theguardian.com

Britain’s first coronavirus field hospital will treat up to 4,000 previously fit and healthy people struck down by Covid-19 once it opens, with sicker patients who are more likely to die being cared for in normal NHS hospitals, according to senior sources with knowledge of the plans.

London patients in need of intensive care but with the best chance of survival will be taken to the Nightingale hospital, which has been constructed within the ExCeL arena in the capital’s Docklands area in the space of a week, the sources said.

Anyone with a serious underlying health condition – such as a heart, kidney or vascular problem – will go to one of the city’s district general or teaching hospitals, it is understood.

The NHS has denied there will be a two-tier system or that the Nightingale will be reserved for healthier or younger people.

Birmingham Nightingale hospital, being created in the city’s National Exhibition Center, will care for non-serious, non-Covid-19 hospital patients and will be staffed mainly by GPs, it is understood. The centre will start with up to 500 beds, with the potential to grow to 2,000, and is designed to take the pressure off the West Midlands, which has emerged as the second-biggest coronavirus hotspot after London.

Other field hospitals are being created at the Manchester Central Conference Center and potentially at the Scottish exhibition center in Glasgow.

The decision to medically profile patients at the first emergency coronavirus hospitals followed days of behind-the-scenes wrangling between senior doctors and NHS planners in preparation for a “tsunami” of coronavirus cases.

It comes as one in four NHS doctors were revealed to have been signed off from work because they were sick or in self-isolation. Prof Andrew Goddard, president of the Royal College of Physicians, told PA News that about 25% of doctors are not available.

The ExCeL center is expected to start receiving patients very soon, most likely by Wednesday.

“There is a two-tier system but it’s a medically appropriate two-tier system,” said a senior doctor with knowledge of the plan. “The sick will go to the ExCeL and the very sick will stay in hospital, because that’s an appropriate use of NHS resources.

“Anyone who goes to either place will be critically ill, be suffering lung failure and be on life support through a ventilator. But those at the ExCeL will be those needing less life support as they will be the ones with nothing else wrong with them,” the doctor added.

Any patient with co-morbidities that mean they may need some form of medical treatment or surgery beyond life support on a ventilator will be treated in a normal hospital. Although the NHS has re-branded the ExCeL as “the Nightingale London hospital”, it will essentially be a massive 4,000-bed critical care unit, with none of the back-up services hospitals have.