Nightingale field hospital completed in London to cope with mass coronavirus deaths

By Richard Tyler
2 April 2020

Built in just ten days, NHS Nightingale, a temporary field hospital with a maximum capacity of 4,000 beds, will begin accepting patients with COVID-19 next week.

The hospital has been erected inside the ExCel conference and exhibition facility in London’s docklands. Construction was undertaken with military personnel, deployed on 15-hour shifts.

NHS Nightingale being built (credit MoD)

ExCel is one of four conversions to temporary hospitals nationally, along with Birmingham’s National Exhibition Centre, Manchester’s Central Convention Centre and Cardiff’s Principality Stadium.

Colonel Ashleigh Boreham, from Army Medical Services, told the press how the plans to transform ExCel had only been drawn up on March 21, “over a brew” (cup of tea). Sixty members of the military worked alongside building contractors and NHS staff to create two massive 2,000-bed facilities inside the building. Each is a kilometre long, divided into 80 wards with 42 beds. Just one ward of 42 beds will open initially, before expansion is “ramped up” to the full 4,000-bed capacity in two weeks’ time if needed.

Coronavirus patients transferred to the hospital would already be on a ventilator and would remain until their course of ventilation was finished. Those suffering other serious conditions, such as cardiac issues, would not be admitted.

While each of the 4,000 beds in Nightingale is supposed to have a ventilator, this is impossible. Last week, junior health minister Edward Argar said there were just 8,000 ventilators throughout the UK. Despite the desperate scenes from hospital wards in China, Italy and elsewhere for the last three months, the government only launched its “Ventilator ChallengeUK” to encourage their manufacture on March 26.

Other vital medical equipment required for patients with COVID-19, such as MRI (magnetic resonance imaging) and CT (computed tomography) scanners, are already in short supply. According to the Royal Society of Radiographers, “Imaging departments will play a vital role in managing patients” during the pandemic, with the Lancet writing, “CT is likely to become increasingly important for the diagnosis and management of COVID-19 pneumonia, given the continuing increase in global cases.”

In response to a government announcement of £200 million funding for MRI and CT scanners last September, Ruth Thorlby, Assistant Director of Policy at the Health Foundation charity, noted, “The government’s announcement of funding for diagnostic equipment—if it is genuinely new funding—would be welcome, but the amount pledged falls considerably below what is needed to bring the UK up to an acceptable level.

“It is uncertain whether this money can truly help create the extra capacity needed… given major NHS workforce shortages across the country. Staff are needed to operate the machinery and report scan results, but shortages contribute significantly to delays in diagnosis and treatment.”

The government has also failed to supply sufficient personal protective equipment, such as face masks, gowns and eye protection, placing the lives of doctors and nurses in grave danger. In Italy, 61 doctors involved in the care of coronavirus patients have died.

The UK has yet to implement widespread testing for COVID-19, particularly among medics and health support staff. As of yesterday, only 152,000 people out of a population of 66 million had been tested.

NHS Nightingale’s chief operating officer, Natalie Forrest, has said that the number of staff required to run one ward is 200; for the 80-ward hospital, this equates to 16,000 staff.

The field hospitals in Birmingham (planned capacity of 2,000 beds), Cardiff (2,000) and Manchester (1,000) will collectively require even more staff than the ExCel/Nightingale.

According to the Unison trade union, at the end of last year there were 106,000 vacancies across the NHS in England, including over 44,000 vacancies in nursing. These figures marked an increase on the previous year. In mid-March, the government appealed to recently retired medical staff to return to the NHS to assist with the coronavirus pandemic. This resulted in 4,000 nurses and 500 doctors heeding the call. Tragically, the first of these returning doctors, 68-year-old Dr. Alfa Saadu, died Tuesday from COVID-19.

Saadu’s passing follows the death of two other NHS staff of COVID-19. Amged El-Hawrani, a 55-year-old ear, nose and throat consultant, died Saturday at Leicester Royal Infirmary. Adil El Tayar, aged 63, an organ transplant specialist, died last Wednesday at London’s West Middlesex University Hospital.

Even by drafting army medics, NHS Nightingale can only be staffed by “robbing Peter to pay Paul.” According to the Health Service Journal (HSJ), “NHS staff are being asked to move quickly to work in the new field hospital.” HSJ quotes an email from a London trust chief executive to their staff, saying, “Along with other NHS trusts, we have been asked to identify a range of our people to help staff the new Nightingale Hospital.”

Given the chronic staff shortages throughout the NHS, the government has already moved to dilute staffing levels, particularly in intensive care. The HSJ wrote that “staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients.”

Intensive Care Unit nurse-patient ratios are to be slashed from 1:1 to 1:6, or one nurse looking after six desperately sick patients. The number of patients a specialist consultant doctor will be expected to look after is to be doubled, with one consultant now expected to care for 30 patients.

Those volunteering to work at NHS Nightingale have been told, “be prepared to see death,” when the hospital opens, according to a report in the Daily Mail. The paper writes, “Volunteers working at the NHS Nightingale coronavirus hospital have been told to prepare for the fact that up to 80 percent of patients who are on ventilators will die.”

It is into such a situation that the new NHS Nightingale will shortly be receiving its first patients. While clearly the temporary hospital is a much-needed facility, given the criminal starving of resources in Britain’s health care system, for many who are taken there it will be little more than a waiting room for the dying.

Two morgues are attached to NHS Nightingale. It emerged Wednesday that just four miles away “an emergency mortuary in east London” is “in preparation for the expected surge in coronavirus deaths.” The Evening Standard reported that the facility, owned by the City of London Corporation and expected to be finished later this week, “is being constructed on Wanstead Flats, Newham, to take pressure off funeral directors.” Along with the temporary doubling in size of the capital’s morgue at Westminster, a temporary mortuary with room for 1,600 bodies has also been built in a car park next to Hillingdon council’s Breakspear Crematorium.

 

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