A&E doctor warns fit and healthy coronavirus patients in their THIRTIES are fighting for their lives and warns medics will eventually have to choose who gets the last ventilator
- Dr Rosena Allin-Khan, an A&E medic in London, said young people are at risk too
- She said there are healthy patients in their 30s and 40s fighting for their lives
- A total 281 coronavirus deaths have been confirmed in the UK with 5,683 cases
- Do you have a coronavirus story? Email [email protected]
- Coronavirus symptoms: what are they and should you see a doctor?
An A&E doctor in London has warned that even people in their 30s are fighting for their lives in intensive care because of the coronavirus crisis.
Dr Rosena Allin-Khan, an emergency doctor and the Labour MP for Tooting, south London, revealed that doctors will soon have to start rationing life support machines.
After working at shift at St George’s Hospital in capital at the weekend Dr Allin-Khan said the number of people being hospitalised is increasing ‘very, very quickly’.
She said patients with other health problems were having to be shipped out to children’s wards so there was enough room to treat the people with COVID-19.
Almost 5,700 people in the UK have been officially diagnosed with the disease but the true number is thought to be dozens of times higher. 281 people have died.
Dr Allin-Khan said the UK is ‘heading for disaster’ and pleaded with people to obey social distancing rules and stop going to busy areas after thousands of people were pictured defiantly visiting tourist destinations at the weekend.
The MP added that doctors will soon have to choose who does and doesn’t get ‘the last ventilator’ in intensive care. At the weekend a doctor working in Italy revealed that in some places over-65s were being knocked down medics’ priority list.
Dr Rosena Allin-Khan, an A&E doctor and Labour MP for Tooting, south London, revealed her experience of working on the coronavirus frontlines over the weekend
Dr Allin-Khan worked a shift at St George’s Hospital, London, over the weekend and told BBC’s Radio 4 what she saw there
Speaking to BBC Radio 4’s Today programme this morning, Dr Allin-Khan gave a glimpse of life on the frontline in the UK’s coronavirus fight.
In a worrying account she said: ‘There is a very real sense that the number of cases are growing and now growing very, very quickly.
‘Some of the most startling news seems to be that some of the sickest patients that we have had in this department recently have been young.
‘We have patients who are in their 30s and early 40s who are previously fit and well who are now in the intensive care and fighting for their lives. This is a virus which is very very difficult to predict.’
Fears of hospitals becoming overwhelmed is one of the driving factors of the UK’s coronavirus response.
Officials are working to try and spread out the number of cases of the disease so that fewer people will need intensive care at any one time and, instead, there will be a longer and less sudden outbreak.
Hospitals in Italy are totally overloaded with patients and video emerged last week of people in beds in the corridors.
Shortages of medical staff and intensive care beds pushes the death rate higher because fewer people are able to get the medical help they need.
Although severe infections are thought to largely be restricted to older patients and those with long-term health conditions, younger people are becoming critically ill, too.
Dr Allin-Khan said ‘fit and healthy’ young people are ending up needing intensive care to save their lives.
One of those is 36-year-old health worker and mother-of-three, Areema Nasreen, who is in intensive care in Walsall, West Midlands.
Ms Nasreen, who is a healthcare assistant at the same hospital where she’s now fighting for her life – Walsall Manor Hospital – became ill while on annual leave.
Her sister, Kazeema, 22, said her sister is currently in a critical condition and on a ventilator, but ‘making tiny little progress’.
Areema Nasreen, 36, is in intensive care in the hospital where she works in Walsall after catching the coronavirus
DOCTOR IN ITALY SAYS OVER-65s ARE LOW PRIORITY
Doctors around the world are having to ration staff and resources in intensive care units and a medic working in Italy said people over the age of 65 were being bumped down the list.
Large numbers of younger people in hospital mean health workers are more likely to give them the most help because they’re most likely to survive.
Dr Jason Van Schoor, an anaesthetist from the UK, said in a Twitter thread that a doctor friend had told him older people were lower priority now that the crisis is so out of hand.
He tweeted: ‘Our hospitals are overwhelmed by Covid-19, they are running at 200% capacity.
‘We’ve stopped all routine [surgery], all [operating rooms] have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of patients with severe respiratory failure and many of them do not have access to anything above a reservoir mask.
‘Patients above 65 or younger with comorbidities [long-term conditions] are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest.
‘Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.’
Speaking to BirminghamLive on Sunday, Kazeema urged people to ‘take coronavirus seriously’.
She said: ‘My sister who is an amazing nurse on the front line and who always helps so many has now caught this virus.
‘She is critically ill in ICU (intensive care unit), on a ventilator and fighting for her life.
‘I want everyone to know how dangerous this is. My sister is only 36 and is normally fit and healthy.
‘People are not taking this seriously enough. She is young – it is not just the elderly who are at risk.’
Dr Allin-Khan said that doctors in the UK will soon start having to make the devastating decisions about who they give intensive care to and who will not be able to get it.
She told Radio 4: ‘This is only going to get worse and there’s a real sense that it’s going to get harder and harder in the coming weeks…
‘In a matter of days or a couple of weeks we will be having to make life and death decisions.
‘Making impossible choices between who gets what may be the last remaining ventilator. The public have to make this easier for us.’
Dr Allin-Khan criticised the Prime Minister Boris Johnson for his ‘relaxed-style mixed messaging’ after thousands of people ventured out to busy places at the weekend.
In a plea to the public to stay at home she added: ‘We are headed for a disaster if people do not heed the social distancing measures.’
Mr Johnson now faces the threat of a Tory revolt unless he imposes Italy-style movement restrictions after the weekend made clear people weren’t listening to his pleas for them to stay at home.
Crowds flocked to parks and landmarks to take advantage of sunshine and the PM effectively put the nation on its final warning last night, saying there should be ‘no doubt’ he would take draconian action.
He made clear a full lockdown would be ‘actively’ considered ‘in the next 24 hours’/
He highlighted measures in Italy and France, where all municipal spaces have been closed and police have been on patrol fining people who leave the house without a valid reason.
Oh I do like to be beside the seaside! Visitors continued to flock to seaside resorts today including this one in West Bay, Dorset
People packed Bournemouth esplanade this morning (Sunday). Paddle boarders and swimmers braved the cold temperatures despite fears over the global coronavirus outbreak
The infamous Columbia Road Flower Market in London showed no signs of slowing down today as many flocked there to purchase flowers
Health Secretary Matt Hancock underlined this morning that a decision is expected ‘very soon’, hitting out at the ‘selfish’ behaviour of people who were still travelling and saying ‘nothing is off the table’.
Pressure has been mounting on Mr Johnson to go further to avert a coronavirus catastrophe, with warnings of a ‘full-scale mutiny’ among his own Cabinet.
Traffic monitoring has suggested that London – regarded by experts as the engine of the UK’s outbreak – is still running at a third of its normal rate, far higher than other European capitals.
WHAT DO WE KNOW ABOUT THE CORONAVIRUS?
What is the coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.
Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.
The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Where does the virus come from?
According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.
However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
What does the virus do to you? What are the symptoms?
Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.
However, an investigation into government surveillance in China said it had found no reason to believe this was true.
Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.
Can the virus be cured?
The COVID-19 virus cannot be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.
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