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Coronavirus: England only has 15 beds for worst respiratory cases

<span>Photograph: Barcroft Media/Getty Images</span>
Photograph: Barcroft Media/Getty Images

England only has 15 available beds for adults to treat the most severe respiratory failure and will struggle to cope if there are more than 28 patients who need them if the number of coronavirus cases rises, according to the government and NHS documents.

Ministers have revealed in parliamentary answers that there are 15 available beds for adult extracorporeal membrane oxygenation (ECMO) treatment at five centres across England. The government said this could be increased in an emergency. There were 30 such beds in total available during the 2018-19 winter flu season.

But an NHS England document prepared in November 2017 reveals the system will struggle to cope if more than 28 patients need the treatment, describing that situation as black/critical.

It suggests that if no beds are available “within the designated and surge capacity” in the UK, they might have to be sourced from other countries, for example, from the Karolinska Institute in Sweden.

The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.

The UN agency advises people to:

  • Frequently wash their hands with an alcohol-based hand rub or warm water and soap

  • Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing

  • Avoid close contact with anyone who has a fever or cough

  • Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers

  • Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas

  • Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.

Despite a surge in sales of face masks in the aftermath of the outbreak of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided they are used correctly.

Justin McCurry

ECMO treatment is used in only the most severe cases of respiratory failure when other treatments are not working. It uses an artificial lung located outside the body to put oxygen into a patient’s blood and continuously pump this blood into and around their body. It has been used to treat Covid-19 cases in China, which is ordering more machines from Germany, according to state media.

In answer to a Labour MP’s question on Thursday about coronavirus preparedness, Jo Churchill, a health minister, said: “Since April 2013, NHS England has commissioned a total of 15 adult respiratory extra corporeal membrane oxygenation beds from five providers in England, with further provision in Scotland. In periods of high demand, capacity can be increased.”

Ministers also revealed that since the beginning of February there have been eight “high-consequence infectious disease” beds and around 500 “infectious disease” beds.

For most of last week, there were roughly 3,700 adult critical care beds in England, of which about 80% were occupied. This left 670 such beds free at the peak of occupancy.

Jon Ashworth, the shadow health secretary, questioned the readiness of the NHS to deal with a sharp escalation of coronavirus cases following years of cutbacks.

“After years of Tory austerity, we know we’ve lost well over 15,000 beds since 2010,” he said. “We know that last week critical care bed occupancy was running at over 80%. There are serious questions about whether the NHS has the resources, the staff and the capacity to provide the care that’s needed should this seriously escalate.”

An NHS spokesperson said: “ECMO is only suitable for a very small number of specific cases for adults, but the NHS is always monitoring demand for this kind of care and can quickly expand provision of these beds.”

Meanwhile the NHS said it was offering a “drive through” coronavirus testing service for patients in west London. The scheme, provided by Central London Community Healthcare NHS Trust in Parsons Green, can only be accessed through a referral from NHS 111. People are invited to an appointment in their car, during which two community nurses carry out a swab in the nose and mouth, which are checked and assessed within 72 hours.

People are asked to self-isolate while checks are completed, to prevent any potential transmission.