Generally, anybody stable on oxygen can be on a regular ward. However, if they are requiring high doses of oxygen and/or deteriorating, they will be moved to the ICU for preventative reasons. With Covid 19 deterioration can be rapid and we are talking about a VIP so those are 2 reasons to have him in the ICU. AIUI, although CPAP (or more likely BiPAP) is a concern with Covid because of aerosolization of the virus, it is standard of care for other diseases to try it before intubation and if there is a ventilator shortage it may free up ventilators. They may also want to do anything possible to avoid having the PM sedated and therefore technically unable to function so this may be a case where the odds are shifted in favor of trying CPAP/BiPAP.
Is Boris on the roof?
He is not a normal patient. He would have had access to a high very level of care at home. Near hospital level. The very fact he was taken to hospital suggest that the ICU was coming.
With the cat?
Yep. He’s a spider.
Nah, then he’d be hanging from the ceiling.
Now he’s up above your head.
Boris the Spider…
{youtube link}
I think he needs to be concerned about his health and/or life. He shouldn’t be trying to keep working through this. Raab can man the oars while he recovers. Take some time off Boris!
Michael Gove has just told the Today program, “The prime minister is not on a ventilator. He has received oxygen support.” Of course, as Past Tense points out, some members of the news media feel that the cabinet has been persistently issuing misleading or deceptive information about Johnson’s condition.
For once, CNN covered this appropriately and without sensationalism. The only real news here – not intending to minimize it, because it’s concerning – is that Johnson’s condition unexpectedly worsened, and he was moved to the ICU as a precaution. That’s about it. Yes, he is being given oxygen, but the move to the ICU was to be ready for more extreme measures such a ventilator as quickly as possible should that be necessary, which at this point it has not been.
Exactly, if you wait till they need a ventilator before moving them to the ICU you’re probably too late. If you think a patient might need a ventilator you have to prepare them for it and hope you don’t need to use it. Apparently, of the patients moved to intensive care with COVID in the UK, there is about a 25% fatality rate.
It’s the first issue that’s likely to be the bigger problem than the second.
While the procedure was the stuff of nerdish speculation (and I’ll include old Dope posts by myself) amongst Cold War historians, it did seem likely that, given no quick succession mechanism otherwise, the PM could appoint a “designated successor” given a threat to their life (most obviously a nuclear decapitation strike). Macmillan possibly got within hours of doing so during the Cuban Missile Crisis, but didn’t, and the option was probably placed before Blair after 9/11.
What we’ve seen in the last fortnight is a) the first official acknowledgement from Whitehall that this can be the procedure and b) Raab as the first known designate. In practical terms, it now looks as if Raab is in charge and the assumption is that he will inherit this authority should the PM die.
The immediate question is then how the Palace handles that. Under the circumstances, I don’t see the usual photo op of him being summoned to meet the Queen (especially since she’s out at Windsor). No, they issue a statement in her name recognising him as PM. Possibly indicating that it’s a interim measure.
So Raab in the short term. A normal Tory leadership election is near impossible. Though the 1992 Committee - who run those - is sufficiently compact that the rule changes - electronic voting by MPs, rather than physical ballots, for instance - are probably manageable. However, I suspect that the sentiment would be to let the crisis run its course and then sort things out. But uncharted waters.
(Two PMs have died in office. Spencer Percival and Lord Palmerston, but both sufficiently long ago that neither acts as a useful precedent.)
I forgot where I read it, but some of the doctors who were interviewed from Wuhan said that they learned from their own experience that you have to stay ahead of the progression of the virus in terms of ventilation. They said that they learned it’s better to be aggressive and be prepared to move quickly to invasive breathing support (i.e. ventilation). I can’t recall whether they said that it was better to skip oxygen support and go straight to ventilation - maybe that’s not accurate, but the treatment Johnson’s getting seems somewhat reassuring in that the physicians are acutely aware of how rapidly his situation could turn for the worse with little or no warning.
Is that actually UK data, or is that the number from this paper based on an Italian case study?
I ask because the headline number out of the Italian study is ‘25% died’ but if you look at the results it’s actually worse than that. By the end of the Italian study (late Feb to late March) a quarter of ICU patients had died, 16% had got better, and the rest were still in ICU.
Worse for over 60s, of course
I heard this on the BBC so I cannot link to a cite - they seemed to suggest these were UK numbers but I wouldn’t be surprised if the correspondent got a quote from a UK doctor that was based on a different country’s data and mistakenly attribute it to the UK.
Google John Oliver’s take on Boris - he’s Trump but planned it. Just imagine someone who chose that persona.
There are COVID-19 patients out of the ICU who are on ventilators and COVID patients in the ICU who are not on ventilators, although this last group tends to be patients who have been on ventilators at some point.
Moderator Note
Keep the political jabs out of this forum.
Colibri
General Questions Moderator