UK COVID-19 Daily: Boris Johnson moved to intensive care

  • Tim Locke, Medscape.com

  • UK Medical News
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

On Monday, Downing Street said Prime Minister Boris Johnson has been moved to intensive care after his coronavirus symptoms worsened. The statement read: "Since Sunday evening, the Prime Minister has been under the care of doctors at St Thomas’ Hospital, in London, after being admitted with persistent symptoms of coronavirus.

"Over the course of this afternoon, the condition of the Prime Minister has worsened and, on the advice of his medical team, he has been moved to the Intensive Care Unit at the hospital.

"The PM has asked Foreign Secretary Dominic Raab, who is the First Secretary of State, to deputise for him where necessary.

"The PM is receiving excellent care, and thanks all NHS staff for their hard work and dedication."

PM Running the Country From Hospital Bed

"If the Prime Minister is ill enough to need to be in hospital, how can he be well enough to run the country at a time of national emergency?" 

"Should individuals who have been hospitalised with coronavirus continue to work from their hospital beds?"

"He's not superhuman. Some would argue that he is taking too much of a risk." 

Just some of the points journalists made at the daily Downing Street briefing to try to get clarity on the Prime Minister's health and ability to run the country from his bed at London's St Thomas' Hospital.

Foreign Secretary Dominic Raab is chairing the Government emergency COVID-19 committee while Boris Johnson is in hospital. Mr Raab said: "The PM had a comfortable night in hospital, and he's in good spirits. 

"He's still in hospital under observation. He's been given regular updates on developments. And he continues to lead the Government." 

However, "Saturday was the last time I spoke to him in person," Mr Raab said.

He wouldn't be drawn on whether it would be better if the PM stepped back, even briefly, in order to recover properly but said. "He'll continue to take doctors' advice on what to do next." 

Government Chief Medical Adviser Professor Chris Whitty was back at work on Monday after self-isolation. "My advice to the Prime Minister was to take the medical advice of the excellent NHS doctors who are advising him, and I'm sure he'll continue to do that," he said.

"The only bit of advice I gave in addition to that was, as widely reported, I did advise him to get tested in the first place because I thought that was prudent. But after that I didn't wish to muddle my role with him. I'm not his medical practitioner. I'm his adviser on wider issues."

He did, however, give a general assessment about people with COVID-19 who are admitted to hospital: "The  clear majority of people who do end up going to hospital, they end up going into a general bed, they may or may not need oxygen and other things, and they don't need to go further than that."

But should someone admitted to hospital still be doing any work? "Patients of mine, to be clear, that is definitely not the Prime Minister," Prof Whitty said, "There are some who are ...perfectly capable of managing massively complicated things from the hospital bed, others clearly are not. That is absolutely a conversation between the individual and the doctors and nurses who are looking after them." 

Lockdown measures are due to be reviewed at the end of this week. Prof Whitty was asked if it was clear they'd have to continue beyond this first 3 weeks: "We do not think we know for certain that the peak will be at the end of this week.

"I think until we're confident we're there, that will be too early to start calling the point where we can make moves to the next phase of this epidemic." 

Mr Raab said it was too early to spell out any lockdown exit strategy: "We do not want to confuse the message right now because we are not past the peak, to get past the peak we must have people respecting those guidelines, otherwise we undo all the good work that so many people have achieved and contributed to through their forbearance, particularly as the weather gets a bit warmer."

Another Nurse Remembered

There was a rise of 439 UK hospital COVID-19 deaths reported today, taking the total to 5373. That's far lower than in recent days, but there could be a 'weekend factor' in delayed reporting.

Of those deaths, 403 were in English hospitals. NHS England said the patients were aged between 35 and 106. Fifteen of the patients aged between 52 and 94 had no known underlying health conditions.  

Among recently announced deaths of healthcare workers was staff nurse Liz Glanister from  Aintree University Hospital in Liverpool, who died on Friday.

In a statement: Liverpool University Hospitals NHS Foundation Trust Chief Nurse Dianne Brown said: "It is with great sadness that I can confirm that Liz Glanister, a long-serving staff nurse at Aintree University Hospital, sadly passed away at the Royal Liverpool University Hospital on Friday after being tested positive for COVID-19.

"All our thoughts are with Liz's family at this time and we offer them our sincere condolences.

"Liz will be sadly missed by all those who knew and worked with her."

Medscape is making sure healthcare workers around the world who died while tackling COVID-19 are remembered: In Memoriam.

Scotland's Interim CMO Starts Work

Dr Gregor Smith has stepped up from deputy CMO to become Scotland's interim CMO after Dr Catherine Calderwood resigned on Sunday. 

She admitted to breaking her own lockdown advice with two visits to her second home and had been given a warning by police.

Nicola Sturgeon said: "It is not ideal, as First Minister, in the midst of a virus outbreak like this to lose my Chief Medical Officer, the Chief Medical Officer of the government, and I wanted to continue to have her advice but I came to the conclusion, it was not possible to do that without risking the Government's message, which is why we came to the view last night that it was the right step for her to resign."

Dr Smith was asked how he'd rebuild trust in lockdown messaging: "Certainly from my team, the behaviours that I expect of all of them is to model those very behaviours they're asking of others," he said. 

In a statement, BMA Scotland Chair Dr Lewis Morrison, said: "This is clearly an extremely disappointing situation in many respects. While the CMO has herself admitted to errors of judgement, it is now absolutely crucial to focus on the clear message that people across Scotland need to stay home to protect our NHS and save lives."

'PPE Shaming'

The Doctors’ Association UK (DAUK) has published new data collected from its PPE reporting app and nhsppe.com. 

Data from 500 reports across 193 trusts and GP practices show: 
  • 43% of doctors do not have any eye protection 

  • 72% of doctors do not have access to FFP3 (respirator) masks 

  • 77% of doctors do not have access to long-sleeve gowns 

  • 60% have not been ‘fit tested’ for masks

Of those carrying out aerosol-generating procedures:
  • 20% do not have access to eye protection

  • 42% do not have access to FFP3 respirator masks

  • 49% do not have access to gowns 

DAUK said it has heard from doctors who had been bullied or shamed into not wearing PPE because of shortages. 

Its President, Dr Samantha Batt-Rawden, said in a statement: "Lack of personal protective equipment continues to be a critical issue. It is heartbreaking to hear that some staff have been told to simply ‘hold their breath’ due to lack of masks. Doctors are dying. Nurses are dying. We are devastated, and can no longer stand by and watch as more dedicated colleagues lose their life." 

More News in Brief
  • Calls and online requests to The National Domestic Abuse helpline have risen by 25% since the lockdown, the charity Refuge said on Monday. There are concerns that isolating and social distancing restrictions could increase domestic tensions and prevent those who have been abused from getting somewhere safe.

  • Experts have been commenting on reports of a tiger at a zoo in New York testing positive for COVID-19. What does this mean for domestic pet cats? "Nothing new – at present there is still only one suspect case where an owner has spread the virus to their pet. It is possible that tigers in captivity are more susceptible to the virus than household moggies as there is a 5% difference between their genomes," Dr Sarah Caddy, vet and clinical research fellow, University of Cambridge, told the Science Media Centre. "The bottom line is that there is no evidence that any cat, large or small, can transmit virus back to humans."

  • When Dr Tom Roberts' bike was stolen from the University Hospital of Wales in Cardiff, he took to Twitter: "To the person who stole my bike while I was working on the intensive care unit - I hope you enjoy it." The tweet was answered by Team INEOS Tour de France rider Luke Rowe, who is donating a new bike to Dr Roberts. "Thanks so much @lukerowe for the really kind gift of a new bike. Really appreciate it!"

  • Golf's Open, due to have taken place in July at Royal St George's in Kent, has been pushed back to 2021. Martin Slumbers, R&A chief executive, said: "Our absolute priority is to protect the health and safety of the fans, players, officials, volunteers and staff involved in The Open. We care deeply about this historic Championship and have made this decision with a heavy heart."

Adapted from Medscape UK.