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Politicians chose not to equip the UK with enough intensive care units before the pandemic, the government’s chief medical officer has said, as a senior NHS doctor described scenes “from hell” on hospital wards.
NHS hospitals were dealing with the equivalent of daily “terrorist attacks” during the pandemic with wards so overwhelmed they ran out of body bags, former national clinical NHS advisor Professor Kevin Fong told the Covid-19 inquiry.
In a tearful account of the pandemic during Thursday’s hearing, he recalled seeing hospital wards with sick patients “raining from the sky”, with staff so overworked they were forced to wear nappies rather than go to the toilet.
The harrowing depiction of the pandemic came before Professor Sir Chris Whitty, chief medical officer for the government, admitted the number of intensive care unit (ICU) beds in the UK was too low compared to provision in other countries.
He said: “Taking ICU, in particular, the UK has a very low ICU capacity compared to most of our peer nations in high-income countries. Now that’s a choice, that’s a political choice. It’s a system configuration choice, but it is a choice. Therefore you have less reserve when a major emergency happens, even if it’s short of something of the scale of Covid.”
He talked about how systems could not be “scaled up” without trained workers, adding that beds and space can be purchased but that the limit to any system is having trained people.
Prof Whitty admitted the government made no plans for the mental health impact of the pandemic and said officials “didn’t get it across well enough” that people should continue to go to hospitals for serious illnesses other than Covid.
He told the inquiry in central London that there was never going to be a “perfect balance” when it came to stay-at-home messaging during the pandemic.
And he admitted that during the beginning of the outbreak, the warning messages to the public risked “overdoing” it.
However, he said the UK faced an “absolutely catastrophic situation” as it headed towards the first Covid lockdown and that there were very serious concerns about how the NHS would cope without such a measure.
When quizzed on shielding advice for people deemed clinically vulnerable, Prof Whitty said he is “unsure” whether it should be used in future pandemics.
He said the messaging around the different masks healthcare workers should use was “quite confused” at the beginning of the pandemic.
He added: “I think the reason that it was confused was it was not entirely clear who was ultimately responsible for making decisions in this fast-moving situation. I think that quite a lot of people thought they were partially responsible, and that’s always an extremely difficult and dangerous situation to find yourself in.
“I think that balance is really hard, and arguably, some people would say we, if anything we overdid it, rather than under, in the beginning.”
Putting people in body bags
Professor Kevin Fong was a former national clinical adviser in emergency preparedness, resilience and response at NHS England.
He told the inquiry he was on the scene of the Soho bombing in 1999 and worked in A&E during the 7 July London bombings “but nothing that I saw… was as bad as Covid was every single day” for the hospitals most badly hit during the pandemic.”
Describing the impact on hospitals and NHS staff he said “The scale of death was truly, truly astounding. I worked on a shift where we had six deaths in a single shift. Another hospital told us that they had 10 deaths on a shift, two of whom were their own staff.
“We had nurses talking about patients raining from the sky, where one of the nurses told me they just got tired of putting people in body bags.”
“(One hospital) said that sometimes they were so overwhelmed that they were putting patients in body bags, lifting them from the bed, putting them on the floor, and putting another patient in that bed straight away because there wasn’t time.
“We went to another hospital where things got so bad, they were so short of resources, that they ran out of body bags, and they were instead issued with 9ft clear plastic sacks and cable ties.”
He said the nurses talk about being traumatised by the experience describing “recurring nightmares about feeling like they were just throwing bodies away”.
In one hospital, nurses took to wearing adult nappies because they were so stretched they could not take toilet breaks. Others went to Screw Fix to buy visors for their own protective equipment, the inquiry heard.
“I’ll never forget it,” he said. “It was a scene from hell.”
“There were so few staff that some of the nurses had chosen to either use the patient commodes in the side rooms, and some of the nurses had chosen to wear adult diapers because there was literally no one to give them a toilet break and take over their nursing duties.
He recalled a doctor in another unit who told him, “‘It’s been like a terrorist attack every day since it started, and we don’t know when the attacks are going to stop’.”
Prof Fong said the experience for NHS staff on the front line in intensive care was “indescribable” and there were units where 70 per cent of patients died.
“It’s genuinely the closest I’ve ever seen a hospital to a state of collapse in my entire career,” he said.
Several people in the public area wiped away tears during Prof Fong’s testimony.
In a statement, the Covid-19 Bereaved Families for Justice UK, which represents thousands of people across the UK, said: “The harrowing evidence heard by the inquiry today from Professor Kevin Fong was painful for Covid-19 Bereaved Families to hear, but incredibly clear – ICU’s across the country were overwhelmed repeatedly throughout the pandemic.
“ICU’s can’t be staffed at pandemic levels at all times, but in the UK they lack capacity in peacetime as well. And when the next crisis hits, whatever it may be, we need to respond from a stronger starting place and we need the resources and systems to respond to frontline needs quickly.”
