Friday, March 17, 2023

Covid Means that the NHS Needs 6000 More Beds

Figure 1

Figure 1 shows that the number of hospital inpatients suffering from Covid is going to settle out at at least 100 NHS hospital beds per million, that is 6,000 beds. This represents an increase of approximately 5% on the present number of beds in the NHS.

There is no slack in the provision of NHS beds to cope with this extra demand. Bed numbers have fallen by 53% since the 1980s, while the number of patients treated has risen. International comparisons (see Fig 2) show that our bed ratio is smaller than those of comparable countries, although we are not quite as poor as Mexico.  Click on the figure to enlarge it.

Figure 2

To make matters worse, the extra 6,000 Covid patients in NHS hospitals are more demanding in terms of staff time, danger and stress, in that they need barrier nursing because of the highly infectious nature of their illness. Nurses and doctors have to use full PPE when attending the patient, and some of them will succumb to the infection, which will take them out of action for a significant amount of time.

Further, it is not just a case of providing another 6,000 physical beds. Each bed needs more personnel and other resources.

It is highly unlikely that the present Government is going to respond to the extra demand created by Covid, so NHS waiting lists are going to continue to increase, along with stress on NHS staff, and the quality of health care for the British nation will continue to spiral downwards.

So what can we do?

There is one approach that could slightly mitigate this situation. Of the Covid cases in hospital, 10-30% caught the infection while in hospital. Therefore the demand for extra beds could be reduced down from 6,000 to between 5,400 and 4,200 by cutting the spread of Covid in hospital. This can be achieved by using the Melbourne Isolation Hood, or Medihood (, which works by drawing off the virus-laden exhaled air from the Covid patient and capturing the virus in a HEPA filter. The unit costs about the same as a two-day stay in ICU bed, so it is an excellent investment. Even cheaper options are available. I engaged in a protracted and ultimately circular correspondence with a sequence of Government decision makers during the pandemic about adopting this technology. More here

The other measure that will slightly lower the burden of Covid, and other infectious diseases like influenza and RSV, on our economy, society and NHS is to reduce the circulation of viruses in the general population. Unfortunately measures such as vaccination, social distancing, ventilation, masking, and staying home if ill are opposed by a highly influential cohort of mainly right wing journalists and social media writers who have succeeded in convincing everyone that Covid is not a problem. This is despite evidence that suggests that Covid causes more serious sequelae with each reinfection.

In view of this famous victory on the part of media influencers, we should try another line of defence. We can install air purifiers in as many public spaces as possible, whether it be offices, restaurants, or public transport. HEPA air purifiers are effective at filtering viruses out of ambient air and trapping them in the filter, where they die. HEPA filters remove all airborne viruses: Covid, irrespective of mutant variants, influenza, RSV, the lot.

An added advantage of such filters is that they could have a small filtering strip applied to them which could be removed and tested intermittently with a standard Lateral Flow Test to detect whether virus is present in the room. In an office, this test could indicate that someone in the room is exhaling virus particles. That person can then be identified and sent home to recover.

Air filtration is already in use in the Houses of Parliament but inexplicably their use has not been rolled out or even discussed in other places. The only drawback of air purifiers is its energy usage, but in that they will be keeping people out of hospital, there will be a net reduction in energy demand from their use. We must hope that concerted push from medical and health professionals as well as from concerned lay people will bring about trials of filtration as a means of reducing Covid infection rates in the general population.

In conclusion, it is clear that Covid is imposing a quantifiable extra burden on the NHS which will further diminish its ability to cope. There are some effective measures that may improve this problem, and we must hope that the next Government will step up to meet this challenge.

I hope that others will join with me in obtaining a commitment from the parties who will form the next Government to implement the policies suggested here.


Richard Lawson

Edited 20/03/2023


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