THE DANGERS HE FACES
Why did Mr Johnson first go to hospital?
He was admitted to St Thomas’ in London at around 8pm on Sunday, ten days after testing positive. Doctors advised him to seek treatment as his ‘persistent symptoms’, including a cough and a temperature, had not improved. His slow recovery is a red flag for complications including pneumonia. No 10 said it was a ‘precautionary step’ so Mr Johnson could have routine tests, which are likely to include procedures which can only be done in hospital.
What happens in intensive care?
Downing Street said the Prime Minister remained conscious last night and was moved to intensive care ‘ should he require ventilation’. There are two types of ventilators used: non-invasive ventilation and invasive ventilation. Noninvasive ventilation means the patient stays conscious and is given a specialised mask which pumps air at high pressure into the lungs. These are called continuous positive airway pressure machines. If this does not work, patients are intubated – have a tube put down their throat into their airway – and placed on an invasive ventilator. They have to be placed in a drug-induced coma and paralysed while the mechanical ventilator takes over their breathing. ICU ventilators have built-in sensors to adjust the amount of oxygen the patient needs.
How common is it to be hospitalised and how high risk is he?
The Prime Minister, 55, is one of 17,911 people to have been admitted to an NHS hospital with coronavirus so far. Latest research estimates between five and ten per cent of those who get the virus end up in hospital. The older you are, the more likely you are to need hospital treatment. A study found that eight per cent of people in their 50s with the virus need hospital treatment and 0.6 per cent die. Mr Johnson has no known underlying health conditions. But he has struggled with his weight and in December 2018 revealed that he weighed 16 and a half stone. Obesity is a risk factor for complications and men are more likely to be hospitalised than women.
How long could he stay in intensive care?
Some patients spend just a day there before recovering and going to a general ward. Others have spent more than three weeks in intensive care units.
What initial tests and treatment did he have and why?
Coronavirus is a respiratory disease so initial tests will have focused on establishing how badly his lungs were damaged. Most patients admitted to hospital with coronavirus have difficulty breathing and get oxygen support. Mr Johnson’s oxygen saturation levels will have been monitored by a sensor clipped to a fingertip. Doctors will also have scanned his lungs. Other tests establish if major organs have been affected by a lack of oxygen. This includes an ECG and blood tests for the liver and kidneys. Patients have their white blood cell counts monitored to show immune response. His move to ICU suggests these key measures, most importantly oxygen levels, were continuing to deteriorate yesterday.
What treatment could he receive?
The highest level is mechanical ventilation, which requires patients to be fully sedated. There are no established drugs for coronavirus and antibiotics do not work on viruses.
Could continuing to work make it worse?
The Prime Minister did not take any time off and vowed to continue leading the Government from his hospital bed. But this went against NHS advice urging those with coronavirus to get plenty of rest and sleep. Exhaustion is a common symptom of coronavirus. Previous studies have shown that a lack of sleep and high stress can suppress the immune system.