Coronavirus: Seven Covid-19 deaths now recorded at Addenbrooke’s but no sharp increase in new patients yet
Seven patients have now died at Addenbrooke’s Hospital after testing positive for Covid-19.
As of Friday (April 3), the Cambridge hospital had 79 inpatients with confirmed cases of the coronavirus and a further 35 waiting test results.
There are 23 Covid-19 patients in critical care, with one waiting for results, and the hospital now has 100 ventilators to help the patients with severe cases, with more machines on the way.
Roland Sinker, chief executive of Cambridge University Hospital NHS Foundation Trust, which runs Addenbrooke’s, said: “Our thoughts are with the families of those who have lost their lives during this outbreak. It is a sobering fact that their grief may well be more complicated as a result of the visitor restrictions that are in place at this time.
“This weighs heavily on all of our minds and while it is an essential protective measure, I know how hard it must be for those who are implementing this with relatives across our clinical services at the moment.”
He added: “We continue to admit around eight to 10 patients per day and have not yet seen the sharp increase to around 25 patients per day predicted by the modelling.”
And there were examples of patients recovering from severe infections, Mr Sinker confirmed.
“There is good news in that five patients have left critical care for ongoing rehabilitation on a ward and over 50 patients have been discharged home,” he said. “The care we are providing and the depth of our clinical expertise is having a growing impact as we work together to save lives.”
Outlining the trust’s strategy, Mr Sinker said: “Our strategy remains to work together to save as many lives as possible and keep our staff safe. These are equal priorities.
“When we think about saving the lives of our patients we are thinking about both Covid-19 positive patients and also those who may be entirely reliant on our specialised clinical services in cancer care, transplantation, neurosurgery and more.
“This balance is at the forefront of our minds as we move into the next phase of our planning. We are working across the whole region and with the private sector to explore all available options to keep both aspects of our services running as effectively as possible in the coming weeks and months.”
As the Cambridge Independent has reported, modelling by the hospital forecasts that 460 beds could be needed for Covid-19 patients, including 135 critical care beds.
He said the trust had made “some really significant progress across all of the taskforces we have established to meet this challenge” this week, which include critical care (ventilation and oxygen), personal protective equipment (PPE) and testing.
Thirty extra ventilators were delivered to the site in the last week, meaning there are now 100 available
But Mr Sinker said: “We are aiming for at least 135 ventilators to manage the peak of demand that we have modelled. However, we are also building in a further stretch target as contingency and will seek an additional 50-100 ventilators through a variety of potential supply routes.”
The trust has made a bed plan to meet this peak demand, planning dynamically which beds will become available, in which order.
Mr Sinker confirmed there were “no major concerns in relation to staffing levels and this a testament to people’s willingness to be redeployed, to be flexible and to be there for each other and our patients”.
And he explained: “Training is being provided for specific skills in critical care, respiratory care, tracheostomy care and for staff returning to inpatient ward areas, both adults and paediatrics.
“We are also receiving support from our research nursing team, and offers to join the trust bank from people who have joined the temporary registers are being received and worked through by our recruitment team.
“We have been truly humbled by the number of people who wish to come and work at Addenbrooke’s and the Rosie Hospitals, to provide support to our current teams.”
Ensuring there is sufficient oxygen supply across the site is also a critical part of the hospital’s planning, said Mr Sinker.
“As we prepare for the peak of Covid-19 cases, we have been working hard to understand the supply of piped oxygen across the site because it is likely that we will need to deliver more oxygen than we have previously needed to.
“We are continuing to work to establish the maximum amount of oxygen we can deliver to each area across the hospital.
“Our clinicians are working to help us understand what the likely peak demand will be, based on the numbers of patients expected and the variety of different oxygen treatments that will be used, including oxygen masks and invasive ventilation, as each therapy (and in some cases each machine) requires very different flow rates of oxygen.
“As contingency, we have also ordered a significant number of additional oxygen cylinders and concentrators and have made a national request for additional capacity for our piped oxygen to cover any higher than expected numbers of Covid-19 infections than are built into our modelling.”
With more personal protective equipment arriving and being donated to the hospital, Mr Sinker said the trust had overcome “a significant hurdle” by clarifying PPE advice and guidance for staff following “a week of intensive clinical discussions”, which has prompted training and reassurance across all clinical areas.
In the week that health secretary Matt Hancock set a target for testing rates to be stepped up to 100,000 a day by the end of April, Mr Sinker said: “Testing for coronavirus is not a simple business. It is a complex process requiring reagents that are now in short supply globally. I would like to pay tribute to staff working in the PHE laboratory on site here at Addenbrooke’s for their tireless work to increase our testing capacity and turnaround times which are important for the whole region’s inpatients.
“There is particularly good news for us here at CUH thanks to the University of Cambridge and its ability to mobilise around this kind of highly technical scientific challenge.
“This week we have received positive national recognition for supporting the introduction of new point of care testing for coronavirus which is now being used on our assessment ward N2. The test, using a machine called Samba 2, has a turnaround time of between 30 and 90 minutes compared with around 24 hours in the PHE laboratory.
“This methodology is being verified through duplicate testing in the PHE laboratory, but once validated could increase our capacity and relieve pressure on the regional testing service.
“I am hugely grateful to the university for driving this forward.
“A second testing project is also under way which uses a different method again and which may come on-line in the next week or two. An advantage of our locally-developed methods is that they use different reagents than those being used by the PHE facility.”
The aim was to test not just inpatients, but frontline staff, he said, providing reassurance and easing the challenge of filling rotas.
“Over the next few days we are focusing on securing more consistent and stable supply routes for PPE and pressing ahead to expand our testing capacity so that it can encompass our frontline staff,” he said.
“We are also focused on undertaking vital regional planning to secure safe, high quality care for Covid-19 positive patients as well as patients who rely on our specialist services.”
Mr Sinker concluded: “We are seeing a new hospital come into being as we respond to this public health crisis. Different priorities have emerged that are changing the nature of our work, our routines and the people we work most closely with. But many things here are just the same, such as our values of working together to be safe, kind and excellent.
“We are committed to providing expert care, delivered with kindness, and pushing at the boundaries of what modern medicine can achieve.”
Globally, there have now been more than one million confirmed cases of the coronavirus, with more than 59,000 deaths.
In the UK, there have been 38,168 confirmed cases.and the number of deaths has risen every day since Tuesday. On Friday, there were 684 deaths from Covid-19, taking the total to 3,605. It is forecast that this rate could rise further.
But there is some evidence that the rate of new infections is slowing - a sign that the social distancing guidelines and government instruction to stay at home is having an impact..
Among those who have died are two nurses - Areema Nasreen, 36, who spent weeks in intensive care with the virus, and Aimee O'Rourke, 39, who died at the hospital where she worked.
England’s chief nursing officer Ruth May urged the public to heed the guidance to stay at home.
“This weekend is going to be very warm and it will be very tempting to go out and enjoy those summer rays.
“But please, I ask to remember Aimee and Areema. Please stay at home for them,” she said.
More by this authorPaul Brackley