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  • we're joined now via the Internet is Hugh Montgomery, who is professor of intensive care medicine at University College London.

  • Professor.

  • We've seen the highest UK deaths in a single day.

  • Do you fear that we're heading for the kind of scale of suffering that we've seen in Italy?

  • Regrettably, the answer has to be yes, Onda reason for that is the simple mathematics of doubling.

  • This is being explained before, but if you assume the worst case that every person with the disease can infect three Maur, by the time each of those has infected people have gone out to ninth or 10th cycle, you're knocking.

  • Somewhere in the region of upwards of 55 60,000 people infected and people were socially engaged with each other until only yesterday.

  • With the lock down, we still saw these completely crazy mass gatherings of the weekend.

  • Six days of incubation 6 to 10 days before people hit intensive care units and then time on intensive care units before they die.

  • So this death rates going to go up steeply intensive care bed use is going to go up steeply, and it's going to follow the same trajectory as the disease infection rate did 10 days or so ago when it suddenly took out.

  • You work in intensive care at a hospital in north London.

  • We've had this warning from 13 trust that they'll run out of intensive care capacity next week.

  • How are you doing?

  • Well, at the moment we're doing well and have to say the N hs.

  • You know, particularly people who work in critical care, emergency medicine and so forth are cut of a cloth that it makes them somewhat more resilient than others.

  • Perhaps because they've chosen that path.

  • We've done our best thes air extraordinary times, and we're certainly coping at the moment with the patients we have.

  • But I have no doubt at all that we will be unable to cope.

  • And that's not because people haven't tried or because government hasn't tried.

  • It's just the mathematics of the speed of the rise.

  • So I would expect we're seeing doubling Sze off cases, which means we're now seeing, doubling or write to you admissions.

  • And if you can do your own Max, if you imagine there might be more than a couple of 100 people on ventilators now or in intensive care in Britain, I don't know.

  • The precise number this evening will be somewhere upwards of 2 300 I guess if you imagine that doubles in two days and then that doubles again in two days.

  • And that doubles again in two days.

  • And it will keep doing that until these impact of social isolation bite and start flattening this curve, flattening the rise.

  • So we're in for a tsunami of cases in the next fortnight.

  • And so when at what point do you estimate that you will run out of capacity at your hospital?

  • Whittington.

  • We've had a benign rise the moment I probably inappropriate for me to tell you quite where we are.

  • Clinically, we're better than some in London.

  • Um, maybe that's because people socially I said, Well, I don't know, but either way, we're slightly better off.

  • But at the moment, the doubling rate, we would be likely, like many other trusts, actually in London to be out of beds by the end of the weekend.

  • I mean, that's very soon.

  • That's extraordinary.

  • What will you do you then?

  • At that point, well, we're all trying to do our best at the moment.

  • Come up with management plans that convert helps mitigate, perhaps help mitigate people coming to intensive care.

  • It's also the first thing which sounds harsh, but it was not meant to be, is just the conversations with your frail and elderly family Or, if that is you, about what is appropriate for you when you become a critically unwell and this is something we planned is a intensive care society nationally is to have a conversation with people nationally this year about it.

  • It's not just about grown of ours, but it does bring it into focus.

  • That's not rationing.

  • That's not the question of saying If you're old, we're not interested in you.

  • Not at all.

  • But it's just to say if life is coming to an end naturally anyway, maybe the way that your life ends shouldn't be on an intensive care unit.

  • The second thing, though, is that we're trying Thio learn from our colleagues in Italy and China and elsewhere about the best ways to manage people without going onto ventilators.

  • And there are some tricks of the trade that seemed to be effective, and we have care pathways to try to do that, too.

  • But no, I mean this.

  • We've never been here before, and people are going to have to be inventive, and the work is going to be very, very hard.

  • Does this new Excel Centre, you know, open up 4000 beds that the health sector has been talking about?

  • Does that give you hope?

  • I don't know.

  • And being on it, I don't think there's, um, any any option except to do that because we are going to run out of beds.

  • So unless we create massive capacity somewhere, somehow we're not going to be able to cope with the patients.

  • It makes sense to me, too.

  • Put those people in one place as much as one can, because perhaps co warding patients allows more effective use of staff and more efficiency.

  • But this is a matter of an enormous scale.

  • I mean, ah, hospital requires staff accommodation, food, beds, drugs, pharmacies, oxygen, ventilators.

  • This is an industrial scale to achieve.

  • I do know one or two of the people involved in the clinical leadership of that, and they are exceptional, so if it could be done, they will do it.

  • I have no doubt these are good people, and just finally we've seen people lighting barbecues.

  • You've got people going to construction sites.

  • What do you say to them?

  • As someone who is working on the front line right now trying to save people's lives?

  • You know, I've lost my temper.

  • Now.

  • I, as you may know, gave an interview for dispatches the channel for a week ago.

  • And I was trying to be polite to encourage people to do the right thing.

  • But this is criminal, and it is not about you.

  • If you're a young person who is reasonably healthy, the odds are overwhelmingly in your favor that you will only get mild disease.

  • But if you pass it on to other people doing those maps within 10 cycles and you pass that on and you've infected 60,000 people on one in 10 of those comes to an intensive cane.

  • It there are only were only 1000 intensive care adult beds in this country.

  • And you will cause the tsunami that will engulf that on your own.

  • For goodness sake, stop!

  • Stop doing this.

  • It's wrong.

  • Professor Hugh Montgomery.

  • Thank you so much for joining us.

we're joined now via the Internet is Hugh Montgomery, who is professor of intensive care medicine at University College London.

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B1 intensive care intensive care people tsunami cope

Intensive care doctor warns of 'tsunami' of UK coronavirus cases - says we 'won't cope' | COVID-19

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    林宜悉 posted on 2020/03/31
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