Early predictions over the possible impact of Covid-19 on the north-east would have led to an almost complete shutdown of health services, NHS bosses have admitted.
Before the pandemic arrived in the region, modelling was carried out by the Imperial College in London, simulating a number of possible scenarios.
Chiefs at NHS Grampian admitted they were fearful in the early days that services would not be able to cope.
Worst-case scenarios suggested hundreds of patients could be hospitalised with the virus every day – leading to Aberdeen Royal Infirmary becoming full in less than a week.
Deputy chief officer of acute Cameron Matthew spoke about the preparations put in place ahead of the first positive case being diagnosed in the Grampian region, on March 3, 2020.
And he said the modelling helped them prepare for “multiples of patients” being admitted to the city hospital every day.
He said: “The only time I would say I felt fear or anxiety was when we saw the modelling from the Imperial College and we were looking at the potential numbers coming in every day.
“At that point we thought we would be switching off everything else, and that’s where you come to the conversation about what the right thing to do is. I don’t think there was ever a time when we couldn’t deliver, but there was a fear that people would have to provide care on as thin a basis as possible.
“The R number in the early days was around five. At first, a lot of those patients would have ended up admitted to us. The numbers were scary because we were looking at filling the hospital with Covid patients in about six days. Fortunately, we were nowhere near that.
“We had booked P&J live, we were looking at Woodend and were looking at where we could fill spaces wherever we could.”
Even though the worst-case scenario was avoided, plans still had to be put in place to ensure NHS Grampian was able to cope.
That included separating the hospital into Covid and non-Covid areas and the creation of a second intensive care unit to prevent infection spreading.
“We were planning for multiples of patients coming in every day,” Cameron said.
“We had to remodel the hospital in the very early stages to become red, amber and green areas, which meant we could manage effectively and safely those patients who were identified as having or potentially having Covid into a red or amber area, and those who definitely didn’t into green areas. That in itself meant we had to change what we did from an A&E point of view, because we had to be able to filter patients who we couldn’t effectively filter straight away.
“We created different pathways for patients into the hospital as well as increasing our bed base for non-ITU patients, but the biggest increase we had to undertake was to plan for a quadrupling of our ITU capacity. We got to around 90 beds, and if we had been pushed we would have been able to keep creeping up.
“That meant to do that, we had to switch off planned care, so everything apart from the most urgent care got cancelled. I remember having to do that the week of March 23 and setting that up between Monday and Friday – everything from letters to cancellations to the remobilising staff so we could change theatres and anaesthetic recovery areas into an expanded ITU.
“At the same time, we also had to change ITU so we could look after Covid patients and non-Covid patients. We had to make our green zone, which is essentially the Matthew Hay building, into our screening areas and red areas.
“The rest of the hospital was turned into a green area. What we realised pretty soon afterwards was that some patients would come in and then after a few days, identify they had some of the symptoms.
“We needed pathways to move them around safely and to manage outbreaks safely on those occasions, which we did pretty effectively. We have had some outbreaks but when you consider the number of patients in a small area what we managed to get was pretty good.”
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