officially opened with great fanfare on
Friday and still they're waiting at the
Nightingale Hospital in the Excel center
for any of the beds to be used for News
understands that the first eight
intensive care patients will be
transferred tomorrow but we also
understand that many of the beds may
never be filled
new modeling shows they may only ever
need three hundred at a time intensive
care specialists have learned a hard
lesson from Italy that the numbers who
benefit from ICU and ventilation are
lower than first thought what we've
learned from our colleagues in Europe
and some from some early data in this
country is that sometimes with this
particular condition people with
extensive underlying illness and people
who are older tend to do less well and
that's meant that our decision-making
has if you like the goal posts have
moved slightly and it's not always the
right thing to do to put someone on a
ventilator with Kovac 19:00 and today at
the Downing Street press conference they
also said social distancing may be
working in the number of cases in our
hospitals is not as bad as it would have
been if we had not made these efforts so
it is working but the big question is is
it is the virus spread slowing down
enough to make hospital admissions
stabilize and then even fall and is
there any suggestion that maybe you
won't need as many beds as the the XL
Center at the Nightingale as you had
expected if we end up in a situation
where we have more ICU beds at all times
during this epidemic than we absolutely
need to deal with with co-ed and other
areas that will be a success that is
something which is critical for our
overall a it is part of the steep and
distressing learning curve that has
become this pandemic so many questions
still too few answers but here is an
attempt Bart's hospital and London as
testing health care workers so research
can look at why does one person for
instance the Prime Minister end up in
hospital while another France
the health secretary is able to return
to work seven days later the potential
use of this research is to design
personalized with scores for people
based on their prior viral exposures or
genetics to detect the earliest changes
a disease to design pre and post
exposure prophylaxis to look at the
immediate changes after infection with
the prior blood samples so that we can
help develop the antibody assays that
are appropriately sensitive and specific
to check for the waning of immunity
after an infection to ensure whether or
not immunity which is likely to be
sustained over time to create
understandings of hospital chains of
transmissions as to whether or not
healthcare workers actually getting it
in certain areas of the hospital they
want to recruit a thousand healthcare
workers and because this was set up with
incredible speed it took them eight days
they've been fundraising to pay for the
research the traditional funding routes
take too long there is a feeling now of
pressure building up the warnings that
peak of admissions could come around
Easter time and staff absences are still
high to Royal Colleges estimating as
many as twenty five percent either self
isolating or infected we'll go into how
you're going to wrap the deceased with
as much dignity and respect to the
families and to the deceased as possible
these are specialist teams being trained
to respond to suspected covered 19
deaths in the community across London
police officers fire and health services
staff they will confirm the person's
identity that they are dead and that
there are no suspicious circumstances
this is sad but necessary planning as
it's now estimated that the number of
people dying in the community is 30% of
all covered deaths today London's Mayor
Sadiq Khan said 10 public transport
workers have died in the capital after
testing positive and on a daily basis
now our reports of patients being
transferred between hospitals because of
a lack of capacity of morgues filling up
and of equipment and drug shortages the
NHS right
at the heart of this crisis and Victoria
joins us now as she does every night
good to see Victoria
yes Matt's at the beginning of my piece
there I was talking about whether the
nightingale will ever be used to the
capacity we were told four thousand beds
now it seems funny to build these
infrastructures right across the UK and
then not use them but that's really what
they want to do sadly some of the
evidence out of Italy is that there is
no point putting some of the very
elderly frail people with lots of
comorbidities onto ventilation and so
they're making harder decisions but in
fact this is what intensive care doctors
and specialists have to do every day
anyway and we will hear more about that
at the further down our program now
there were some quite alarming reports
over the weekend of hospitals running
out of oxygen is that actually true yes
what the general actually had a problem
it comes down to good planning now what
I've been told by a chief executive of
one hospital is that you you have to
look at the size of your pipes the
capacity of your oxygen tanks and how
many machines are in use and you should
be able to see in advance when it's
going to become a problem and that's why
we've been seeing patients being moved
around from one hospital to another too
as they become aware that the oxygen is
going to be an issue at that Hospital
it's not about oxygen supply it's about
the hospital's ability to get the supply
through its system oxygen plumbing
Victorian thanks very much indeed well
joining me now is dr. Anthony Costello
who's professor of global health at
University College London and the former
director of the World Health
Organization thanks for coming on the
program again Anthony let's just start
with one thing to clear up you know we
heard the Prime Minister's symptoms
described there as you know is mild and
then he seemed to be getting better than
he seemed to be getting worse this is
sort of the rhythm of the disease isn't
it yes I mean he's got a very good team
of physicians I'm sure they're assessing
him they've obviously wanted to do some
tests but if he's feeling reasonably
well there's no reason why he shouldn't
continue working and
I'm sure they'll come to the right
decision but also in the sense that he
might feel he's getting better one day
and then the next day he's gonna get
worse again I've heard that described
with quite a lot of patience yeah that
may be the case okay
let's move on to the wider picture then
I mean he is the Prime Minister's in his
mid-50s that's my age as well there seem
to be an awful lot of patients in ICU in
their mid 50s or younger have we
basically sent out the wrong message
from the very beginning of this disease
by saying that it only really affects
seriously you know people above the age
of 65 or so yeah I mean this is I mean
obviously that is an older age group who
are more at risk but you know if we want
to really suppress this disease and I'm
still unclear from the press conference
today there's been good progress with
surge capacity the the social distancing
is working but I'm really not clear
whether this is a delay policy to let
the epidemic run smoothly all and build
herd immunity or whether we are really
trying to suppress the disease so that
younger people that you're talking about
will not get it and that for that we've
got to suppress the chain of
transmission and to do that we've got to
find the the virus and and I spoke to a
world expert on epidemic control the
other day and you know I said will
social distancing work and and they said
no not of that this is guerilla warfare
you've got a bundle of measures that
you've got to do you've got to get out
into communities talk to people who've
got symptoms reassure them find their
contact sort their problems out and
monitor their symptoms and go back and
do that repeatedly and you've got to do
it at speed we've been a bit slower
that's why our death rates are much
higher than the Asian states but we've
got a public health system to do that in
fact it was the influenza surveillance
people that picked up the first cases of
a corona virus here and I think that we
need to mobilize now that we've got this
much bigger problem of getting out to
communities with our primary health care
teams I think we've got environmental
health officers trained in contact
tracing we've got 750,000 volunteers
many of them with clinical and nursing
skills well I think we could tap into
that even if we've been a bit late to
the party and then we can suppress it
and I think that's an important
difference from a delayed policy but
just to be clear the government would
say that it ditched the herd immunity
policies some time ago it's now all
about suppression you don't think that
they've got there because they're not
doing all the things they need to do in
order to suppress the infections well I
think they can boost it I mean I I hope
it's not clear to me because they
stopped formal contact tracing on March
the 12 and I haven't heard them say that
they are reinstating that personally I
think that should happen over the next
month because really what we want to
focus on are the 3% of people who've got
the infection or are contacts rather
than closing the entire economy down and
affecting you know 80 percent of us
right and the evidence is mounting that
this approach to case detection testing
isolation and close follow-up in the
community is a much more effective and
efficient way and it will get the the
epidemic down much quicker right just in
ten seconds what you're saying is that
if we have a lockdown and we test but we
don't do the tracing there's no point to
the lockdown because we're not going to
solve the wider issue well you're not
going to find all the cases and and we
need a mechanism to monitor that you see
in Korea and China Singapore that's what
they're doing they're well aware that
this may come back up but because
they've got their death rates right down
much lower than us they've now got a
mechanism to go and look for it okay
that's really important and we should be
holding the government to account on
that okay professor Antonia Costello
thank you very much indeed