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  • memo to staff seen by Channel four News.

  • It shows the level of precious some hospitals across the country are already under.

  • The memo says.

  • There has been a significant rise in the numbers of patients being admitted and also how sick they are.

  • I think I should be honest with you or in saying that this has been a distressing weekend for many of our staff in the front line as people been coming in through the door sick and have deteriorated at an alarming rate.

  • Whilst it's fair to say that most of the patients who have died probably would have died from the flu or any other major infective illness, the volume of patients in this situation is unprecedented.

  • Today's all the highest jump in death so far, much of its still centered on London between Friday and today, 21 were at London Northwest Trust, which includes Northward Park, the hospital that last week declared a critical alert after running out of beds.

  • An intensive care specialist on the north of England told us today that they were watching and waiting.

  • We'll be seeing the kind of condom kind of explain lived a blessed wear, a few subtle lady are we're just before how are you really going to see patients come in?

  • We're already starting primitive extension plan after essential part least we forget this is still winter and patients are also ill with other conditions.

  • Wales illustrating this 45% of their critical care units are occupied.

  • 15% of the patients are suspected or confirmed covered 19 cases.

  • A survey by the HSE J Journal reveals that 13 trust in England have warned they will run out of intensive care beds next week.

  • This trust said huge surge in London on We will run out of staff because of self isolation, plus some staff now sick.

  • We will run out of ventilators later and on personal protection equipment.

  • A Midlands hospital said.

  • P P E shortages fitful and inconsistent delivery combined with a near revolt amongst my clinical staff about the national guidance on use of surgical masks for non aerosol generating work.

  • These pictures show the army delivering equipment this morning and the health secretary promising Maur to come later having the protective equipment for the staff on the front line, especially in the neck, chest and social care, but also in other frontline service is is very important.

  • We are moving heaven and earth, as he asks on the military involvement, is ramping up the delivery off that off that equipment the race is on to find a tracking app.

  • They were used in China and can help with contact tracing who you've been in touch with if you've been infected.

  • Report symptoms.

  • Today, King's College launched their own app.

  • I'm not feeling quite right, and then it goes down through not just the persistent cough but unusual fatigue, unusual shortness of breath, loss of smell, taste, unusually horse voice, unusual chest pain or tightness.

  • We look a whole spots.

  • We can see trans emerging.

  • We'll see how fast things are spreading and we can see with their high risk areas.

  • The aim is to fill in what many see as a critical gap in the knowledge of covered 19.

  • How many people don't ever have symptoms if they do?

  • What are those symptoms precisely, and how many people have already been infected?

  • 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.

  • On the 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 Well, 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, 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 impacts of social isolation bite and start flattening this curve, flattening their eyes.

  • 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 were 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 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 Corona virus, 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, opening 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, drug spar, Missy's 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 can 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, 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 scores 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 or the Army stepped in today to deliver personal protective equipment to hospitals across the UK after N hs staff repeatedly called for better supplies of gloves, masks and gowns are North London Correspondent Claire Fallon has been speaking to one nurse who works in an intensive care unit.

  • She paints a bleak picture of the situation inside hospitals, and she fears the situation could get worse.

  • Protect the N.

  • H.

  • S is the message.

  • The rain works for the n hs.

  • She's a nurse in intensive care and she doesn't feel protected.

  • If we go down, Nobody's gonna look after you.

  • No, Bud.

  • A and I, um Yeah, This is a m Tsunami waiting.

  • We are just pre empting a tsunami at the minute, which will come in the next couple of weeks.

  • You're really scared, aren't you?

  • Yeah, I am really scared.

  • I'm really scared, and I'm willing to be in work.

  • I want to be work.

  • I'm not a hero.

  • We're not.

  • We're not.

  • Hair grows.

  • They seize out with job.

  • But we signed up for it with a promise our government would look after the staff and you're not looking after the staff.

  • Lorraine work for the hospital in Greater Manchester.

  • She doesn't have permission to do this interview but felt she had to speak out despite assurances from the Health Secretary that there is enough protective equipment.

  • She told me that's not the experience of staff at her hospital.

  • I won't to save people's lives, but I won't Mac Hancock to realize that we have not got enough equipment and we need the equipment now.

  • A week ago, we were asked to share masks this type of a mask so that when your husband's this is my crossbones, which I will hopefully be able to use when I returned back to work because he doesn't work in the NHL.

  • No, he works in pest control.

  • Um, what I'm concerned about now is the sharing of filters because they will hold bacteria.

  • The trust where I worked on everything they possibly can't prevent this and we are willing to share masks.

  • That's what gets May is that we are willing to put our own lives at risk, to share filters and to share masks.

  • But it's not acceptable to get more personal protective equipment into hospitals.

  • This nurse says the government should be asking private companies what stock they have in case it can be used.

  • For now, she will keep on working, risking her own life to save others.

  • How worried is your husband about you?

  • And for the past week case, been waking up every morning telling me how scared years.

  • I've not been scared.

  • Funny, you know, until today.

  • But my husband's been very, very scared.

  • And every morning when we woke up, he said, may just keep safe.

  • We did ask that upon of health to respond.

  • And they said, We're working around the clock to make sure trucks are on the ground across the country, delivering protective equipment toe all who need it so they are well equipped to continue to fight the virus.

  • Well, joining me now is Chris Hopson, who leads N HS providers, the group, which represents every hospital and health service trust in England.

  • Just first, we just heard from intensive care nurse there who said that she'd been asked to share a mask.

  • Does the N HS have enough personal protective equipment now or not?

  • So nothing could be more important than ensuring that the frontline staff on who we're going to rely so heavily over the next few weeks have got the right equipment.

  • What the national leaders tell us is that there are sufficient stocks off the required supplies.

  • The issue is we talked about a couple of times before.

  • Kaffee is that actually we had a distribution problem in terms of guessing those supplies to where they need to get it.

  • But we have talked about that a couple of times, and I'm just astonished that we're still hearing from the nurse we just heard from that.

  • This is still a problem.

  • Does that astonish you?

  • Does it anger you?

  • Well, so all I couldn't judge on Kathy is the fact that we have a ongoing, literally hour by hour dialogue with our 233 Trust chief executives.

  • And three or four days ago, there was huge levels of concern around the fact that the distribution was not getting through all I can measure, and I got a national picture as opposed to an individual star.

  • Remember, picture is that the number of chief executives who were saying to ask that Liza coming through is growing.

  • We still it's growing very rapidly.

  • We still got a small number who are saying that the distribution isn't quite there yet.

  • So what we're seeing is a very rapidly improving position.

  • We know that the army has now been involved.

  • We know that national logistics companies being involved of what we've said is it's really vital.

  • But that improvement continues.

  • So can you promise staff that they'll have a ll the protective equipment that they need?

  • How soon I I'm not a national leader, Kathy is you very correctly said when we when you introduce me, I'm the representative off trust.

  • What we're saying to national leaders is it's incredibly important that a A a ll start have access to the equipment that they need.

  • And obviously the reason for that is that an H s staff are falling ill because they don't have the proper equipment.

  • How many N HS staff do you believe are currently ill again?

  • That's not a question.

  • I can answer that.

  • I don't have the information underling that, as I said, I don't work for Nick.

  • Just England.

  • I'm a representative of trust.

  • Or, I can tell you is that in the conversations we have with our trust chief executives, they're saying that is absolutely fundamental.

  • That we, in order to rely on the clinicians who were doing all the work that you've heard about it from that nurse but also from Professor Montgomery, is that the equipment is there when it's needed on we we know the national team's working incredibly hard to make that happen, and clearly it's not acceptable if there are places where the equipment isn't there.

  • But we know this huge amounts of work being done to make sure that that equipment is where it needs to be when it needs to be, Chris hopes, and thanks very much for joining us.

memo to staff seen by Channel four News.

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