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Coronavirus: Half of all intensive care patients won't live, says Belfast ICU doctor

Let family know if you want to be ventilated, senior doctor advises

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Intensive care consultant Dr Paul Glover

Intensive care consultant Dr Paul Glover

Kevin Scott / Belfast Telegraph

Health Minister Robin Swann and Chief Nursing Officer Charlotte McArdle during a visit to Northern Ireland’s Nightingale Hospital, based in the City Hospital, yesterday

Health Minister Robin Swann and Chief Nursing Officer Charlotte McArdle during a visit to Northern Ireland’s Nightingale Hospital, based in the City Hospital, yesterday

Michael Cooper

Intensive care consultant Dr Paul Glover

People across Northern Ireland should discuss with their families whether they want to be ventilated if they become critically ill with coronavirus, a senior doctor has said.

Dr Paul Glover, who heads up intensive care medicine in the Belfast Trust, said it is expected that half of Covid-19 patients admitted to ICU will not survive.

As a result, he said it is essential people have the difficult conversation with their next of kin ahead of the anticipated coronavirus surge.

The intensive care consultant was speaking as staff on the second floor of the tower block at Belfast City Hospital - Northern Ireland's Nightingale Hospital - prepared for the arrival of the first critically ill patients.

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Belfast City Hospital

Belfast City Hospital

Kevin Scott / Belfast Telegraph

Belfast City Hospital

"When you work in critical care, part of our job is making decisions, in discussion with the patient and their families, as to whether a patient should be ventilated," he said.

"We have to decide whether being ventilated is in the patient's best interests and whether it will be of benefit to them. The decision-making process for Covid-19 will not be any different from the one we already have in place.

"However, it would be useful for families to discuss their wishes with one another. It's always much easier to make decisions in the cold light of day as opposed to making a decision in an emergency situation. It's almost like the debate that we encourage people to have around organ donation. Having that conversation and knowing what your loved one would want to happen to them if they have to be ventilated will relieve families of a burden of responsibility.

"If they know that their relative had said they didn't want to be put on a life support machine if it wasn't going to be the best option for them, then I think that will make it all much easier."

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Northern Ireland’s Nightingale Hospital, based in the City Hospital

Northern Ireland’s Nightingale Hospital, based in the City Hospital

Kevin Scott / Belfast Telegraph

Northern Ireland’s Nightingale Hospital, based in the City Hospital

According to latest figures, three more Covid-19 deaths were registered in Northern Ireland on Tuesday, bringing the total number of deaths here to 73.

Meanwhile, there were 55 Covid-19 patients in critical care in hospitals across the province on Tuesday afternoon.

There were 17 coronavirus patients already on ventilation machines at the Nightingale Hospital on Tuesday afternoon, with the ICU on the second floor ready to receive patients from Tuesday night.

Dr Glover, who has been an intensive care consultant for 20 years, continued: "At the moment, we are planning for 230 ventilated patients at any one time and there will be patients ventilated in other trusts. We have based our plans upon the modelling of how Covid-19 has been evolving and I am confident in terms of the preparation we have put in place.

"We are planning that each floor will require around 200 nurses and possibly 50 doctors to ensure that it is adequately staffed and so that staff will be able to get some down time.

"Staff will be working long shifts, it will be very demanding, not just the hours that they work but also in terms of the numbers of critically ill patients. We anticipate that up to 50% of patients admitted to intensive care will not survive, so working in that situation is very demanding on staff. We have about 40 intensive care consultants in the trust and all of the doctors and nurses will be working under their supervision, all the major decisions will be made by intensive care consultants," Dr Glover said.

"I think what our response has shown is that there is an overwhelming willingness by healthcare staff to step up and it is unbelievable how staff have pulled together."

Inside Northern Ireland's Nightingale Hospital [Photos] Close

Nurse Marie McNaney showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Nurse Marie McNaney showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

Nurse Marie McNaney showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Nurse Marie McNaney showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

Dr Paul Glover showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Dr Paul Glover showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

General views showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Kevin Scott / Belfast Telegraph

Nurse Marie McNaney showing the new Northern Ireland Nightingale Hospital wards designed to treat coronavirus sufferers at Belfast City Hospital on April 7th 2020 (Photo by Kevin Scott for Belfast Telegraph)

Issuing a plea to the public to stay at home, he continued: "We are as ready as we can be, we are prepared, we have got the equipment that we need, we have got the staff that we need, the drugs that we need, everything is in place.

"But the demand on our services will really depend on how rapidly the pandemic evolves, but the one thing that will control how quickly it spreads is the behaviour of the public.

"People must stay at home, they must socially isolate.

"No-one working in the NHS has dealt with this type of problem before, this is a very contagious virus, with the spectrum of severity of the illness ranging from asymptomatic (no symptoms) to life-threatening.

"There is no major treatment for this illness, there is no medication that will cure everyone and no-one is immune from this virus. Initial reports from China suggested the people who suffered the greatest from this virus were elderly and those with significant medical conditions - however, that isn't the case.

"We are finding that all ages can be severely affected, we have a significant number of people in intensive care who have no underlying conditions.

"We don't know why that is, but it means that everyone must be conscious of their behaviour and do everything possible to protect themselves," he warned,

Belfast Telegraph