Intensive care units face ‘grim’ situation despite fall in Covid cases

Hospital intensive care units remain under substantial pressure despite a fall in Covid cases, the president of the Intensive Care Society has warned, as more NHS trusts cancel operations across England.

Stephen Webb, a consultant in intensive care and deputy medical director at the Royal Papworth Hospital Trust, told The Independent many ICUs were facing a “grim” situation despite the dramatic drop in infections in recent weeks.

With the numbers of Covid patients in critical care at just under 900 across England, he said this represents more than 20 per cent of intensive care capacity at a time when the NHS was facing a summer crisis in non-Covid emergency demand, as well as pressure to do more operations to cut its growing waiting list.

His comments come as more operations have been cancelled at Newcastle upon Tyne Hospitals and at Nottingham University Hospitals Trust.

Overall the number of Coronavirus patients in hospital across England has now dropped below 5,000 and follows a dramatic drop in reported positive cases since the end of July.

Dr Webb told The Independent: “Cases of Covid infections are coming down but that’s not having much of an impact on hospitals and on intensive care units yet. The situation in ICUs is pretty grim at the moment and it’s grim for a completely different reasons from wave one and two of the pandemic.”

He explained that in previous waves the NHS stopped a lot of its planned surgery in the face of huge numbers of Covid patients, with many ICUs doubling or even tripling in size with a peak of more than 4,100 patients in critical care in January.

Dr Webb said the NHS was instead now facing a “triple whammy” of pressures including an increase in non-Covid emergency patients adding: “A&Es are full, and these are sick patients. Some of them will need ICU beds.” Alongside this he said was the need to do more planned surgery to recover waiting lists.

The increase in Covid cases recently among younger people meant those in ICU were staying longer than normal, sometimes many weeks while at the same time many NHS staff were still being forced to isolate, are off sick while others have booked annual leave which was delayed throughout the pandemic.

“It’s because of these factors that pressure in ICUs is still a problem,” he said adding: “The only way to live with Covid and cope with the demand is to increase critical care capacity in the NHS.”

In recent weeks hospitals across England have been forced to delay operations including for cancer patients. Hospitals affected include those in Leeds, Birmingham, Manchester, London, Newcastle, Barnsley and London.

At the Royal Victoria Infirmary, in Newcastle Upon Tyne, the trust has seen huge pressure on its A&E department with over 60 Covid patients admitted and 17 in intensive care. The trust has cancelled a number of non-urgent operations.

The trust chief executive Dame Jackie Daniels said: “Our emergency department and assessment suite have experienced a pressured 24 hours after weeks of unprecedented patient numbers. The team are facing relentless demand but are continuing to respond with outstanding care, kindness and compassion.”

In Nottingham, two wards for routine surgeries have been taken over to cope with an increase in sick patients. Three wards in total have now been converted to help deal with the pressures. The trust has around 85 Covid patients in beds with 18 in intensive care with a small number of operations being cancelled.

The Independent has been told many of those in critical care are young, health and most are unvaccinated.

Deputy chief operating officer for Nottingham University Hospitals, Duane McLean, said: “We have made the decision to temporarily change the use of some of our wards to help care for increasing numbers of patients with Covid-19.

“We continue to see more admissions to our hospitals, as well as an increase in demand in our emergency department, but we are still carrying out the vast majority of operations and urge everyone to get vaccinated and access the care they need by using the NHS 111 online service.”