'Doctors Say U.K. Is Ill Prepared for Coronavirus' diff viewer (18/19)

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Doctors Say U.K. Is Ill Prepared for Coronavirus	Doctors Say U.K. Is Ill Prepared for Coronavirus
2020-06-24 16:05:23 UTC	2020-07-02 20:52:55 UTC (8 days later)
LONDON — Ventilators in short supply. Intensive care beds already overflowing. Some health workers buying their own face masks or hoods. And if cases of the deadly coronavirus surge in anything like the numbers some experts have predicted, doctors say they would have to consider denying lifesaving care to the frailest patients to prioritize those with better chances of surviving.	LONDON — Ventilators in short supply. Intensive care beds already overflowing. Some health workers buying their own face masks or hoods. And if cases of the deadly coronavirus surge in anything like the numbers some experts have predicted, doctors say they would have to consider denying lifesaving care to the frailest patients to prioritize those with better chances of surviving.
“If we haven’t got ventilatory support to offer them, it’s going to end in death,” said Dr. George Priestley, an intensive care doctor and anesthesiologist in Yorkshire in northern England. “I don’t want to be alarmist. I just want someone to pay attention.”	“If we haven’t got ventilatory support to offer them, it’s going to end in death,” said Dr. George Priestley, an intensive care doctor and anesthesiologist in Yorkshire in northern England. “I don’t want to be alarmist. I just want someone to pay attention.”
With the number of coronavirus cases in Britain climbing to 115 this week, and on Thursday the first fatality, Prime Minister Boris Johnson offered the first hints of how a health system sapped by years of austerity-driven reductions in budget growth would try to cope.	With the number of coronavirus cases in Britain climbing to 115 this week, and on Thursday the first fatality, Prime Minister Boris Johnson offered the first hints of how a health system sapped by years of austerity-driven reductions in budget growth would try to cope.
But for doctors already dealing with overflowing wintertime wards, there was little faith that even the most ambitious plans could keep the National Health Service from being deluged by a crisis that strikes where it is weakest — a severe shortage of beds for critically ill patients, which puts it behind much of Europe and has alarmed doctors for years.	But for doctors already dealing with overflowing wintertime wards, there was little faith that even the most ambitious plans could keep the National Health Service from being deluged by a crisis that strikes where it is weakest — a severe shortage of beds for critically ill patients, which puts it behind much of Europe and has alarmed doctors for years.
“The N.H.S. has never been in a worse state going into something like this,” said Dr. Dominic Pimenta, a cardiologist and author in London. “The dominoes have been stacked for 10 years. It wouldn’t have taken much to tip them over.”	“The N.H.S. has never been in a worse state going into something like this,” said Dr. Dominic Pimenta, a cardiologist and author in London. “The dominoes have been stacked for 10 years. It wouldn’t have taken much to tip them over.”
In many ways, Britain’s response to the coronavirus highlights the advantages of free health care in a crisis, analysts said. Roughly 18,000 Britons have received free testing so far. A national helpline has kept less serious cases away from hospitals. And doctors are counting on intensive care units coordinating closely as the crisis mounts to ensure the sickest patients have beds.	In many ways, Britain’s response to the coronavirus highlights the advantages of free health care in a crisis, analysts said. Roughly 18,000 Britons have received free testing so far. A national helpline has kept less serious cases away from hospitals. And doctors are counting on intensive care units coordinating closely as the crisis mounts to ensure the sickest patients have beds.
But in a dozen interviews with doctors and public health experts, the shortcomings of Britain’s efforts were laid bare, a lesson in the devastating consequences of a decade of trims to spending growth that have starved the health service of workers and beds at the very moment Britain most needs them.	But in a dozen interviews with doctors and public health experts, the shortcomings of Britain’s efforts were laid bare, a lesson in the devastating consequences of a decade of trims to spending growth that have starved the health service of workers and beds at the very moment Britain most needs them.
“We’re already at maximum capacity and clearing out beds as best we can,” said Dr. Nick Scriven, a specialist in urgent conditions in Halifax, a town in northern England, and the former president of The Society for Acute Medicine.	“We’re already at maximum capacity and clearing out beds as best we can,” said Dr. Nick Scriven, a specialist in urgent conditions in Halifax, a town in northern England, and the former president of The Society for Acute Medicine.
Britain has shed roughly 160,000 hospital beds since the late 1980s as doctors shortened recovery times and tried to reduce reliance on hospital care, mirroring efforts across Europe. But Britain now has the second-fewest hospital beds per capita in Europe, according to the European Union. And a 2011 study suggested that it had one-seventh the number of intensive care beds per person that the United States did.	Britain has shed roughly 160,000 hospital beds since the late 1980s as doctors shortened recovery times and tried to reduce reliance on hospital care, mirroring efforts across Europe. But Britain now has the second-fewest hospital beds per capita in Europe, according to the European Union. And a 2011 study suggested that it had one-seventh the number of intensive care beds per person that the United States did.
Admitting one patient now almost inevitably means finding a way to discharge another. The occupancy rate for intensive care beds regularly exceeds 90 percent, about 20 percentage points higher than intensive care specialists consider safe.	Admitting one patient now almost inevitably means finding a way to discharge another. The occupancy rate for intensive care beds regularly exceeds 90 percent, about 20 percentage points higher than intensive care specialists consider safe.
For severely ill coronavirus patients, that could spell trouble.	For severely ill coronavirus patients, that could spell trouble.
By Dr. Priestley’s estimate, hundreds of people out of a population of several hundred thousand in his area could require respiratory support as the coronavirus spreads. But his unit has only 17 intensive care beds. Doctors could make use of another 18 or so ventilators stationed in operating rooms, but beyond that, he said, “We’re talking about people squeezing bags.”	By Dr. Priestley’s estimate, hundreds of people out of a population of several hundred thousand in his area could require respiratory support as the coronavirus spreads. But his unit has only 17 intensive care beds. Doctors could make use of another 18 or so ventilators stationed in operating rooms, but beyond that, he said, “We’re talking about people squeezing bags.”
“If we get those kinds of numbers, nobody knows how we’d possibly cope,” Dr. Priestley said. “We’d have to do a very robust triage where only those with a high chance of getting better would get near a ventilator.”	“If we get those kinds of numbers, nobody knows how we’d possibly cope,” Dr. Priestley said. “We’d have to do a very robust triage where only those with a high chance of getting better would get near a ventilator.”
Intensive care doctors cautioned that Britain was still some ways from having to make decisions like that. Even so, doctors said, it has been difficult getting the ear of hospital administrators.	Intensive care doctors cautioned that Britain was still some ways from having to make decisions like that. Even so, doctors said, it has been difficult getting the ear of hospital administrators.
At some hospitals, administrators have only recently started asking about supplies of ventilators and oxygen. Doctors are still doing their normal jobs — and sometimes picking up extra shifts — as they try to prepare their wards.	At some hospitals, administrators have only recently started asking about supplies of ventilators and oxygen. Doctors are still doing their normal jobs — and sometimes picking up extra shifts — as they try to prepare their wards.
In some cases, they find parts of hospitals lacking even basic training and supplies to tackle the virus.	In some cases, they find parts of hospitals lacking even basic training and supplies to tackle the virus.
Doctors at an emergency room in south London, for example, were faced last week with a coughing, gasping patient who had recently traveled to a high-risk country in Asia. They considered whether to insert a breathing tube.	Doctors at an emergency room in south London, for example, were faced last week with a coughing, gasping patient who had recently traveled to a high-risk country in Asia. They considered whether to insert a breathing tube.
But there was a problem: The doctors who were supposed to administer an anesthetic had none of the right protective gear. Many had not been fitted for face masks at all, a major liability, said one of the doctors who handled the case.	But there was a problem: The doctors who were supposed to administer an anesthetic had none of the right protective gear. Many had not been fitted for face masks at all, a major liability, said one of the doctors who handled the case.
So instead of being rushed to a hospital ward, the patient had to remain in the emergency department.	So instead of being rushed to a hospital ward, the patient had to remain in the emergency department.
Before 2009, when the swine flu arrived in Britain near the end of a period of larger spending growth for the health service, hospital administrators had expressed concern about preparing for a pandemic, doctors said.	Before 2009, when the swine flu arrived in Britain near the end of a period of larger spending growth for the health service, hospital administrators had expressed concern about preparing for a pandemic, doctors said.
But administrators dismissed some proposals to increase bed or ventilator supplies as too costly, they said, and after withstanding the swine flu outbreak, never dealt with the underlying shortage of beds.	But administrators dismissed some proposals to increase bed or ventilator supplies as too costly, they said, and after withstanding the swine flu outbreak, never dealt with the underlying shortage of beds.
Protective gear has grown even more scarce since then at some hospitals. Dr. Scriven said every doctor where he worked had his or her own heavy-duty face mask during the swine flu. Now they need to be shared, though Dr. Scriven said a quick scrub between uses was enough to remove traces of the coronavirus.	Protective gear has grown even more scarce since then at some hospitals. Dr. Scriven said every doctor where he worked had his or her own heavy-duty face mask during the swine flu. Now they need to be shared, though Dr. Scriven said a quick scrub between uses was enough to remove traces of the coronavirus.
Dr. Ganesh Suntharalingam, the president of the Intensive Care Society, said, “We do have the advantage of a unified health care system, but we’re also starting from further behind the start block than other countries because we historically have fewer intensive care beds per population, and they tend to be more full.”	Dr. Ganesh Suntharalingam, the president of the Intensive Care Society, said, “We do have the advantage of a unified health care system, but we’re also starting from further behind the start block than other countries because we historically have fewer intensive care beds per population, and they tend to be more full.”
Chris Whitty, Britain’s chief medical officer, has acknowledged that a large outbreak “will put very high pressure on the N.H.S..” But he added that the government would try to delay any explosion of cases until the warmer months, and that in any case the N.H.S. would be up to the task.	Chris Whitty, Britain’s chief medical officer, has acknowledged that a large outbreak “will put very high pressure on the N.H.S..” But he added that the government would try to delay any explosion of cases until the warmer months, and that in any case the N.H.S. would be up to the task.
~~Updated June ~~24,~~ 2020~~	Updated June 30, 2020
	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.	Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
“The N.H.S. will always cope because the N.H.S. is an emergency service that is very good at adapting to what it finds itself with,” he said this week.	“The N.H.S. will always cope because the N.H.S. is an emergency service that is very good at adapting to what it finds itself with,” he said this week.