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Thank you for the link - I hadn't seen that article. This quote struck me:
In Wuhan, ICU capacity was increased by over 1,000 beds in two weeks by building a new hospital, but this is not possible in the UK.
Why not? Also struck by the fact the US has 10 times more ICU beds per capita than the UK.
I guess given the lead times (trained staff, specialised equipment etc) it is not possible to solve the problem by chucking money at it?
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Not in the time frame we need - I know it’s a tired phrase, but this is a direct consequence of austerity. Cutting the nursing bursary, systematically decreasing the number of acute hospital beds (over the long term), underfunding services, the list goes on. All of this means the NHS is continuously running at >95% capacity when it should be at 80-85% to have the slack to soak up things like COVID, and because it’s been going on for years it will take years to rebuild from the damage. Although it does pretty well outcomes-wise given the amount of money spent on it, if you compare the NHS with health systems in comparable countries across a number of metrics (eg ITU beds, Acute hospital beds, physicians per capita etc) it’s lagging a long way behind. All of this is scary when faced with something like COVID, because whatever Rishi Sunak says we can’t pull 5,000 ITU nurses out of our backsides at the drop of a hat.
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Why not?
There are times when a totalitarian government running a command economy (albeit with pseudo-capitalist areas) can do certain things much more quickly than a democracy. The democracy needs to declare a full-blown emergency before it can even think of just repurposing buildings arbitrarily. The totalitarians can just order medical staff to relocate, can order citizens to observe disciplined self-isolation under pain of pain etc. Also, China, being huge, has ready resources to reallocate in the short term.
Of course, the comparison is worse when the democracy
- has cut its health system to the bone and runs it continually under severe stress
- is notionally lead by a blustering lightweight who prefers to pretend problems don't exist or are trivially solved by this "great nation"
- is actually lead by neo-Darwinist sociopathic disaster capitalists
- is in the middle of an ideologically-driven crusade to remove itself from systems that could help, supported by a population who have made it clear that their emotional devotion to a mythical image of the nation is more important than practical issues. Hence Boris stopping his Health Secretary from working with existing EU agencies designed to cope with pandemics.
- has cut its health system to the bone and runs it continually under severe stress
kimchi
itsbruce
Rapidly increasing ITU capacity is tricky - the main issue is having enough ITU-trained nursing staff to properly look after someone on a ventilator as it’s a highly specialised job. It’s complicated by the fact that COVID is aerosol generating and you therefore can’t use less invasive (and therefore less resource intensive) forms of ventilation such as BIPAP which would otherwise work well in a lot of the covid cases.
Physical capacity isn’t so hard - there are plans to incrementally cancel non-urgent surgery and use the operating theatres and anaesthetic machines in them as demand requires.
There’s a good article here from an ITU consultant talking through what’s going on behind the scenes, and why it’s such a challenge - https://www.theguardian.com/commentisfree/2020/mar/03/icu-doctor-nhs-coronavirus-pandemic-hospitals