Technology

How Boris Johnson will be treated for coronavirus

The Prime Minister, Boris Johnson, has been admitted to intensive care with Covid-19. But what type of treatment are patients offered?

April 07, 2020
The Prime Minister is in intensive care with Codi-19. Photo: SOPA Images/SIPA USA/PA Images
The Prime Minister is in intensive care with Codi-19. Photo: SOPA Images/SIPA USA/PA Images

This week, Boris Johnson was admitted to a London hospital with Covid-19, the disease caused by coronavirus. But not everybody who is infected will need medical assistance. In fact, the majority of those infected will not attend hospital.

For some people, coronavirus is asymptomatic, meaning they will not notice anything the matter. (Indeed, this is part of what makes the virus so dangerous, as it can be easily passed on.) For people who display symptoms—such as a fever or a new persistent cough—the advice is to self-isolate at home for at least 7 days, and 14 days for other members of the household, depending on how long symptoms last.

The likelihood of being admitted to hospital varies with age. One paper published in the respected medical journal The Lancet in late March suggested that around 1 per cent of people under 30 are likely to require hospitalisation, as opposed to 1 in five people over the age of 80.

[su_box title="Where to find help"]An online service can help you decide what to do if you have symptoms, and can be accessed at 111.nhs.uk, or if need be over the phone by dialling 111. Dial 999 in an emergency.[/su_box]

The Prime Minister initially self-isolated with what were described as “mild” symptoms. On Day 10, however, his condition worsened and he was admitted to hospital.

Most people who arrive at a UK NHS hospital will go through a triage process. NHS England advises that patients arriving at the hospital with symptoms should go through a dedicated service—not through regular A&E or the main hospital. Hospitals will have procedures in place to facilitate this as well as possible.

For more serious cases, treatment options can include being given oxygen, or being treated with a ventilator, of which different types may be used. In Boris Johnson's case, he was admitted to the intensive care unit because his condition had worsened and doctors were worried he might require ventilation.

Intensive care units have more staff compared to the number of patients. They also have sophisticated monitoring equipment.

Assessing patients

Aside from testing oxygen levels, the Prime Minister is likely to have undergone tests to check his oxygen levels, white blood cell count and liver and kidney function, as well as an ECG (electrocardiogram) to check his heart.

X-Rays and CT scans are used to look for the “white patches” which indicate pneumonia. Early research based on cases in Wuhan in February explored how imaging can be used to assess a patients’ lungs and help ascertain the stage of the disease, with global collaboration continually providing more information to doctors about what to look for.

Guy’s and St Thomas’s NHS trust, where the Prime Minister is being treated, has published a portion of the criteria they use to assess cases. These help dictate whether a patient is given oxygen via a mask or prepared for intubation.

Why ventilators matter

Different types of breathing support can be offered in intensive care, including something called Cpap (which stands for “continuous positive airway pressure”). More severe cases may need invasive ventilation, which involves a tube being put into the airway.

63 per cent of patients admitted to critical care units were ventilated within the first 24 hours.

As well as using machines to support a patient, NHS staff may do things like roll the patient on to their front, which some studies suggest this can help with oxygenation. Nurses will monitor patients and also help with things like brushing their teeth and making them as comfortable as possible.

Some people may also need organ support. In some cases of Covid-19, the immune system creates something called a “cytokine storm” as it attempts to fight off the virus. This means it has gone into overdrive and begun attacking the patient’s organs.

The most frequently affected organs are the heart, liver and kidneys, all of which can be supported by machines in the ICU.

Early outcomes

An NHS report published by the Intensive Care National Audit and Research Centre in early April found that, of 2621 admissions to such units, 346 patients had died and 344 had been discharged alive. They caution, however, that due to the low proportion of individuals who had completed their care, these outcomes should be interpreted with caution.

Patients who are well enough to leave intensive care will be moved to another part of the hospital, freeing up the bed for another seriously ill person who needs it. Doctors report that many patients will stay on a ventilator for a week or longer before hopefully being able to safely breathe on their own again.

Many doctors will have to make difficult decisions when it comes to the most severe cases of Covid-19, as can be the case with any type of serious illness. For those patients who sadly do die, the British Medical Association collates up-to-date advice on best practice, and Co-op Funeralcare has published extensive information for families and loved ones who need to navigate a funeral service during this period.

It's normal to feel anxious

Overall, it is worth remembering that the vast majority of people infected with coronavirus will recover, with most people not requiring hospital care but only isolation at home to rest and help protect others.

Nevertheless, it is normal to feel scared or worried—especially with everyday life disrupted.

The NHS has published 10 tips to try if you are experiencing anxiety around coronavirus. In a crisis, the Samaritans can be contacted by phone on 116 123 or over e-mail.