Britain’s National Health Service “is now on a war footing,” one of its top medical officials warned on Thursday, saying its hospitals would erect field wards to help deal with the surge in coronavirus cases that has produced a steep rise in hospitalizations nationally.
Health experts were bracing for more challenges in the coming weeks that would further strain the system, which is besieged by the absences of tens of thousands of health care workers who are sick themselves, or isolating. Officials also cautioned that absences could have a far-reaching impact on public services like transportation.
Coronavirus cases in Britain reached new highs this week, driven by the highly transmissible omicron variant, with 189,213 cases reported across the country on Wednesday — twice the highest daily count recorded in previous waves. More than 11,000 people with the coronavirus were hospitalized in England on Thursday, the highest number since March, though it is still unclear how many were hospitalized for illness caused by the virus and how many were there for another reason but also tested positive.
A full picture of the rise in hospitalizations and deaths has been difficult to determine over the Christmas period, with inconsistent data reporting, and public health experts have said it is likely to be days before the full impact of socializing over the holidays is reflected.
Professor Alison Leary, chair of health care and workforce modeling at London South Bank University, told BBC Radio on Monday that the London hospitals were already seeing a 30% increase in absences. And in a worst-case scenario, the health service in England could see up to 40% of its staff off as a result of the coronavirus, she said.
It’s not just the health care service that has been affected by absences; some train service has been suspended in southern England because of a shortage of workers.
Because the omicron variant flared so early and so dramatically in Britain, its impact on medical and other services positions England, and its capital, London, as a bellwether for the challenges to come in places like the United States, which set its own record for daily cases on Wednesday with 488,000.
On Thursday, the National Health Service outlined plans for new field hospitals in England in response to the wave of omicron cases.
Stephen Powis, the medical director of Britain’s National Health Service, has said that given the high number of infections and the rise in hospital admissions, the health system is now “on a war footing” as it introduced the new measures.
These temporary facilities, called “Nightingale hubs” would be capable of housing around 100 patients each, the health service said in a statement, and would be set up at eight hospitals across the country.
“We do not yet know exactly how many of those who catch the virus will need hospital treatment,” Powis said in a statement. “But given the number of infections we cannot wait to find out before we act and so work is beginning from today to ensure these facilities are in place.”
The NHS said it was also trying to identify gyms and schools that could be converted to temporary medical centers.
The preparations are reminiscent of the early stages of the pandemic. Last year, seven temporary hospitals were set up around the country in convention centers and other facilities, though they closed in March this year as the demand for hospital beds subsided.
The new centers will be placed on the grounds of existing hospitals to make it easier to move staff and equipment, if needed, and to allow access to more specialized care.
Work will begin as early as this week, the health service said, but Powis noted, “We hoped never to have to use the original Nightingales, and I hope we never to have to use these new hubs.”
Hospitals had already been advised to expedite the discharge of any patients who were medically able to leave to clear beds for new cases, and the health service said that hospitals have been using hotels, hospice centers and nursing homes to accommodate them.
Sajid Javid, Britain’s health minister, said that while he, too, hoped the surge hubs would not have to be used, “it is absolutely right that we prepare for all scenarios and increase capacity.”
Paul Hunter, a professor of medicine at the University of East Anglia, noted that even though cases are continuing to rise, they are doing so at a lower rate that previously anticipated. He said that while it was appropriate for the health service to prepare for the worst, that didn’t mean the worst would happen.
“It’s actually impossible to look at the data and say for certain what’s going on,” he said, citing the opaque nature of reporting at the moment and delays caused by the holidays. But there have been some positive signs, he said. The doubling rate of cases appears to have slowed since the start of the month.
While the number of people in hospitals has increased, there still has not been an uptick in coronavirus patients needing the most serious care. On Thursday, some 771 patients were on ventilators, a figure comparable to the start of December.
Deaths have not trended upward, either, with just 64 deaths reported on Wednesday compared with 171 deaths on Dec. 1. On Thursday, 332 deaths were reported, but this included a backlog from the Christmas holidays. But Hunter and others warn it is to early to say for certain if that trend will hold as the number of cases increases.
But some public health experts say the government’s reluctance to impose more restrictions will further burden the health system, and many are pressing for more action.
Peter English, a retired consultant in communicable disease control, said that hospital staff are already stretched thin, and he warned that the measures do not take into account broader public health concerns.
“It will not address any of the problems,” English said. “By the time the problems happen, it’s already too late.”
He is urging stricter mask mandates, restrictions on social mixing and better ventilation in schools among other measures. English noted that it may take a number of weeks before data from the holiday period is collected and analyzed.
“There’s going to be a delay before we see exactly how bad it is,” he said. “And it’s extremely likely that in the second week of January, we’ll look back at the data over Christmas and the New Year and see these rocketing case numbers that weren’t being reported at the time just because it’s a holiday period.”
What is most worrying, he said, is the ripple effect that a surge in hospitalizations will have on the overall quality of health care in the country, as hospitals come under major strain and are forced to halt less urgent care. Those seeking critical but nonemergency medical treatment are likely to be the hardest hit.
Doctors and nurses working in the national health system have also raised alarms; anecdotes on social media from workers on the front lines paint a partial picture of just how difficult the challenges are.
Many pointed to the disconnect in England between the government’s decision to allow nightclubs to remain open and New Year’s Eve gatherings to continue without restrictions, even as temporary field hospitals were being erected.
“If you are planning to build a field hospital in a car park and to care for patients in an understaffed tent,” Dr. Matthew Knight wrote in a post on Twitter, “I think you can justify stopping a few New Year’s Eve parties and asking everyone to stay at home for a fortnight.”