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  • officially opened with great fanfare on Friday and still there, waiting at the Nightingale Hospital in the Excel Centre for any of the beds to be used.

  • Channel four News understands that the 1st 8 intensive care patients will be transferred tomorrow.

  • But we also understand that many of the beds may never be filled.

  • New modeling shows they may only ever need 300 of the time intensive care specialists have learned a hard lesson from Italy that the numbers who benefit from I, c.

  • U and ventilation a lower than first thought.

  • What we've learned from our colleagues in Europe, handsome from some early data in this country, is that sometimes with this particular condition, people with extensive underlying illness on people who are older tend to do less well.

  • And that's meant that our decision making has, if you like, the goalposts have moved slightly, and it's not always the right thing to do to put someone on a ventilator with covert 19 and today.

  • At the Downing Street press conference, they also said social distancing may be working in the number of cases in our hospitals is not as bad as it would have been if we had not made these efforts, so it is working.

  • But the big question is, is it?

  • Is the virus spread slowing down enough to make hospital admissions stabilize and then even full?

  • Is there any suggestion that maybe you won't need a CZ many beds as the the Excel Centre of the Nightingale, as you had expected?

  • If we end up in a situation where we have Maur, I seeyou beds at all times during this epidemic than we absolutely need to deal with with Cove, it and other areas that will be a success.

  • That is something which is critical for our overall A.

  • It is part of the steep and distressing learning curve that has become this pandemic.

  • So many questions, still too few answers.

  • But here is an attempt.

  • Bart's Hospital and London is testing healthcare workers so research can look at.

  • Why does one person, for instance, the prime minister end up in hospital while another, for instance, the health secretary is able to return to work seven days later?

  • The potential use of this research is to design personalized with scores for people based on their prior viral exposures or genetics to detect the earliest.

  • Change the disease to design a prion post exposure prophylaxis.

  • Look at the immediate changes after infection with the prior blood sample so that weaken help develop the antibody essays that are appropriately sensitive and specific to check for the waning of immunity after an infection.

  • To ensure whether or not immunity, what is likely to be sustained over time to create understandings of hospital chains of transmissions as to whether or not health care workers actually getting it in certain areas of the hospital, they want to recruit 1000 health care workers.

  • And because this was set up with incredible speed, it took them eight days.

  • They've been fundraising to pay for the research.

  • The traditional funding roots take too long.

  • There is a feeling now of pressure, building up the warnings that peak of admissions could come around Easter time and staff absences.

  • Air still high to Royal College is estimating as many as 25% either self isolating or infected.

  • We'll go into how you gonna wrap the deceased with as much dignity and respect to the families onto the deceased as possible thes are specialist teams being trained to respond to suspected covered 19 deaths in the community across London, police officers, Fire and Health Service's staff.

  • They will confirm the person's identity, that they are dead and that there are no suspicious circumstances.

  • This is sad but necessary planning, as it's now estimated that the number of people dying in the community is 30% off all covered deaths today, London's mayor, Sadiq Khan, said 10 public transport workers have died in the capital after testing positive and on a daily basis now are reports of patients being transferred between hospitals because of a lack of capacity off morgues filling up and of equipment and drug shortages.

  • The N HS right at the heart of this crisis on Victoria joins us now as she does every night.

  • Good to see Victoria.

  • Yes, Matt, a TTE.

  • The beginning of my piece there I was talking about whether the Nightingale will ever be used to the capacity we were told.

  • 4000 beds.

  • Now it seems funny to build these infrastructures right across the UK and then not use them.

  • But that's really what they want to do.

  • Sadly, some of the evidence out of Italy is that there is no point putting some of the very elderly, frail people with lots of co morbidity.

  • He's on ventilation, so they're making hard decisions.

  • But in fact, this is what intensive care doctors and specialists have to do every day anyway.

  • And we will hear more about that.

  • The further down our program now.

  • There were some quite alarming reports over the weekend of hospitals running out of oxygen.

  • Is that actually true?

  • Yes.

  • What for?

  • General actually had a problem.

  • It comes down to good planning.

  • Now.

  • What I've been told by a chief executive of one hospital is that you you have to look at the size of your pipes, the capacity of your oxygen tanks and how many machines Aaron use, and you should be able to see in advance when it's going to come a problem.

  • And that's why we've been seeing patients being moved around from one hospital to another two.

  • As they become aware that the oxygen is going to be an issue at that hospital.

  • It's not about oxygen supply.

  • It's about the hospital's ability to get the supply through its system.

  • Oxygen, plumbing, Victoria Thanks very much indeed, for joining Me now is Dr Anthony Castelo, who's professor of global health at University College, London, the former director of the World Health Organization.

  • Thanks for coming on the program again.

  • Anthony.

  • Let's just start with one thing to clear up.

  • You know, we heard the prime minister symptoms described, as you know, is mild.

  • And then he seemed to be getting better than he seemed to be getting worse.

  • This is sort of the rhythm of the disease, isn't it?

  • Yes.

  • I mean, he's got a very good team of physicians.

  • I'm sure they're assessing him.

  • They've obviously wanted to do some tests, but if he's feeling reasonably well, there's no reason why he shouldn't continue working.

  • And I'm sure they'll come to the right decision.

  • But also in the sense that he might feel he's getting better one day, and then the next day he's going to get worse again.

  • I've heard that described with quite a lot of patients.

  • Yeah, that may be the case.

  • Okay, let's move on to the wider picture, then.

  • I mean, he is.

  • The prime minister is in his mid fifties.

  • That's my age as well.

  • There seemed to be an awful lot of patients in I C U in their mid fifties or younger.

  • Have we basically sent out the wrong message from the very beginning of this disease by saying that it only really effects seriously, people above the age of 65 or so, Yeah.

  • I mean, this is I mean, obviously, that is an older age group who are more risk.

  • But, you know, if we want to really suppress this disease and I'm still unclear from the press conference today, there's been good progress with surge capacity.

  • The social distancing is working.

  • But I'm really not clear whether this is a delay policy to let the epidemic run smoothly all on build herd immunity or whether we are really trying to suppress the disease so that younger people that you're talking about will not get it and that for that we've got to suppress the chain of transmission.

  • And to do that, we've gotta find the the virus.

  • And I spoke to a world expert on epidemic control the other day on Dhe.

  • You know, I said, will social distancing work on dhe?

  • They said no, not a though this is guerrilla warfare.

  • You've got a bundle of measures that you got to do.

  • You've got to get out into communities, talk to people who've got symptoms, reassure them, find their contacts, sort their problems out on, monitor their symptoms and go back and do that repeatedly on.

  • You've got to do it at speed.

  • We've been a bit slower.

  • That's why our death rates are much higher than the Asian states.

  • But we've got a public health system to do that.

  • In fact, it was the influenza surveillance people that picked up the first cases off a Corona virus here on, I think that we need to mobilize now that we've got this much bigger problem of getting out to communities without primary healthcare teams.

  • I think we've got environmental health officers trained in contact tracing.

  • We've got 750,000 volunteers, many of them with clinical the nursing skills.

  • So I think we could tap into that even if we've been a bit late to the party and then we can suppress it, and I think that's an important difference from a delay policy.

  • But just to be clear, the government would say that it ditched the herd immunity policies sometime ago.

  • It's not all about suppression.

  • You don't think that they've got there because they're not doing all the things they need to do in order to suppress the infections.

  • Well, I think they can boost it.

  • I mean, I hope it's not clear to me because they stopped formal contact tracing on March the 12 and I haven't heard them say that they were reinstating that.

  • Personally, I think that should happen over the next month because really, what we want to focus on other 3% of people who have caught the infection or contacts rather than closing the entire economy down on affecting, you know, 80% of us on the evidence is mounting that this approach to case detection, testing, isolation and close follow up in the community is a much more effective and efficient way.

  • And it will get the the epidemic down much quicker, right?

  • Just in 10 seconds.

  • What you're saying is that if we have a lock down on, we test, but we don't do the tracing.

  • There's no point to the lock down because we're not going to solve the wider issue.

  • Well, you're not gonna find all the cases and and we need a mechanism to monitor that you see, in career and China Singapore.

  • That's what they're doing.

  • They're well aware that this may come back up, but because they've got their death threats right down much lower than us, they've now got a mechanism to go look for it.

  • That's really important on.

  • We should be holding the government to accountable.

  • Okay, Professor Anthony Castelo, Thank you very much indeed.

officially opened with great fanfare on Friday and still there, waiting at the Nightingale Hospital in the Excel Centre for any of the beds to be used.

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