‘Crystal ball gazing’ has left Nightingale hospitals empty
NIGHTINGALE hospitals are largely empty after government modelling miscalculated how many people would need intensive care treatment for Covid-19, The Sunday Telegraph has learnt.
Doctors and researchers at Oxford University believe ministers became overly reliant on the “crystal ball gazing” and worst-case scenarios from Imperial College and have continued ramping up capacity while ignoring what is actually happening on wards.
Projections released on March 16, by a team led by Prof Neil Ferguson, suggested almost a third of infected over-80s would be hospitalised, 71 per cent of whom would need critical care.
The following day NHS trusts were asked to prepare to postpone all nonurgent elective operations from mid-April for at least three months to free up critical care capacity. Six days later Matt Hancock, the Health Secretary, announced the first Nightingale hospital in London.
However, a group of senior ICU doctors, speaking to The Telegraph on condition of anonymity, believe the models failed to take fully into account that ventilator use is rarely advised for elderly people because they are too frail to cope with such an invasive procedure.
“There is no disease on the planet that would mean we would intubate and ventilate 70 per cent of over 80-year-olds, because they don’t survive – they’re too frail,” said one intensive care doctor. Fears that the NHS would be overwhelmed were further
compounded by a second Imperial paper published on March 17, suggesting that Britain could face 250,000 deaths without wide-scale suppression.
Ministers moved swiftly to the current lockdown and called for a huge increase in ICU capacity.
Yet as the virus peaked in the second week of April, just three per cent of those in critical care were over 80, it can be disclosed, prompting accusations that time and money has been wasted on the nine Nightingale hospitals, based in London, Birmingham, Manchester, Harrogate, Exeter, Cardiff, Glasgow, Belfast and Bristol.
Statistics from the Intensive Care National Audit & Research Centre have consistently shown that just 10 per cent of people who have died from coronavirus were admitted to intensive care.
Another doctor said the original modelling assuming seven in 10 hospitalised patients over 80 would be ventilated was “so far from real-world practice, that it’s kind of laughable”.
At the peak of the crisis over the Easter weekend, figures from the NHS operational dashboard showed 40.9 per cent of acute beds were unoccupied, about four times the normal number – and just 19 patients were being treated at the London hospital. Another doctor told The Telegraph: “It’s been very clear now for weeks that most of these [Nightingale] hospitals are not going to see a single patient.”
Carl Heneghan, professor of evidence-based medicine at Oxford University, said: “With an outbreak you need to keep responding to the emerging data and what’s happening on the ground, not gazing into a crystal ball.”
Last night, Prof Ferguson defended the estimates he delivered to the Government. The figures “reflect the reasonable worst-case planning scenario agreed by Sage (Scientific Advisory Group for Emergencies) and NHS in early March”.
“The healthcare demand figures were based on extensive clinical input from NHS and academic clinicians, including intensivists,” he added.
“The Sage subgroup involved in developing the reasonable worst-case scenario was aware that triage decisions are sometimes made regarding the over-80s, but felt that planning scenarios intended to inform worst-case capacity planning should, by definition, be conservative. In a crisis, it is better to have more healthcare capacity than needed than less.”
An NHS spokesman said: “The NHS has needed to plan flexibly on the basis of the regularly updated Covid demand scenarios commissioned through Sage.”