Oxygen supply at Southend Hospital 'reaches critical situation' as doctors face intense strain amid rising numbers of coronavirus patients

The oxygen supply at a hospital under intense strain with coronavirus patients has 'reached a critical situation', according to an internal document.

Bosses at Southend Hospital said there is 'high demand for oxygen' because of rising numbers of Covid-19 patients and they 'are working to manage this'.

An internal memo seen by BBC Essex revealed that the hospital has had to cut down on the amount of oxygen it uses to treat ill patients — but bosses insist no-one 'will come to harm' as a result of the move.

It means that patients with oxygen saturation levels of more than 92 per cent 'should have their oxygen weaned', saving supplies for the most critically-ill patients.  

Several hospitals have warned in recent days that the surge in Covid admissions is placing oxygen supplies under pressure. 

The Mail revealed last week how staff at a huge London hospital were told to prepare for an 'oxygen supply failure' in which they may have to manually ventilate patients using an 'ambu bag' — a hand pumped plastic sphere which pushes air into the lungs. 

Fears of an oxygen shortage prompted the NHS to order its suppliers to quadruple their production back in March.

Patients arrive at Southend Hospital in Essex last Friday. The oxygen supply at the hospital, which is under intense strain with coronavirus patients, has 'reached a critical situation'

Some 480 deaths linked to Covid-19 have been recorded at Southend Hospital in Essex alone

PRIVATE DOCTORS SHOULD BE 'SHAMED' OUT OF PERFORMING NON-URGENT OPS, NHS BOSSES CLAIM 

Private doctors have been slammed for performing non-urgent operations while the NHS is under 'unthinkable pressure' caused by soaring Covid cases.

Medics performing elective operations privately should be 'shamed' out of it amid concerns they are 'once again taking the p*** and walking off with the money', London's top NHS medics believe.

All of London's acute hospital trusts have been told to 'think very carefully' about whether it is 'appropriate' to perform elective surgeries, when the same operations have been pushed back by the NHS.

A letter - signed by top medics and several of London's hospital trusts - calls for non-urgent surgeries to be pushed back for one month to allow case figures to drop.

This means private medics will instead be able to work for the NHS to help ease the strain.

The UK announced a further 573 coronavirus deaths yesterday in the highest Sunday rise since April, and the third-deadliest Sunday of the entire pandemic.

The document, shown to the BBC, said: 'We have reached a critical situation with oxygen supply. It is imperative we use oxygen safely and efficiently.

'All patients should have a target saturation of 88-92 per cent. Patients with a saturation above 92 per cent which are on oxygen should have their oxygen weaned within the target range.

'I can assure all that maintaining saturations within this target range is safe and no patient will come to harm as a result.

'It is imperative that this is acted on immediately.'

Current NHS guidelines consider patients to be in the healthy range if their blood oxygen levels are between 94 and 98 per cent. The cut-off for hospitalisation is around 92 per cent.

One doctor said it was a 'bold baseline', and another told how it was 'pretty worrying' while a third medic said there was no evidence it would harm patients.

Duncan Young, a former professor of intensive care medicine at Oxford University, told MailOnline keeping blood oxygen levels between 88 and 92 per cent was 'safe' and 'doesn't usually cause significant breathlessness'.

'However, it does mean the hospital staff have to be vigilant for deteriorating patients, as their oxygen saturations could reduce to unsafe levels more quickly.' 

Yvonne Blucher, managing director of Southend Hospital, said: 'We are experiencing high demand for oxygen because of rising numbers of inpatients with Covid and we are working to manage this. 

'The public can play their part by staying home and, where they cannot, following the "hands, face, space" advice to cut the spread of the virus.'

The coronavirus can, in severe cases, lead to pneumonia and leave patients in need of life support machines which help them to breathe.

The machines pump pure oxygen out of tanks and through tubes directly into a patient's airways so their failing lungs can get enough of it into their blood.

Hospitals have central pipelines of high-flow oxygen which pump the gas into ventilators from a large reservoir tank. 

Ventilation with oxygen can be the difference between life and death for many critically ill Covid patients. 

NHS Providers chief exectuvie Chris Hopson said a number of hospitals were already facing pressure on their oxygen systems

UK Research and Innovation - which funds scientific research in Britain - says low oxygen levels is the 'main reason' Britons suffering from the virus are admitted to hospital.

'Infected and damaged lungs are less effective at allowing oxygen to pass from the environment to the bloodstream,' they said.

'The main reason for being admitted to hospital with Covid is to receive supplemental oxygen, to increase the amount of oxygen in the lungs and blood.'

They add: 'This will be sufficient treatment before recovery in most cases.'

NHS Providers chief executive Chris Hopson said today there were already a 'number' of hospitals where their oxygen supply system is under 'huge pressure'.

'If you push your oxygen levels to an absolutely critical level the thing that you can't do is to have the oxygen system break down,' he told the BBC.

'So what you will do - and we know there have been a couple of instances of this in the first wave and a couple of instances recently - is effectively you need to dial it down. In which case, you will have to transfer patients to the nearest neighbouring hospital for a short period of time.'

This graphic shows how daily case rates have soared in Southend-on-Sea over the past month

Daily deaths within 28 days of a positive test in Southend-on-Sea have also risen significantly

South East Essex has been particularly badly hit by the new variant of Covid-19, with 480 deaths linked to the virus recorded at Southend Hospital alone. 

This includes 17 Covid-related deaths at the hospital announced yesterday, which happened between the latest data period of December 26 and January 6.

It comes less than a fortnight after Essex declared a 'major incident' as the number of coronavirus cases threatened to overwhelm its hospitals.

HOSPITAL STAFF TOLD TO PREPARE TO VENTILATE PATIENTS MANUALLY IF OXYGEN RUNS OUT

Hospital staff were told to prepare to ventilate patients manually if oxygen runs out as NHS bosses warned of ‘nail-bitingly difficult’ weeks ahead, it was revealed last week.

Admissions are soaring as Covid rates continue to rise - with health bosses saying staff are at ‘battle stations’ across the country.

Nearly 23,000 beds in England were occupied by coronavirus patients on New Year’s Eve - significantly higher even than the 19,000 occupied at the peak of the first wave in April.

Several hospitals have warned in recent weeks that the surge in admissions is placing oxygen supplies under pressure.

Staff at one major London hospital were told to prepare for an ‘oxygen supply failure’ in which they could be forced to manually ventilate patients using an ‘ambu bag’ - a hand pumped plastic sphere which pushes air into the lungs.

A note circulated to staff said: ‘There is a very high demand for medical oxygen across the healthcare system at the moment.

‘All hospitals are closely monitoring their use to ensure that piped oxygen supplies are safely monitored.’ In a stark warning, it added: ‘You need to know what to do in the event of oxygen supply failure.

‘Disconnect tubing from patient. Connect inflating bag to oxygen bottle. If no oxygen bottles, don’t panic, just inflate with ambu bag.

‘Manually ventilate - 12 breaths per minute.’

The move allowed hospitals to transfer patients elsewhere, speed up discharging, call in extra staff and cancel non-emergency care and operations.

Southend Hospital was also where Dr Habib Zaidi, one of the first frontline health workers to die in the pandemic, passed away in intensive care on March 25 last year. 

Hospital staff at one major site in London were ordered to prepare to ventilate patients manually should their oxygen supplies run out at the start of this month.

Workers were told to prepare for the 'oxygen supply failure' in which they could be forced to give oxygen to patients using a 'ambu bag' - a hand pumped plastic sphere which pushes air into the lungs.

A note circulated to staff last month read: 'There is a very high demand for medical oxygen across the healthcare system at the moment. 

'All hospitals are closely monitoring their use to ensure that piped oxygen supplies are safely monitored.'

In a stark warning, it added: 'You need to know what to do in the event of oxygen supply failure. 

'Disconnect tubing from patient. Connect inflating bag to oxygen bottle. If no oxygen bottles, don't panic, just inflate with ambu bag. Manually ventilate – 12 breaths per minute.'

There are also warnings that London hospitals are 'in competition' for ventilators to keep their patients alive.

NHS England has insisted that it has enough oxygen to meet current demand and is working with suppliers to manage future needs.

It told them to quadruple production back in March at the start of the pandemic, amid fears they could 'run out' within hours if they were hit by a wave of patients.

Adult intensive care was around 76 per cent full for England as a whole in the last week of 2020, compared to 69 per cent in the same week a year earlier.

This was an average for the entire country and some hospitals were 100 per cent full in the areas worst affected by coronavirus, with no extra critical care beds for the entire week and potentially even longer.

Looking at London, which is now once again the epicentre of the country's crisis, data show that 13 out of 18 hospital trusts in the city had six or fewer intensive care beds available to take new patients last week.

Two hospital trusts had no spare intensive care beds and three only had an average of one extra bed throughout the week.

Intensive care is usually a last-ditch attempt to save the life of someone who is starting to die of coronavirus and is reserved for only the sickest people, and usually rules out elderly patients who tend to be too weak to survive the damaging impacts of ventilators.

Comparing intensive care wards in London to a year earlier shows that, in 2019, the busiest ICU wards in the city were at 86 per cent capacity, compared to 100 per cent this year. Only five hospitals are this year less full than the very busiest ones were the year before. 

Southend Hospital has been contacted for comment by MailOnline this morning.