Coronavirus: Greater Manchester cases could overwhelm intensive care by 12 November, warns Downing Street

Intensive care units in Greater Manchester will be overwhelmed by coronavirus patients by 12 November on current trends, even if hospitals release surge capacity, Downing Street has warned.

The warning came amid an ongoing stand-off between Boris Johnson’s government and Greater Manchester mayor Andy Burnham, who wants promises of further financial support before agreeing to move the city into tier 3 “very high alert” restrictions.

The Independent revealed on Friday that Greater Manchester is on course to have almost all its intensive care beds taken up with coronavirus patients within weeks.

And Mr Johnson’s official spokesman today confirmed that the “sharply rising” rate of infections in the city meant the number of Covid patients in ICU beds had already reached 40 per cent of the peak of the first wave in the spring.

Dr Indeewar Kapila, a consultant in anaesthesia and intensive care medicine in Manchester, said the situation in hospitals was "very concerning" as admissions rise and limited bed spaces are filled.

The situation could look very different in a week, Dr Kapila said as around one-third of ICU beds are currently filled but Manchester’s rising number of coronavirus cases threatens to fill wards to capacity

“We have about 440 cases per 100,000, which is extremely high, we are very concerned that we may reach a situation very soon where intensive care beds are beginning to run out," Dr Kapila told BBC Radio 4’s Today programme.

Dr Kapila’s warning follows a leaked NHS document that showed some hospitals in Greater Manchester were already at capacity.

The document showed hospitals in Salford, Stockport and Bolton were already full by last Friday, according to The Guardian.

The PM’s official spokesman said that hospital admissions for coronavirus in Greater Manchester were doubling every nine days and positive cases involving the more vulnerable over-60 age-group had trebled in 15 days from 89 per 100,000 population on 27 September to 282 on 12 October.

Numbers of Covid-19 patients in ICUs in the city had reached 40 per cent of the level at the height of the first wave in the spring and the number is expected to rise “significantly” over the coming weeks, he said.

On the “best case” assumption of the government’s SPI-M advisory group, rates will double every 14 days as the lag between infections and hospitalisations works its way through, said the spokesman.

On that basis, Greater Manchester’s ICU capacity can be expected to be used up by 28 October. By 2 November, ICU occupancy by coronavirus patients would outstrip the peak of the first wave and by 8 November, Covid patients alone would entirely fill ICU beds.

Even if hospital managers implement “surge” measures to free up more intensive care beds for coronavirus patients, capacity will be reached by 12 November, said the PM’s spokesman, though this does not include spaces in Manchester’s Nightingale field hospital, which has been put on standby.

Asked whether doctors will need to turn to the Nightingale hospitals in the north of England to provide the additional beds needed, Dr Kapila responded: "I understand the Nightingale hospitals are being prepared for the possibility of beds being used if we reach capacity.

“I think the strategy currently is that we are trying to avoid the surge capacity we had during the first wave where he had to use beds outside the intensive care unit.

“That had a huge impact on planned activity, on cancellation of operations et cetera, which we are trying to avoid in the second surge.”

Dr Kapila said calls for a “circuit-breaker” lockdown were increasing, adding that stronger restrictions “will have some impact."

Talks between local leaders in Greater Manchester and the government in Westminster are set to resume on Monday as the dispute over new restrictions in the region continues.

Robert Jenrick, the communities secretary, told Sky News on Monday morning he was “hopeful” an agreement could be reached with local authorities after the imposition of the highest level of restrictions was rejected last week. 

Opposition to the Tier 3 restrictions has been led by Greater Manchester mayor Andy Burnham, who has called on the government to provide additional financial support for businesses forced to close and affected workers.

Mr Jenrick stopped short of saying he had offered a larger financial settlement to local leaders when asked, telling Sky News: “I have offered, in discussions that we have had, a range of different things that local leaders would like."

He added: “The contours of an agreement are there. But, as I say, every side needs to now come together and reach an amicable conclusion for the sake of people in Greater Manchester.”

The PM’s spokesman said Mr Johnson was ready to impose tighter restrictions if they could not be agreed voluntarily.

“If at all possible, we do want to engage constructively with Greater Manchester and agree on a way forward,” said the spokesman.

“But, as the prime minister said on Friday, if agreement can’t be reached we will need to intervene to protect hospitals and save lives of residents. Efforts will be more effective if we can work with local authorities.”