Anyone else worried about the way in which DR’s will have to prioritise patients?

[Potkettlexx]

Just thinking, if it comes to the point patients outweigh supply of intensive care beds etc... or ventilation etc then how are they going to decide who gets them.

For example if there’s no beds left and a 40 year old female gets admitted with 3 young children. What would happen? Would they take the older person in their 80’s out of ICU? Is it going to get that bad?! Rhetorical question.

This is the stuff that’s worrying me rather than whether I’ve got enough bog roll!

Potentially, I can't imagine the medical professionals are too excited about the idea of having to do so if it comes to that either. The truth is that nobody knows what numbers we will be looking at aside from projections which aren't always accurate, and the severity. It would be naieve to think that it's not likely though, unfortunately.

Yes there will be difficult decisions to be made.
But doctors and nurses make them all the time- there will just be more than usual but the processes used to make them will be the same. Ethics around rationing of healthcare is well known.

It is really important for doctors to discuss in advance with very elderly or frail patients what their actually wishes are for escalation of care so that those who do not want to receive intensive cafe don’t end up being given beds that can go elsewhere.
Advanced care planning has never been more important

Try not to worry OP

It’s possible there will be an age and health criteria. So if the 40 yo is an obese, diabetic neither she nor the older person would get the bed - but it would be earmarked for someone healthier even if that person isn’t there yet. ICU isn’t a joke - you often need to be fit and healthy just to survive it. Having said that, however, I am convinced this type of rationing will disproportionately impact poorer people - the rich elderly tend to be healthier than the poor elderly and so death rates for the former may be a lot lower than the latter.

My mum, who is pushing 80, said she had heard coronavirus was worse in the old and very young. Then the narrative changed to just the old, and she said her first thought was "thank god for that". She'd drag herself out of the bed if she was capable to give it to a child.

Would all be more of a moot point if we had an NHS that was well funded, staffed and looked after. But we don't have enough beds for an average flu season or Saturday night so here we are.

It is going to get that bad. It's already that bad elsewhere. I'd rather there was an age/health criteria than a first come first served (guess who gets ill quickest)

It certainly seems like we could’ve heading down that route as you say, it’s hardly well funded so there will be times where health/age will need to be priority I guess.

Very good points raised about a younger, but obese person compared to an older but healthier person.

Tough times ahead

I keep thinking about people like the homeless who can't get admitted on a good day. In the States you're talking about millions. A city like LA is going to have bodies piled in the streets if it infects the homeless population.

I read that in Italy they aren’t even treating the over 65s or people with severe co-morbidities now. They don’t have the ICU beds or equipment for everyone so are having to prioritise the younger and healthier.

One of the long lasting effects of this virus will be the toll on the mental health of the healthcare workers who will have to make these decisions. Just because they are used to making difficult decisions doesn’t mean that it doesn’t affect them.

They are already planning to use the 'three wise men' protocol when three senior hospital consultants prioritise based on age and existing conditions.
www.google.com/amp/s/www.independent.co.uk/news/health/coronavirus-uk-deaths-nhs-intensive-care-flu-wise-men-protocol-a9361916.html%3famp

What most people don't get is that being obese lowers your chance of survival.....if the three wise men have to a choose those that are fat get beds after the fit and trim. This isn't just making a call between a 90 year old and a 40 year old.

Will they just turn patients away to die a particularly distressing death or will they at least provide sedation to ease suffering. I imagine the former.

In Italy they bought in 5000 be ventilators and new ICU beds. They put up tents made ready loads of extra beds. They have brought back retired health professionals and rushed through Ney qualified students

Even then they were overwhelmed within a couple of weeks or so) We are not even doing that as far as I can see

Some people will already have advance decisions in place refusing life sustaining treatment, so that will be another factor. Not everyone will want their life prolonged/preserved at any cost.