A coronavirus surge is already hitting London – where more than half of England’s infected patients are being treated.
The NHS is scrambling to avert the worst-case scenario, described as “armageddon”, when the virus reaches its expected peak in seven to 10 days.
It’s hoped that the newly assembled temporary hospital at east London’s ExCel centre will be able to bear the brunt of the surge, with NHS leaders ruling out shipping patients elsewhere in the country, so that Covid-19 can be better contained.
The capital is at the epicentre of the UK epidemic — with Chris Hopson, chief executive of NHS Providers, warning of a tsunami of cases. But analysis seen by The Independent shows the majority of London patients are in the outer suburbs.
The analysis, by company Edge Health, shows there is a doughnut-type shape of cases forming around central London hospitals where the population is younger than in the outer boroughs.
NHS England on Thursday confirmed there were 2,000 Covid-19 patients in London hospitals, with 4,300 in hospital across the rest of England. Meanwhile, the Department of Health and Social Care said there were now 11,658 cases and 578 confirmed deaths.
Doctors working in hospitals across the capital told The Independent differing accounts of what was happening in their units, with some already at risk of being overstretched while others are putting together their final plans for when the surge hits them.
There are around 800 intensive care beds in London with a surge capacity of up to 3,000 beds, but bosses at NHS England believe they will need up to seven times more, which is why the ExCel centre, dubbed the NHS Nightingale, is so crucial.
The Independent has also learned tonight that NHS bosses are in advanced discussions to create up to five field hospitals across England, in addition to the ExCel centre.
The military was understood to be at Birmingham’s NEC conference centre today as part of plans to create a hospital there, as well as at the Manchester Central conference venue.
A senior NHS England source said some London hospitals were under “huge pressure” while others were still able to cope.
They added: “All the modelling suggests that unless the ExCel opens on top of surge [beds] in trusts then in seven to 10 days we would be looking at armageddon across London.”
They said there would be no regional mutual assistance for London as “everyone needs to consume their own smoke” – it’s feared that transporting patients would spread the disease.
They said Downing Street had taken special interest in the preparations across the city, but they added most big cities will need an ExCel-type field hospital as the virus spreads.
Edge Health told The Independent the peak for the city would hit in the coming weeks.
George Batchelor, director and co-founder of Edge Health said: “The peak in London based on our modelling will be around 5 April, with the numbers in hospital peaking around 8 April and critical care around 15 April. It will get worse before it gets better.”
He said areas with older populations around the centre of London appeared to be the worst hit, explaining: “It’s within the doughnut around London, the Hillingdon, Croydon areas where there are district general hospitals that are also less well equipped than hospitals in central London.
“London, and even outer London, are younger than other areas in England, which is a worry as the virus spreads to other parts of the UK.”
He added: “We are tracking Italy almost exactly but it does depend really on how well the NHS is going to cope. It had some advanced warning compared with Italy, which was really caught out.”
Earlier on Thursday, Mr Hopson of NHS Providers said the capital had seen “an explosion in demand” in recent days but hospitals had been able to increase their capacity “between five and seven-fold”.
However, he warned that hospital bosses were describing “a continuous tsunami” in seriously ill patients.
Northwick Park Hospital in northwest London reported a critical incident last week, and earlier this week reported 21 deaths of patients with coronavirus in a single day.
At the Royal London hospital, in Whitechapel, bosses have sought to create 200 extra intensive care beds. But on Wednesday, the hospital ran out of capacity and used beds in operating theatre recovery areas.
At St George’s Hospital in south London, doctors reported an increasing number of intensive care admissions with one patient an hour being admitted on Wednesday, although this slowed overnight. One source said many of the patients were younger than 70 and many younger than that, although most had underlying issues such as obesity.
They said the hospital still had spare beds on Thursday and escalation plans were ready.
A doctor at St Mary’s Hospital in Paddington said the hospital was busy but still had intensive care capacity. They said there was an expectation the situation would worsen in coming days.