Initial hospital preparation and response to fight the COVID-19 pandemic, based on the British university hospital experience

Dear Editor,
Responding to the excellent initiative of Prof. Janusz Andres and the Polish Society of Anaesthesiology and Intensive Therapy, I would like to share our initial experience of the preparations and the actual hospital response to the coronavirus (COVID-19) pandemic from the British perspective.
At the time of writing of the article (03.04.2020), the number of patients diagnosed with COVID-19 has exceeded 38 000 in Great Britain, and in England and Wales alone, the number of patients with COVID-19 in intensive care units has exceeded 2200 [1]. Those numbers alone show the extent of the problems that we have been dealing with.
The University Hospitals Birmingham NHS Foundation Trust (UHB NHS FT) is one of the largest hospital organisations in England, providing specialist healthcare in the West Midlands, inclusive of Birmingham, the second biggest city in England. The largest and the leading hospital in our Trust is the Queen Elizabeth Hospital Birmingham (QEHB), where I have been working. The QEHB hospital also hosts the Royal Centre for Defence Medicine, with a significant percentage of military medical personnel with the experience in fighting past epidemics, e.g. the Ebola virus across the world. In “peaceful” times, the Critical Care Unit has the capacity to provide intensive care for almost 100 patients.
Based on the Italian experience, from the outbreak of the pandemic, it has become clear that the only chance to deliver intensive care to all the patients requiring ventilation is to significantly increase the footprint of critical care beds across the country, even to triple the preceding number. The obvious challenge has been to provide the appropriate equipment for newly created, but fully functional critical care beds, but even more importantly, to ensure proper staffing, nursing and medical alike.
In early March, it was decided nationally to suspend any elective surgical work, which allowed us to use idle anaesthesia care stations as ventilators. In Great Britain, each operating theatre is traditionally equipped with two anaesthesia machines (one in the anaesthetic induction room, the other one in the actual operating room). Thus, in our institution, the transfer of anaesthetic equipment and beds to the ICU instantly doubled the number of available intensive care stations with fully usable ventilators. In addition to that, further ventilators have been purchased and delivered shortly afterwards...


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