Coronavirus demand on intensive care units not set to overwhelm NHS during peak, says health expert

Decision on whether to lift lockdown in three or four weeks 'will determine whether outbreak returns'

Andrew Woodcock
Political Editor
,Ashley Cowburn
Wednesday 25 March 2020 12:49 GMT
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Prof Neil Ferguson of Imperial College predicts peak coronavirus in 2-3 weeks' time

Coronavirus demand on intensive care units should peak in two and a half to three weeks’ time at a level which will not overwhelm the NHS, a leading scientist has told MPs.

Professor Neil Ferguson of Imperial College London, whose shock report warning of 250,000 deaths if politicians did nothing spurred Boris Johnson to order the nationwide lockdown, said that current measures should limit UK fatalities to a maximum of 20,000 – and potentially “substantially lower”.

He said politicians will face crucial decisions in three to four weeks’ time on whether to risk lifting restrictions on movements and social contact, which could see a possible resurgence in Covid-19 infections or to maintain the lockdown for as long as a year.

While there is likely to be a second wave of Covid-19 cases after the lifting of the lockdown, it is possible that a programme of intensive testing and contact tracing could allow the UK to keep numbers at low levels “indefinitely” until the problem is solved by the development of a vaccine, he said.

Prof Ferguson, the director of the MRC Centre for Global Infectious Disease Analysis and a member of the prime minister's Scientific Advisers Group on Emergencies (Sage), has himself caught coronavirus, and told the House of Commons Science and Technology Committee that his case was flu-like and “for a couple of days really quite unpleasant” but he was now self-isolating and on the mend.

Giving evidence via video link, he told the committee: “With the current strategy being adopted now, we think that in some areas of the country intensive care units will get very close to capacity but it won’t be breached at a national level. There will be some areas of the country which will experience stress, but we are reasonably confident – which is all we can be at the present time – at a national level we will be within capacity.”

Asked when he expected the outbreak to peak in the UK, Prof Ferguson said: “If – and it’s an if, we are moderately confident but can’t be completely sure – the current measures work as we expect them to, then we will see intensive care unit demand peak in approximately two and a half to three weeks’ time and then decline thereafter.

“The reason for that lag is because it takes people something like two to three weeks between being infected and actually being in an intensive care unit.”

Prof Ferguson played down a recent Oxford University study suggesting that as many as half of the UK population may have been infected with Covid-19 already but not noticed the mild symptoms, saying it did not seem “consistent with the observed data”.

Infection rates can be expected to vary a lot by geographic area, with London being worst-hit in the UK, he told the committee.

Up to 5-10 per cent of the London population is likely to have some form of infection within the next six months, he said, adding: “Once we achieve suppression and case numbers go down to a low level, that number is unlikely to increase much beyond that.”

The 16 March Imperial College report estimated that the lockdown and intensive social distancing policy now adopted could cap the number of British deaths at 20,000, and the final death toll “could be substantially lower than that”, he told MPs.

Amid fears that coronavirus cases could spike up again it the Chinese city of Wuhan, where the outbreak began, as restrictions are lifted, Prof Ferguson was asked about the danger of a “second peak” in Britain later this year.

A nurse in Germany gets a coronavirus test ready
A nurse in Germany gets a coronavirus test ready (Reuters)

“We think the government’s measures could well – with a reasonable but not certain degree of confidence – turn the curve over, turn the epidemic from a growing epidemic to a declining epidemic,” he said.

“Whether we get a resurgence depends on policy decisions in three to four weeks’ time and the effectiveness of the measures we put in place to replace the current regime.

“It comes back to the issue of can we move from a complete lockdown, which almost certainly isn’t sustainable for the rest of the year, to something making better and more intensive use of testing and contact tracing.

“There will be a resurgence of transmission, but the hope is that by deploying more focused policies to suppress local outbreaks, we can maintain infection levels at low levels in the country as a whole indefinitely.

“It remains to be seen how we actually achieve that and how practical it proves to be.”

Dr Richard Horton, the editor-in-chief of medical magazine The Lancet, told the committee that the UK had "missed an opportunity" to prepare for the current outbreak during February and early March.

Dr Horton said the severity of the outbreak of coronavirus in China’s Hubei province was beginning to be understood in the final week of January and that many at The Lancet viewed the events in Wuhan then as a "red flag".

The magazine published three papers on the outbreak of Covid-19 at the time, and has been critical of the slow pace of the government's response to the outbreak.

“It’s been seven to eight weeks since that time and February was the opportunity for the UK to really prepare, based upon testing, isolation, quarantine, physical distancing, ICU capacity and so on," said Dr Horton.

"We missed that opportunity. We could have used the month of February based upon what we knew in January.

“When I looked at the evidence Sage posted on its website ... what strikes me is the mismatch between the urgent warning that was coming from the frontline in China in January and the honestly somewhat pedestrian emulation of the likely severity outbreak in that evidence. That suggests to me that we didn’t fully understand what was taking place on the frontline.”

Committee chair Greg Clark announced that the cross-party panel will conduct an inquiry into the lessons to be learnt from the coronavirus outbreak once the current crisis is over.

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