Demand for critical care from coronavirus patients in Wales ‘lower than expected’

The number of coronavirus patients in Wales needing critical care is less than half of what it was during the peak of the virus despite rising hospital admissions, the chief executive of NHS Wales said.

Dr Andrew Goodall (pictured) said early intervention by doctors, aided by increased testing, and improvements with oxygen therapies meant that both demand on intensive care units and mortality rates were lower compared with April.

Demand for critical care capacity in Wales is 60% lower than at the peak, with 57 people currently receiving treatment, while 1,275 people currently occupy hospital beds because of Covid-19 in non-critical care areas.

The number of Covid patients occupying non-critical hospital beds is just 9% lower than it was in April and is the highest amount since that time, with numbers expected to rise further in the coming days.

But Dr Goodall said increasing admissions were not resulting in greater demand for critical care beds, saying the numbers were “lower than expected” and represented “a good sign”.

He told the Welsh Government’s Covid-19 briefing on Tuesday: “By now I would have expected, if it was the first wave’s experience, to have seen more coronavirus patients in our critical care areas.

“I think that’s a good sign, of course, because we don’t want patients to be in critical care with coronavirus. We want them to be supported and to be able to be discharged home safely and back to their family arrangements.”

Dr Goodall said using oxygen treatments instead of putting patients on ventilators was proving a “more effective” way of treating patients compared with the first wave of the virus.

That, added to early interventions, was also leading to lower death rates compared with the peak not just in Wales but across the UK.

“With the high level of testing that is going on across Wales at the moment, it does mean we’re identifying people with coronavirus earlier,” Dr Goodall said.

Public Health Wales data showed that 10,212 Covid-19 tests were carried out on Monday, with overall testing capacity in Wales said to be around 15,000.

Asked about Liverpool piloting city-wide testing, Dr Goodall said NHS Wales was involved with discussions about “targeted actions”, and added “we may well have some opportunities to do similar in Wales”.

Dr Goodall said the next “two or three weeks” would be important for the NHS in anticipation of Wales’s 17-day firebreak lockdown having an effect on the number of hospital admissions.

But he warned that if transmission rates and admissions continued to increase, it could lead to the health service becoming “overwhelmed”.

He also said it was proving “incredibly difficult” to prevent transmission of the virus in hospitals, after Cwm Taf Morgannwg University Health Board reported another 30 deaths linked to Covid-19 outbreaks at four of its sites.

A total of 99 deaths have now been linked to infections caught at the health board’s hospitals, with 51 of those at the Royal Glamorgan Hospital in Llantrisant.

The outbreaks have also been linked to 469 cases of Covid-19, with medical director Dr Nick Lyons saying his health board was facing “some difficult times”.

Dr Goodall said: “I want to be clear, this is not as simple as a failure of handwashing or poor infection control procedures.

“This virus is highly infectious and it can be passed on at asymptomatic, pre-symptomatic, and symptomatic stages of the infection.

“It is incredibly difficult to prevent its spread in busy healthcare environments, especially with around 90 people with Covid currently admitted each day.”

On Tuesday, Public Health Wales said there were a further 1,119 cases of coronavirus in Wales, bringing the total number of confirmed cases to 54,456.

A further four deaths were also reported, taking the total in Wales since the start of the pandemic to 1,895.

Copyright (c) PA Media Ltd. 2020, All Rights Reserved. Picture (c) The Welsh Government.