Hospitals may only treat patients likely to survive

[Kmx123]

Safe to say my anxiety Is now through the roof

apple.news/Ay4fqP_ODSsSYPGb_13nfpw

It's not a nice thought but it's the most sensible thing to do in a crisis.

I read a report coming out of Italy 3 days ago which said in a certain place people over the age of 60 were not being treated - very scary

The UK has one of the lowest person to bed ratios in the entire developed world. Hospitals trying to operate above their capacity is a normal day in the NHS. We have nothing extra to deal with something like this. So yes, sadly when this really kicks off there will be far more critically ill people than there are ICU beds, and we will have to choose who we try and save.

They do that now, don't they?

When it comes to transplant lists and things.

Probably ICU beds too.

How will those not treated be cared for? Will they be allowed to be taken home, if family are there?

Will we be able to assess ourselves beforehand? For example knowing what the age or health exclusions will be, so we get the chance to decide that as we won’t be given that life saving treatment we’d prefer not to spend our last hours in a corridor but stay at home with those we love, knowing we are accepting the consequences.

Is there any medication or equipment we can reasonably have at home to make such a death as comfortable as possible?

Well, the person will be asphyxiating neome, probably relatively slowly over quite a protracted period. It’s going to be quite scary for the person dying and probably traumatising for those that have to watch it happen

What I mean, is it won’t be ‘going home to die peacefully’. It won’t be peaceful by any stretch

You wouldn’t send a dog home to die like that

This isn’t new. My mum has heart failure but because of other medical issues that she has the Drs have told us that they won’t be treating her for the heart failure and are just keeping her comfortable until the end comes. I think that this goes on a lot in day to day life. I know that they can’t save everyone but so hard When it’s one of your loved ones.

It didnt have to be like this though, did it?
So why is everyone acting like it is inevitable?
There was time to do what was needed.
Also why was the government saying that the NHS was well equipped to deal with the virus if they are now having to make choices like this?

My mum has COPD and often ends up in hospital with pneumonia. A few years back after a particularly nasty bout the consultant took me and my dad into a side room and explained;

That ultimately they were dealing with lung failure
That they would continue to treat infections with antibiotics
They would not recommend my mum be intubated if things got worse
They would not put her in icu
They have made the decision that her notes should read 'do not resuscitate'

My mum was 65 at that time. She's still with us two years later but her quality of life is poor, she suffers from memory issues due to oxygen/carbon monoxide problems and has almost constant infections.

What I'm getting at though is that hospitals have to make the decisions all the time about who would/would not be suitable for icu or resuscitation. This isn't new. Yes, the NHS is underfunded and will likely be on its knees soon due to Coronavirus but...but, I've no doubt they would do whatever was in their capacity to do for people in their care at that time. If it does sadly come to prioritising an otherwise healthy person for an icu bed than someone who is likely to never fully recover from covid19 then they have to do the right thing, don't they?

A lot of these patients will be patients that COULD survive, but there isn’t enough equipment/staff. On a massive scale. It is war time medicine. There will be no ‘making people comfortable’

www.theguardian.com/world/2020/mar/13/italian-doctor-an-experience-i-would-compare-to-a-world-war

‘Patients over 65 are not even being assessed’
metro.co.uk/2020/03/10/italian-doctors-forced-choose-save-coronavirus-12377883/

All the more reason for people to stop being selfish and consider how their actions could affect others

I think the same doctors also had to make the decision not to assess/attend people under 65 with relevant kinds of underlying conditions.

I do think that a lot will depend on the age of most of those infected. People over 65 make up I think around just under 20% of the population. How much of the infected population will be made of up these older people or of younger people with significant underlying issues will be key. If most of the infected people are younger and healthier then they are much less likely to need ICU support and the NHS could cope much better. In Italy it seems that older people were actually disproportionately represented in terms of numbers infected, I do not know why. What we need to do here is really focus on protecting the more vulnerable and elderly from becoming infected.

I’m afraid this was obvious from the start, it is as a PP said akin to a war type situation. This is why everybody needs to act responsibly and play their part.

Thats always been the way. The cost of intensive care means that those who will benefit most from their care go there.

Others will go to different wards. It does not mean you wont get care.

Where i worked there was a specific stroke ward with 20 beds. If a bed was available and 2 stroke patients arrived at at A&E , the patient who was more likely to respond to the treatment would get the specialist bed. The other would go to an acute medical bed. So both get treatment. Its often hard to explain all the protocol if somebody has not worked there.

will go to different wards. It does not mean you wont get care

Yes. It does mean they won’t get care.

Corona patients won’t go to another ward. They won’t be assessed, they won’t be treated

Others will go to different wards. It does not mean you wont get care.

Everywhere else will fill up very quickly. The hospitals will be overflowing. And they won't want people wirh the virus spreading it to all the other vulnerable patients in the hospital. That would cause more deaths.

So yes, it absolutely does mean that won't get care.

Will GPs and community hcps give palliative care at home,?

My DM is 85 and has alzheimer's so would not receive active treatment but the thought that she would be left to slowly drown at home, with a ravaging cough is terrifying me

There aren't enough critical care beds and nurses. It's basically going to be about making choices. 3 patients one bed who will benefit the most? Think war not normal nhs process and policy!

But why must we think war when there could have been precautions taken?
It seems like survival of the fittest and 65 is not even old.

This makes me larf. Not.

BJ's government wants to bring back post-retirement GPs and nurses to man the barricades. Hang on...aren't they like, old?

But seeing as the younglings will just have the sniffles, shouldn't they be kicking anyone under 60 to the kerb?

gerti care for elderly people is being ‘stepped down’... presumably the idea is that they don’t want HCP spreading it . GPS are not seeing anyone with symptoms

On another thread, there is a manager of a care home; talking about quitting her job. 8 of her staff self isolating, not enough staff to care for residents

I’m in the same situation with my dad and my husband has a lung condition. I am furious that they are considered collateral damage. I suppose if they got sick NOW, they may get treated. But give it a week, then no. An 85 year old with dementia is going to be at the back of the queue