Hospitals have been asked to identify sites for up to 4,000 emergency beds to deal with a potential wave of Omicron admissions in England, as cases hit a record 183,000.
Rowena Mason www.theguardian.com
On Wednesday, more than 10,000 patients were in hospital with Covid, a figure not reached since March.
NHS England confirmed that it was creating new small-scale “Nightingale” facilities with up to 100 beds each at eight hospitals across the country. The health service said it had asked trusts to identify empty spaces to accommodate beds in places such as gyms or teaching areas. NHS managers are aiming to create up to 4,000 beds as surge capacity if needed, with work on the first tranche, in temporary structures, starting this week.
A number of huge temporary hospitals, called the “Nightingales”, were built in exhibition halls in the first wave of the pandemic but were dismantled without being used to capacity.
The new approach will ask for surge capacity to be built in the grounds of hospitals to make it easier for staff to move between new and old sites and keep patients closer to diagnostics and emergency care. The first sites will be at Preston, Leeds, Birmingham, Leicester, Stevenage, St George’s in London, Ashford and Bristol. There are currently almost 90,000 adult acute and general beds available in England, with occupancy at about 90% on 19 December.
The announcement came as new data showed there were 10,462 people in hospital in England with Covid as of Wednesday, although it is still unclear how many were admitted with the disease and how many are there for another reason while also testing positive.
The number of patients on mechanical ventilation has remained fairly stable in recent weeks and even reduced since November. On Wednesday the number of deaths reported was 57.
Boris Johnson returned from his Christmas break at Chequers on Wednesday with a visit to a vaccine centre to urge people to get their booster jabs, saying up to 90% of people in intensive care had not received their third dose. He said people should celebrate New Year’s Eve but called on them to exercise caution and take tests.
The prime minister also warned that Omicron continued to “cause real problems” even though it was “obviously milder than the Delta variant”.
The NHS has called on people to have a “jabby new year”, highlighting research from the Intensive Care National Audit and Research Centre (ICNARC) that found that at the start of last month about three out of five patients in London’s intensive care units had not received a jab, a figure that it said was rising.
Prof Stephen Powis, the NHS national medical director, said the health service hoped never to have to use the surge beds but added: “Given the high level of Covid-19 infections and increasing hospital admissions, the NHS is now on a war footing.”
Sajid Javid, the health secretary, also said it was “absolutely right that we prepare for all scenarios and increase capacity”.
With the government still concerned about the possibility that the high case numbers of Omicron could overwhelm the NHS, Johnson is holding off from cutting the Covid isolation period to five days for those without symptoms.
The prime minister has come under pressure to reduce the UK’s isolation period again, after the US decided to halve it for those without symptoms from five to 10 days as long as they wear a mask in public.
The UK reduced its quarantine period from 10 to seven days last week if people test negative by lateral flow, but some other countries around the world are now looking at going further.
Sir John Bell, regius professor of medicine at Oxford University and the government’s life sciences adviser, has indicated support for a shorter isolation period “if it was supported by lateral flow data”.
A No 10 source said everything was “kept under review” but insisted that there were “no immediate plans” to revise the quarantine period again so soon.
Several Tory backbenchers called on the government to consider a move similar to the US. Andrew Bridgen urged Johnson to reduce the isolation period, saying the biggest threat to the NHS was “forced absentees due to self-isolation”.
David Davis, the former Brexit secretary, said a five-day isolation period followed by a lateral flow test “sounded sensible” for Omicron cases. “If the Americans are doing it, the question is why are we not doing it, not why we should,” he said.
Davis also called on the government to make sure it has enough doses of therapies such as Paxlovid that can reduce the risk of hospitalisation in severe Covid cases and to improve data on how many people are in hospital because of the coronavirus, rather than for another condition while also testing positive for the virus.
Lee Anderson, a 2019 intake Tory backbencher, said “all options to get people back to work quicker should be looked at”. Another MP added said “isolation could be a bigger issue than actual illness” and they would “support a review at the very least”.
Chloe Smith, the minister for disabled people, health and work, said on Wednesday there were “no current plans in England to change the period” for isolation. She told BBC Breakfast on Wednesday: “Of course, we have actually only recently taken it down from 10 to seven, and we want to look at that – we want to make sure that that is working as we believe it ought to. We think the current period, therefore, is the right one, so we haven’t any plans to change that further.”
NHS managers have said they are as worried about the impact on patient care of staff shortages from people having to isolate as they are about surging admissions from Covid.
The chief executive of NHS Providers, Chris Hopson,said the effect of greater social mixing over Christmas was still to come. He told BBC Breakfast: “We’re now seeing a significant increase in the level of staff absences, and quite a few of our chief executives are saying that they think that that’s probably going to be a bigger problem and a bigger challenge for them than necessarily the number of people coming in who need treatment because of Covid.”
In response to the new Nightingale sites, Hopson said it “must be the right ‘no regrets later’ move to make these preparations now” but highlighted the difficulty of staffing them.
“Given the other pressures on the NHS and the current level of staff absences, staffing this capacity would be a major challenge,” he said. “But co-location on existing hospital sites maximises the NHS’s ability to meet that challenge.”