THE number of intensive care beds in Scotland should be doubled to help the NHS cope with a surge in critically ill coronavirus patients, the Health Secretary has said.
Jeane Freeman said there are also plans to train non-intensive care staff to take on extra duties as demand increases, and warned that the infection is likely to claim many lives.
It comes as the Chancellor prepares to unveil a multi-billion package today to help businesses manage the coronavirus crisis, with England’s deputy chief medical officer Dr Jenny Harries warning that the UK’s peak epidemic stage will begin in around two weeks’ time when “many thousands” will be infected.
The number of confirmed cases in Scotland of Covid-19, the disease caused by the virus, has reached 27 with a sixth death now recorded in the UK.
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The man, who was in his 80s and had underlying health conditions, died on Monday night in Watford General Hospital in Hertfordshire. He had picked up the infection within the UK.
To date, 382 people in the UK have tested positive for the virus.
Briefing MSPs in the Scottish Parliament, Ms Freeman said increasing intensive care capacity and “flattening the peak” in coronavirus cases so that they were spread out over a longer period would be vital to easing pressure on the NHS.
She said: “Part of the work we’re undertaking is in terms of looking at bed capacity across the whole estate and doubling our intensive care beds, and ensuring we have the right trained staff and the right equipment in order to be able to do that.
“We will continue to look at what more can we do to maximise our capacity to respond to this. At the same time, we’re taking the action to flatten that peak so that we give ourselves the best possible chance to do so.
“All of us need to understand that the situation is a serious one. That whilst many people will be mildly affected for some this will be a serious infection, and for many people it will potentially cause their death.”
According to the most recent audit, NHS Scotland currently has a maximum of 275 intensive care beds with occupancy running at around 84 per cent.
An estimated 5% of patients who develop Covid-19 become critically ill with complications such as pneumonia, sepsis and organ failure which will require ventilation to keep them alive.
Ms Freeman said the extra beds would be staffed by training skilled NHS staff from other departments to take on new roles within intensive care “leaving our highly skilled intensive care staff to do only the things that they are qualified to do”.
She added: “What that means in practical terms is that, as far as it is possible within the bounds of patient safety and good clinical care, the model for intensive care will have to shift a bit in order to allow us to cope with more people in intensive care beds with the maximum clinical input and maximum patient safety.”
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All cases of the virus so far identified in Scotland can be traced to recent travel, especially to northern Italy, or to contact with other known cases. Ms Freeman said there was “no evidence yet of community transmission” in Scotland.
A Shell employee in Aberdeen is among the latest cases of coronavirus. The member of staff is understood to be based at the firm’s Tullos base.
Health Protection Scotland has been notified and other staff who worked closely with the person have been asked to work from home.
Ms Freeman said work was underway to scale up NHS 24 to handle an increasing number of telephone consultations as restrictions are placed on people visiting GP surgeries, and that £1.24 million was being invested immediately to accelerate the wider roll-out of video consultation technology which has previously been piloted in rural areas.
Talks are also taking place on how to temporarily increase staffing by deploying retired and student nurses, said Ms Freeman.
She said: “We are working with the professional regulators to establish urgent arrangements to allow us to bring back recently retired nurses and others if they are willing to do so.
“And work is in hand to explore how we might use students who are close to finishing their training in nursing and in medicine to allow them to be registered temporarily to support our efforts if needed.”
Asked why holidaymakers were not being thermally screened at airports for signs of fever when they were returning from known coronavirus hotspots, Ms Freeman stressed that the tests were unreliable.
She said: “Only a third of people with the coronavirus infection experience a spike in temperature.
“One of the difficulties with screening people at airports is that you will miss people who are not showing an increase in their temperature and you then have false reassurance.
“That’s why screening at airports, based on scientific and clinical guidance, is not the right option.”
The UK is lagging behind countries including France, Germany and Spain, which have each now recorded well over 1000 cases of the virus, with Italy - which imposed a nationwide quarantine on Sunday - nearing 10,000 cases.
However, Dr Harries said the UK was currently in the “slow take off” phase and that cases “will start to rise quite sharply” by the end of March.
She said: “Within 10 to 14 days we will be likely to advise people with symptoms to self-isolate and we are expecting that start of the peak to come within that period.”
England’s chief medical officer Professor Chris Whitty previously said that half of all UK coronavirus cases would probably occur in a three-week period, with 95% of them over a nine-week period.
Staying at home in self-isolation was “extremely effective in trying to move our epidemic curve forward” into Spring, said Dr Harries, although she conceded that “many thousands of people” would contract coronavirus as it spreads in the UK.
The UK and Scottish Governments said a “worst case scenario” could see 50-80% of the population infected, although bacteriologist Professor Hugh Pennington told the Herald this was “not a realistic estimate” and based on no containment measures being used.
Dr Harries said: “Large numbers of the population will become infected because it’s a naive population - nobody has got antibodies to fight this virus currently.
“We will see many thousands of people infected by coronavirus, that’s what we’re seeing in other countries, and the important thing for us is to make sure that we manage those infections.”
However, she said it was too early for the UK to launch infection delay tactics such as closing schools, and added that cancelling big outdoor events such as football matches was not supported by science.
“The virus will not survive very long outside,” she said. “Many outdoor events, particularly, are relatively safe.”
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