Who gets the ventilator? British doctors contemplate harrowing coronavirus care choices by AndyMacaskill and StephenGrey
LONDON - The coronavirus pandemic is forcing senior doctors in Britain’s National Health Service to contemplate the unthinkable: how to ration access to critical care beds and ventilators should resources fall short.
Rahuldeb Sarkar, a consultant physician in respiratory medicine and critical care in the English county of Kent, said local NHS trusts across the country were reviewing decision-making procedures drawn up, but never needed, during the 2009 H1N1 flu pandemic. They cover how to choose who, in the event of a shortage, would be put on a ventilator and for how long.
“In normal days, that patient would be given some more days to see which way it goes,” he added. But if the worst predictions about the spread of the virus proved correct, he suspected “it will happen quicker than before”. Estimates of the potential death toll in Britain range from a government estimate of around 20,000 to an upper end of over 250,000 predicted by researchers at Imperial College. As of March 19, 64,621 people had been tested, with 3,269 positive.
“Unmitigated, there is no health service in the world that would be able to cope if the virus let rip,” said NHS England head Simon Stevens. “In the meantime, what the NHS is doing, of course, is pulling out all the stops to make sure that we have as many staff, beds and other facilities available.”Health Secretary Matt Hancock said on Sunday that hospitals had around 5,000 but that they needed “many times more than that”.
But he emphasized that, for now, admission criteria would stay unaltered: “We are a country mile from that at the moment.”While shortages of critical care equipment may be most alarming, the coronavirus has exposed how generally ill-equipped the health system is for a pandemic. PHE referred queries about doctors’ worries to the health department, which did not respond to requests for comment on the matter.
The department of health said that they had tested certain products to see if it is possible to extend their use.
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