Coronavirus: What it means to be admitted to intensive care

Being admitted to intensive care – as Boris Johnson was on Monday night – is a serious escalation in treatment and a decision not taken lightly by medics.

His doctors at St Thomas’ Hospital will have done so because of a clear concern for the prime minister’s welfare and a fear that, without action, the 55-year-old could become much sicker.

Intensive care is, as the name suggests, a department dedicated to treating the most sick and injured patients. Critical care, as it is otherwise known, is reserved for the most seriously ill patients who are there because they are at a very real risk.

Medical and nursing teams work around the clock, with highly trained specialist nurses often caring for just one patient each, monitoring their entire body and physical response.

At the most severe end of the ICU spectrum, patients are sedated and put into a medically induced coma and need to be intubated, with a tube put into their windpipe, so that a ventilator can breathe for them.

The patient will depend entirely on the medical and nursing staff for their needs. Machines will monitor their heart, lungs and vital organs constantly.

The idea is to support the body medically with fluids, drugs and oxygen to give the body the best chance to fight off the infection or heal any traumatic injury.

We don’t know the exact details of how serious Mr Johnson’s condition is and being admitted to critical care does not automatically mean he will be sedated or ventilated.

Intensive care can also mean supporting patients who are near to, but not quite at, that severe stage. They need help and support and may yet avoid needing to be sedated and ventilated.

For coronavirus, which attacks the lungs causing severe pneumonia which leaves patients struggling to get enough oxygen in their blood, one of the most common treatments is what is known as CPAP, or continuous positive airway pressure.

This involves a hood and mask over the face that delivers a constant steady air pressure keeping the lungs inflated and helping people to breathe.

The patient remains awake, is not sedated and can move their arms and legs. CPAP is a less invasive form of intensive support for Covid-19 sufferers.

It remains a very serious step and can be a frightening experience to go through but will be done only when there is serious concern for the patient’s ability to get oxygen into their blood.

We do not know the exact state of Mr Johnson’s health but his admission to ICU is a very serious development. Intensive care does not offer cures or miracle treatments, it is designed to support the body’s organs to help them as much as possible to fight off the virus. It buys the patient time so the body can do what it needs to do.

The latest data from the Intensive Care National Audit and Research Centre showed 2,249 patients with coronavirus were admitted to 210 intensive care units by 3 April. Of those around 15 per cent, or 346 died, and 344 were discharged alive. The vast majority are still in intensive care.

Mr Johnson’s stay in intensive care, if he is receiving only minimal support and oxygen therapy, may last a matter of days.

If he has been sedated and intubated his stay on critical care could last for up to and beyond 10 days. The outcomes for any patient are hard to predict and coronavirus does not discriminate.

There is no doubt Mr Johnson will be receiving some of the best care available. St Thomas’ is one of the UK’s and the world’s leading hospitals and it was among the first to treat coronavirus patients in the UK.

Its intensive care teams are experienced at handling coronavirus. Mr Johnson is in good hands.