Hospitals may only treat coronavirus patients ‘most likely to survive’

Hospitals could have to prioritise patients who are most likely to survive if the coronavirus pandemic escalates.

Intensive care experts have suggested that treatment for the deadly bug may need to be saved for those with the best prognosis, as they prepare for a surge of infections in the UK.

Under new triage guidelines, the very ill may even be taken off ventilators to free up space for those with a better chance of recovery, the Daily Mail reports.

Professional bodies have been asked to draw up the new measures as the number of cases in the UK today reached 798 and Europe was declared by the WHO to be the 'epicentre' of the global pandemic.

Dr Shondipon Laha of the Intensive Care Society says that if triage has to be put in place, decisions on who to treat would need to be 'patient-based and survival-based'.

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He warned that the very frail may struggle to survive being put on a ventilator for two weeks.

"Intensive care can be very invasive and severe before you get better, some people can't tolerate this," he said.

The Faculty of Intensive Care Medicine and Intensive Care Society are drafting the guidelines, which, if endorsed by the General Medical Council would be rolled out across the country.

Legal and ethical departments of both organisations are involved in the discussions.

It comes as hospitals work to quickly scale up their intensive care capacity.

NHS England figures show that four in five of the country's 4,123 critical care beds for adults – one of the lowest figures in Europe – were occupied before the COVID-19 outbreak began.

Italy – where doctors have already been instructed to prioritise caring for those with 'the highest hope of life and survival' – has 12.5 beds per 100,000 people, compared to just 6.6 in the UK.

The NHS is now scrambling to make an extra 5,000 beds for patients available.

But Dr Laha, a consultant at Lancashire Teaching Hospitals, says that the situation already feels 'like a war zone' and that demand is surging.

"The units have been full. It is already feeling like a war zone. There is that war mentality of everyone will do their best. Everyone is on a mission," he said, adding that the situation is the worst since the swine flu epidemic in 2009-10.

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"Every hospital is planning how they're going to escalate beds. We're looking at stopping routine operations. Nationally cancellations are likely to start over the next few weeks."

Patients suffering the flu-like COVID-19 are admitted to intensive care units if their lives are deemed to be at risk or if their organs have failed.

Ventilators keep patients breathing while they are put in a coma.

Severe cases of the virus can result in lung, kidney and heart failure, all of which can be fatal.

Four professional bodies also recommended yesterday that anaesthetists be recruited to intensive care units, to boost staff numbers.

The GMB union, which represents NHS staff, has also said private hospital beds should be brought into use.

Meanwhile, GPs have been instructed to hold all appointments by phone or video, with face-to-face consultations discouraged unless physical examination is absolutely necessary.

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