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‘A tsunami of cases’: Britain must enter coronavirus lockdown now to avoid overwhelming NHS, Italian experts warn

Report for European Society of Anaesthesiology warns Italy may not reach outbreak turning point until April

Shaun Lintern
Health Correspondent
Friday 20 March 2020 10:23 EDT
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Coronavirus in numbers

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Britain must enter stricter lockdown as soon as possible to stop a “tsunami” of coronavirus patients overwhelming hospitals, Italian experts have warned.

In a new report based on the latest data coming out of Italian hospitals Davide Manca, a professor of process systems engineering in Milan, warned half-measures were not going to be enough.

In his report for the European Society of Anaesthesiology, he said: “If other countries want to have enough ICU beds to treat all the Covid-19 patients that are going to be arriving in their hospitals, they have to decrease the peak of the tsunami of cases that are coming.

“The most effective way to do this is to follow and enforce Italy’s very strict quarantine and social distancing measures, and make sure they are implemented.”

His warning comes as the NHS scrambles to free up 30,000 beds and set up makeshift intensive care beds, with 65,000 retired nurses and doctors urged to return to work.

In a bid to “flatten the peak” of the epidemic, the government has urged the public to stop visiting pubs and restaurants, to work from home where possible and to self-isolate for up to 14 days if anyone in their home shows symptoms.

But so far the measures are voluntary, unlike in many European countries where citizens face arrest for breaching rules on leaving their homes without a valid reason.

Italy has been hit hard by the coronavirus pandemic, with more than 40,000 infections and 3,400 deaths – making the outbreak there deadlier than in China.

In the new report, Prof Manca said the rate of intensive care patients in Lombardy may now have peaked, but was still peaking across Italy as a whole.

He said numbers of ICU patients doubled every two to four days in an “explosion” observed for up to 18 days. This then continued for another four days.

He said patients were spending an average of 15 days in intensive care. Initially there were just 500 ICU beds in Lombardy but this has increased to more than 900 now.

Explaining the need for tougher lockdown measures, Prof Manca said other parts of Italy without restrictions were now seeing a rising number of cases.

“The difference between Lombardy and Italy was only due to the restrictive measures to movement and contacts among people adopted first in Lombardy and then all over Italy.

“Every day counts. After the inflection point, the rate of increase slows although overall numbers still increase steadily. However, the rate of increase slows down progressively until it flattens, with no further increase in the rate of people entering intensive care. The best estimate of when this will occur in Italy on this data is between days 38 and 40, which is to say in the first few days of April.”

However, he adds: “This prediction is an extrapolation of the data and should be interpreted with caution, and will depend on how effective Italy’s quarantine measures are in these next two weeks. As various reports are showing, many people in Italy are not respecting the quarantine and social distancing rules.”

The president of the European Society of Anaesthesiology has previously warned Europe was unprepared for the virus.

Professor Kai Zacharowski, from the University Hospital Frankfurt said: “For the last decade across Europe we have been cutting down on hospital beds, including intensive care beds. And now we are realising that we don’t have enough.

“If we had arranged and distributed equipment at the right time, countries might have been able to avoid the situation in Italy. But now, there has been a rush to order equipment such as ventilators, which companies are struggling to provide due to interruption in supply of parts from China.”

The UK government has issued a call to manufacturers to help make new ventilators for use in the NHS.

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