptional so if it can be
done they will do it I have no doubt
these are good people and just finally
we've seen people lighting barbecues you
know you've got people going to
construction sites what do you say to
them as someone who is working on the
front line right now trying to save
people's lives you know I've lost my
temper now I as you may know gave an
interview for dispatches for channel 4 a
week ago and I was trying to be polite
to encourage people to do the right
thing but this is criminal and it is not
about you if you're a young person who
is reasonably healthy the odds are
overwhelmingly in your favor that you
only get mild disease but if you pass it
on to other people doing those maps
within 10 cycles and you pass that on
and you've infected 60,000 people and
one in 10 of those comes to an intensive
care unit there are only or were only a
thousand intensive care and adult beds
in this country and you would have
caused a tsunami that would engulf that
on your own for goodness sakes stop stop
doing this it's wrong
professor Hugh Montgomery thank you so
much for joining us well the Army
stepped in today to deliver personal
protective equipment to hospitals across
the UK after NHS staff repeatedly called
for better supplies of gloves masks and
gowns on North England correspondent
Claire Fallon has been speaking to one
nurse who works in an intensive care
unit she paints a bleak picture of the
situation inside hospitals and she fears
the situation could get worse protect
the NHS is the message the rain works
for the NHS she's a nurse in intensive
care and she doesn't feel protected if
we go down nobody's gonna look after you
nobody
and I am yeah this is a em tsunami
waiting to happen
we are just pre-empting a tsunami at the
minute which will come in the next
couple of weeks you're really scared
aren't you yeah I am really scared I'm
really scared and I'm and I'm willing to
be in work I want to be in work I'm not
too hero we're not were not heroes this
is our job but we signed up for it with
a promise our government would look
after the staff and you're not looking
after the staff Lorraine works at a
hospital in Greater Manchester
she doesn't have permission to do this
interview but felt she had to speak out
despite assurances from the health
secretary that there is enough
protective equipment she told me that's
not the experience of staff at her
hospital I want to save people's lives
but I want Matt Hancock to realize that
we have not got enough equipment and we
need the equipment now a week ago we
were asked to share masks this type of a
mask so that when your husband's this is
my husband's which I will hopefully be
able to use when I return back to work
to be clear he doesn't work in the NHS
no no he works in pest control but what
I'm concerned about now is the sharing
of filters because they will hold
bacteria the trust where I work I've
done everything they possibly can to
prevent this and we are willing to share
masks that's what gets me is that we are
willing to put our own lives at risk to
share filters and to share masks
but it's not acceptable to get more
personal protective equipment into
hospitals this nurse says the government
should be asking private companies what
stock they have in case it can be used
for now she will keep on working risking
her own life to save others how worried
is your husband about you um for the
past week Keith's been waking up every
morning telling me how scared he is I've
not been scared funny enough until today
but my husband's been very very scared
and every morning when we woke up he
said to me just keep safe we did ask
that a pond of health to respond and
they said we're working around the clock
to make sure trucks are on the ground
across the country delivering protective
equipment to all who need it so they are
well-equipped to continue to fight the
virus well joining me now is Chris
Hobson who leads NHS providers the group
which represents every hospital and
health service trusts in England just
first we just heard from the intensive
care nurse there who said that she's
been asked to share a mask does the NHS
have enough personal protective
equipment now or not so nothing could be
more important than ensuring that the
frontline staff on who we're going to
rely so heavily over the next few weeks
have got the right equipment what the
national leaders tell us is that there
are sufficient stocks of the required
supplies the issue as we've talked about
a couple of times before Kathy is that
actually we've had a distribution
problem in terms of getting those
supplies to where they need to get to a
couple of times and I'm just astonished
that we're still hearing from the nurse
we've just heard from that this is still
a problem
does that astonish you does it anger you
well so all I can judge on Kathy is the
fact that we have a ongoing literally
hour by hour dialogue with our 233 trust
chief executives and three or four days
ago there was huge levels of concern
around the fact that the distribution
was not getting through
all I can measure and I've got a
national picture as opposed to an
individual staff member picture is that
the number of chief executives who are
saying to us that supplies are coming
through is growing we still it's growing
very rapidly we still got a small number
who are saying that the distribution is
quite there yet so what we're seeing is
a very rapidly improving position and we
know that the Army has now been involved
we know that national logistics
companies has been involved and what
we've said is it's really vital that
that improvement continues so can you
promise staff that they'll have all the
protective equipment that they need
housing all right well I'm not a
national leader Kathy as you very
correctly said when we when you
introduced me I'm the representative of
the Trust's what we're saying to
national leaders is it's incredibly
important that all staff have access to
the equipment that they need okay and
obviously the reason for that is that
NHS staff are falling ill because they
don't have the proper equipment
how many NHS staff do you believe are
currently ill again that's not a
question I can answer because I don't
have the information I'm knowing that as
I said I don't work for NHS England I'm
a representative in the trust all I can
tell you is that in the conversations we
have with our trust chief executives
they're saying that is absolutely
fundamental but we in order to rely on
the clinician see we're doing all the
work that you've heard about both from
that nurse but also from professor
Montgomery is that the equipment is
there when it's needed and we we know
the National Teams has been working
incredibly hard to make that happen and
clearly it's not acceptable if there are
places where the equipment isn't there
but we know this huge amounts of work
being done to make sure that that
equipment is where it needs to be when
it needs to be Chris Hopson thanks very
much for joining us