Ventilator ‘Rationing’ Begins In UK: Only Patients With ‘Reasonable Certainty’ of Survival Are Put on Machines

Ventilator “rationing” has begun in the UK as only patients with a “reasonable certainty” of survival are to be put on the machines at a London hospital.

The UK coronavirus death toll has risen by 209 in 24 hours from 1,019 to 1,228, as infections jumped by 2,483 to 19,522.

“Machines used to keep patients breathing are being restricted on medical grounds, not because of a lack of capacity, Imperial College Healthcare NHS Trust told the Daily Telegraph.

“The trust said that ‘very poorly patients with coronavirus may need to be on a ventilator for extended periods’, adding that ‘for some patients this would not be in their best interests’.”

A senior consultant told the paper: “As we learn more about the disease, we are being much more careful about which patients are being considered for critical care. In normal times we will give most people the benefit of the doubt. That has changed.

“With this infection you need a couple of weeks on a ventilator, so with resources being used for such a long time, you have to be reasonably certain the person is going to get better. Delaying their death for two or three weeks is not the right thing for them or for society.”

But the medical director of the trust said “clinicians at our trust are not making decisions about ventilating patients based on capacity considerations. Our trust currently has good capacity for patients requiring ventilation and already has plans in place to increase that capacity”.

An NHS spokesperson said: “There are hundreds of critical care beds available in London and thousands in the rest of the country so any patient that would benefit can get the care they need.”

There are now 19,522 confirmed cases nationwide, up from 17,089 yesterday.  Sunday’s increase in fatalities is the second biggest Britain has seen so far, but with 51 fewer deaths than yesterday, offering some hope that the figures are beginning to plateau.

Mail Online reports: “The vast majority of cases and deaths were in England, with 190 dead aged between 39 and 105. All but four of them, aged between 57 and 87, had underlying health conditions.

In Scotland, one more person has died of the virus, bringing their total to 41. In Northern Ireland there were six more COVID-19 deaths, making 21 in total and in Wales there were 10 further reported deaths, taking their total to 48.

Professor Sir David Spiegelhalter, who chairs the Winton Centre for Risk and Evidence Communication, University of Cambridge, said: ‘It may seem callous to say that 209 deaths is reassuring, but it breaks the run of 30% daily increases we have seen recently.

“But it is still too early to claim that the curve is beginning to flatten off. It is also important not to over-interpret counts for single days: delays in reporting can lead to the numbers varying far more than one would expect by chance alone. For example, one of the deaths reported today actually occurred 13 days ago,” he said.

Eleanor Riley, Professor of Immunology and Infectious Disease, University of Edinburgh, said: ‘It would be most unwise to infer any trend from a single day’s data.

“Only when the epidemic has peaked – which is some time away – and we get sustained daily reductions in new cases and then sustained daily reductions in deaths, will we know that are beginning to get on top of the epidemic.”

The Republic of Ireland, meanwhile, saw a fatality rise of 10 today, bringing its total to 46. It recorded 200 new confirmed cases for a total of 2,615.

“It comes after a senior health chief warned that Britain must stay in total lockdown until June to properly prevent the full extent of the deadly coronavirus.

“Professor Neil Ferguson, the government’s leading epidemiology adviser, said Britons would have to remain in their homes for nearly three months, and continue social distancing until October.

“To try and ensure the effectiveness of the lockdown, the Government is spending approximately £5.8million on letters that will land on 30 million doorsteps along with a leaflet spelling out the Government’s advice following much public confusion,” the report added.

Figures, recorded between 5pm on Friday and 5pm on Saturday, come after a healthcare data company predicted more than 1.6million people in the UK could already have coronavirus.

“The total number of deaths recorded today is 21 per cent higher than the equivalent figure yesterday. The day-on-day percentage increase yesterday was 34 per cent.

“It took 16 days for the number of deaths in the UK to go from one to just over 200. It has taken a further eight days for the total to go from just over 200 to just over 1,200.

“Meanwhile, the number of people in the UK who have been tested for coronavirus has now passed 125,000. The total as of 9am on March 29 was 127,737. On average, around 7,000 new tests a day were carried out in the seven days to 9am March 29.

“In the previous seven days the daily average was around 5,400. The total number of confirmed cases of coronavirus in the UK now stands at 19,522, as of 9am March 29. One week ago, on March 22, the total stood at 5,683.”

• Top Feature Photo: Medical staff with a patient at the back of an ambulance outside St Thomas hosptial as the spread of the coronavirus disease (COVID-19) continues in central London