UK health service gears up for COVID-19 peak

London: Dr Nishant Joshi is on the front line of the coronavirus pandemic - and he’s angry.

The emergency medicine specialist says he risks his life every time he walks into a British hospital because doctors and nurses haven’t been equipped with the personal protection equipment they need to prevent them from being infected with COVID-19.

But he’s not just a doctor: he’s a 31-year-old husband expecting his first child.

“Some of my colleagues have been taking out life insurance in the last few weeks,” Joshi told The Associated Press. “The government has to take square responsibility for this, because you should never be putting your health care workers in a situation where we are scared for our lives.”

Britain’s National Health Service, the cornerstone of the nation’s post-war welfare state, will be stretched to the breaking point in the coming weeks as hospitals treat an expected tsunami of critically ill patients when the pandemic reaches its peak across the United Kingdom.

Free medical care

Created in 1948, the NHS is a revered institution that promises free medical care to everyone in the UK.

Yet with years of austerity cuts and rising demand already straining NHS resources, the health service is facing the biggest test in its 72-year history. After delays that have been sharply criticised, the Conservative government is racing to ensure that hospitals and clinics across the country have the staffing and equipment they need to cope with the coronavirus onslaught.

Authorities have urged retired doctors and nurses to return to work - and some 20,000 have complied. Routine surgeries are being cancelled so resources can be focused on COVID-19. The government is building several makeshift hospitals as it scrambles to find thousands of additional ventilators and build up stocks of masks, gloves and other protective equipment.

But Britain, like other countries around the world, is relying on one non-medical tactic to stretch NHS resources: emergency rules that require most people to stay indoors except to buy groceries, exercise or work in essential industries. Public health officials hope this social distancing will slow the rate of infections, delaying the flood of cases so the peak of the wave is lower and hits after the flu season. Some 750,000 volunteers have stepped forward to help bring food and medicine to people who cannot leave their homes.

Even so, the mood in Britain is sombre.

“It’s important for me to level with you - we know things will get worse before they get better,” Prime Minister Boris Johnson said in a letter sent to 30 million households. “But we are making the right preparations, and the more we all follow the rules, the fewer lives will be lost and the sooner life can return to normal.”

Military mobilised

In the meantime, the British military has mobilised. Soldiers are delivering millions of face masks to hospitals and helping to build makeshift medical facilities, including one at London’s massive ExCel convention centre that can treat as many as 4,000 patients.

Ventilators are an especially pressing need because COVID-19 can cause severe damage to the lungs in the most serious cases. Industries in Britain are scrambling to quickly design and build the lung machines. Even veterinary ventilators are being re-purposed for human patients.

Communities Secretary Robert Jenrick said 170 million masks, 42.8 million gloves, 13.7 million aprons, 182,000 gowns, 10 million items of cleaning equipment and 2.3 million eye protectors were being delivered to front-line staff.

Celebrities are also pitching in. Actor James McAvoy donated 275,000 pounds ($341,000) to a campaign to provide protective equipment for NHS staff.

Skilled health-care workers needed

NHS Professionals, which provides a pool of medical staff who can be deployed wherever there is a need, is working overtime to get skilled health-care workers to the right places.

This includes registering retired doctors and nurses so they can return to work - a process that now takes as little as 24 hours - and helping them get training to perform tasks they’ve never done before, like doctors doing the work of intensive care nurses, said Juliette Cosgrove, the former chief nurse of the job bank, who is now herself working at a front-line hospital.

“We’re asking people to step into situations which they’ve never stepped into before,” she said.

The additional resources are helping the NHS plug gaps in a system that struggles to meet the demand every winter flu season.

In November, all of England’s 118 major accident and emergency units failed to meet a government target that 95 per cent of patients be seen within four hours. Only 81 cent of patients received treatment within that target window, the worst performance since the metric was introduced in 2004.

Targets missed

The NHS also missed its targets for starting treatment of cancer patients and for waiting times for non-emergency procedures.

The NHS said it was “widely recognised that no health care system in the world could cope if this virus really took hold, and NHS services are going to come under pressure.”

The editor of a respected British medical journal has put the blame on the Conservative government, accusing it in a scathing editorial of doing too little, too late, to expand virus testing capacity, distribute protective gear and set up training programs and guidelines for protecting NHS staff.

“Patients will die unnecessarily. NHS staff will die unnecessarily,” Dr. Richard Horton wrote in a commentary on The Lancet website. “It is, indeed, as one health worker wrote last week, ‘a national scandal.’ The gravity of that scandal has yet to be understood.”

Doctors on the front lines shaken

That has left doctors and nurses on the front lines shaken as they look at the devastation already taking place among medical workers in Italy, Spain and France. Over 60 doctors have died in the last few months in Italy alone.

“I never thought in my wildest dreams that I wouldn’t be sure of a surgical mask in this country,” Joshi said. “I never thought in my wildest dreams that we would be feeling consistently unsafe as doctors.”

“In Italy, they said we didn’t take care of our doctors first - now they’re dropping like flies. Just do what you can to protect your health-care staff because we are no good when we’re lying on the bed next to our patients.”

Ordinary Britons know in their gut what their beloved NHS staff is facing.

In what is becoming a weekly ritual, hundreds of thousands of people open their front doors and windows at night, clapping hands, banging pots and cheering for the brave medical workers battling the virus. Children have been drawing “Thank You NHS” cards. The display of emotion from a stiff-upper-lip country has brought many to tears.

Doctors like Joshi appreciate the applause and the volunteers who show up with cake, pizzas and other acts of kindness. But that doesn’t ease his worries.

“I’ve taken out life insurance as well,” he said.