A physician friend of mine in the UK just forwarded me memo email she was sent from a consultant at one of the hospitals in London. It is scary. I just spent 3 hours on the phone with family members and close friends planning, sharing info and advising. Whoever posted the article about the plan of not resuscitating older patients- apparently it’s already being done in some places in the UK and quietly in the hard hit places in the USA. See below copy and pasted.
Dear all,
This is a full and frank message. Please forward to the rest of the family, and your loved ones if you choose.
I had a meeting today with our Medical Director, who has been in touch with government. The following therefore has some authority.
By the weekend, London will be in full lockdown, with Army manned checkpoints. Only key workers, NHS staff, police, ambulance, fire, delivery drivers, and teachers looking after the children of the above, will be allowed to move around the city.
By next week, those restrictions will apply to the country.
Tonight Lewisham Hospital is overwhelmed, ambulances on divert, and only a few ventilators left. QEH is close behind. My Trust is in the frontline of this epidemic, mainly due to local demographics. The rest of the NHS is probably little more than a week behind. We have denied critical care to four patients today, who will die as a result.
I must now be clear. Anyone over 75 years old will be denied critical care; anyone over 65 with diseases, eg diabetes, COPD, will be denied critical care. We are ramping up palliative care services. If an elderly patient falls sick, and requires hospital care, there will be an immediate DNAR order on them. They will be palliated, and they will live or die. The government forecast of 250,000 deaths is, we believe, hopelessly optimistic.
The mortality rate is very high in the elderly. The ICU stay on a ventilator even in survivors is about three weeks. We will run out of ventilators in a week.
The Army is setting up field hospitals, no doubt with squaddies manually bagging patients.
You will not hear this from Boris Johnson for a few days. But please be assured it is coming. We are two weeks behind Italy.
For the family therefore, anyone over 65 is to self isolate, possibly for many weeks. Maintain contact through frequent video calls. If they need food or supplies, take them over and leave the bags on the doorstep, and wave at them from at least a six foot distance. They are not to touch the bags for 15 minutes. Do not visit for 14 days if you or anyone in your household is unwell with and fever, cough or 'flu like symptoms. If you are unwell, stay indoors, along with your whole family. Have a neighbour or a friend drop off supplies, with no social contact.
We need to blunt the curve, which is right now exponentially rising.
For myself, you cannot imagine the stress we are under. The awful decisions we will have to make. We will be taking otherise healthy 60 year olds off a ventilator to die so we can save a 30 year old.
Please stay safe. I'll email when I can with news from the frontline.
With much love to you all,