UK hospitals have been told to create makeshift intensive care units and to stop treating coronavirus cases in isolation, as pressures on wards soar.
As the World Health Organization (WHO) declared a global pandemic, NHS chiefs said hospitals should aim to expand intensive care capacity “several-fold”.
Tens of thousands of student nurses will be sent to assist on the front line, amid fears that the spread of the virus could see the NHS lose almost a third of its staff at any one time.
NHS trusts have been ordered to relax current standards for intensive care units, as pressures on services rise. Matt Hancock, the Health Secretary, told Parliament last night that the number of cases could keep rising “for months”.
Professor Keith Willett, NHS England Strategic Incident Director, said yesterday this would mean relaxing the normal ratios of critical care staff to patients, and stopping treating coronavirus patients in isolation.
Despite the extremely infectious nature of the virus, he said it would soon not be possible to keep cases in separate rooms.
Instead, NHS staff should attempt to keep enough space between beds to limit the risk of the spread of infection, Health Service Journal reported.
Professor Willett said the service expected to have to cancel non-urgent operations, and was attempting to buy extra equipment for patients from abroad.
Earlier yesterday, Sir Simon Stevens, Chief Executive of NHS England, announced plans to “invite up to 18,000 third-year undergraduate nurses to help out on the front line” in the battle against coronavirus.
He told a meeting of senior nurses that the country was now braced to take measures “at population level” and warned that large numbers of “hospital patients would soon need specialist support”.
Sir Simon told the Chief Nursing Officer summit in Birmingham: “An enormous amount has changed in the last month. Coronavirus is now the single biggest challenge facing all European health services, and the NHS will be no exception.
“We will need to respond flexibly and pragmatically, in the way the NHS always does.
“This response will involve all parts of the health service, from hospitals to community health and primary care, as well as our partners in social care and other public services.
“As we move through the ‘contain’ and ‘delay’ phases into ‘mitigation’, we are going to have look after an increasing number of people with coronavirus, and our own staff are going to be affected, too.”
It came as Jeane Freeman, the Scottish Health Minister revealed NHS modelling suggesting the virus could result in absence rates of between 25 and 30 per cent among healthcare staff.
The coronavirus outbreak was declared a global pandemic last night as the director general of WHO called for “urgent and aggressive” countermeasures to halt the ongoing spread.
Announcing the new status, Tedros Adhanom Ghebreyesus warned that “alarming levels of inaction” had failed to contain the growing epidemic and said he expected to see more cases, more countries impacted and more deaths.
The announcement puts pressure on all countries to step up their response to outbreaks, with Dr Tedros expressing impatience that some were not doing enough to counter the threat.
“Some countries are struggling with a lack of capacity. Some countries are struggling with a lack of resources. Some countries are struggling with a lack of resolve,” he said.
“We have called every day for countries to take urgent and aggressive action. We have rung the alarm bell loud and clear.”
He said the number of cases outside China has increased 13-fold in the past two weeks, while the number of affected countries has tripled (see map below).
“WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.
“We have therefore made the assessment that Covid-19 can be characterised as a pandemic.”
Some 118,381 people have now been infected worldwide, and 4,292 have died.
The NHS action plans have been drawn up because health officials are desperate to avoid the kind of crisis seen in Italy, where hospitals have been overwhelmed by the numbers in need of help.
Before the coronavirus outbreak, Italy’s hospitals had only 60 per cent of critical care beds in use. Britain’s hospital bed numbers are among the lowest in Europe, with occupancy rates of around 80 per cent in critical care.
Government estimates suggest that in a worst-case scenario, up to 80 per cent of people could contract the virus, with between 15 and 20 per cent classed as severe or critical.
Health officials expect 50 per cent of all cases to occur over just three weeks, warning earlier this week that severe pressures could start within a fortnight.
This could mean millions of patients requiring hospital care, with less than 100,000 beds and less than 4,000 critical care beds in England.
The WHO declaration, which puts pressure on all countries to limit population movement, came as new modelling from the University of Southampton showed that coronavirus could have infected 7.6 million people in China alone, had the country not gone into lockdown.
Researchers calculated that the estimated number of cases – 114,325 by Feb 29 – would have risen 67-fold, had draconian measures not been enacted to shut down transport systems, cut off cities, restrict social contact and quickly isolate suspected patients.
A widespread quarantine came into effect in China from Jan 23, but the new figures show that if restrictions had been brought in three weeks earlier, cases could have been cut to under 6,000.
The report authors said it was clear that early intervention would have significantly limited the geographical spread of the disease, which has now reached 114 countries.
Dr Shengjie Lai, a research fellow within Geography and Environmental Science department of the University of Southampton, said: “Our study demonstrates how important it is for countries which are facing an imminent outbreak to proactively plan a coordinated response which swiftly tackles the spread of the disease on a number of fronts.
“We also show that China’s comprehensive response, in a relatively short period, greatly reduced the potential health impact of the outbreak.”