Staff 'need clearer guidance' as COVID overwhelms ICUs

Hospital staff are receiving insufficient support as they make agonising choices about who does and does not receive care, writes Dr Katharina Hauck.

In an opinion piece for the Financial Times, Dr Hauck warns that existing guidelines in an overstretched NHS are “only partly helpful”. They avoid “the tough question of how to prioritise care with severely curtailed resources, leaving heartbreaking life-or-death decision-making to clinicians.” 

The most severe shortage is not in beds, but in staff. Dr Katharina Hauck Deputy Director, J-IDEA

This situation “takes a heavy toll” with 40 per cent of ICU staff in England reporting “symptoms of post-traumatic stress disorder, 11 per cent had severe anxiety and 7 per cent were problem drinking. In contrast, PTSD is reported by 17 per cent of recent UK army veterans.”

“ICU staff are our frontline soldiers in this battle, and we are failing them,” says Dr Hauck, who is Deputy Director of the Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA) at Imperial.

A recent report by Dr Hauck and team describes the impact of current policies and provides possible scenarios that maximizes life years gained and cost compared to the current official ‘blanket policy’ that is in place.  

She argues that: “Blanket policies that prioritise emergency patients lead to more people dying younger than policies that prioritise elective patients with specific diseases including cancer, cardiovascular and digestive diseases. If we want to achieve the greatest benefit for the greatest number of people, we need to free hospital capacity for those with urgent clinical need — at the expense of some emergency patients.” 

The full comment piece can be read in the Financial Times.