Coronavirus: Why is Boris Johnson in intensive care and what treatment will he get?
A microbiologist has said it is likely the prime minister will be receiving oxygen to help his breathing.
Tuesday 7 April 2020 03:41, UK
There is currently no known cure for COVID-19, so why would Boris Johnson have been moved to intensive care and what treatment will he get?
At 5pm, Foreign Secretary Dominic Raab led the government's daily briefing on the UK's coronavirus fightback, assuring the public that Mr Johnson was still in charge. Sky News' Beth Rigby said "things moved quite rapidly after that".
"His condition deteriorated, he had to be given oxygen - he was struggling to breathe. The decision was taken at 7pm to move the prime minister to that intensive care unit," she said.
"He is not on a ventilator. He was conscious, indeed he phoned Dominic Raab to ask him to deputise, to take over. The ventilator is there should his condition worsen."
And she added: "This is deeply worrying and upsetting for his colleagues and his loved ones, and the country."
Why intensive care?
Urgent care doctor Kishan Rees told Sky News: "Judging by how he gave the instruction to Dominic Raab, it doesn't sound like he has been intubated… which is obviously a good thing, and we wish him well. I think he will be on an intensive care unit because that allows for a far higher degree of monitoring in terms of the body's physiology and there's also one-to-one nursing. There's a very close eye from a medical point of view and they can really monitor his observations - his temperature, his blood pressure, his heart rate and his oxygen saturation."
Professor Derek Hill, Professor of Medical Imaging, University College London said: "It seems clear that the prime minister went to hospital because he had difficulty breathing. It seems he was initially put on oxygen, and was conscious. But as often happens with COVID-19, his condition has now deteriorated."
Why has the PM's illness gone on so long and worsened?
Doctor Rees said: "Some people have a flu-like illness for five to seven days and then they get completely better. Other people... there are the at risk categories - people who have diabetes, chronic kidney disease - as far as I'm aware the PM doesn't fall into those categories...
"The second stage of this disease in some people that get it can involve a really severe auto-immune reaction, something called cytokine storm - basically the body's natural defences are overwhelmed and the body shuts down with multi-organ failure." Doctor Rees pointed out that the prime minister's case does not sound as severe as this.
What are the treatments he could get in intensive care?
"The treatment is very much supportive," Dr Rees said. "That means fluids, maybe paracetamol to control fever, but also, if patients' cases do deteriorate to the point where they're no longer able to maintain their blood pressure, then they could end up on an intensive care unit and they would be getting inotropic support. That is when your body cannot maintain blood pressure anymore because your body is getting to the point where it is failing. Inotropic support is basically a powerful 'vaso-constrictor', which means all the blood vessels constrict, diverting blood to your vital organs - your brain your heart and your kidneys."
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Prof Hill said: "He is very likely to have been put on a mechanical ventilator to breath for him. A ventilator can be invasive (involving a tube being put down the patient's throat) or non invasive, for example breathing through a specialised mask. Invasive ventilation tends to be recommended for COVID-19 patients. Intensive care ventilators have sophisticated software and sensors to enable them to adjust the way they work around the needs of the patient, and to change the amount of oxygen inhaled with the air."
Dr Simon Clarke, a microbiologist, has told Sky News that the NHS will probably be supporting the prime minister with fluids and "potentially also trying to dampen down the immune response". But he added: "I think probably what's most likely is that he's receiving some oxygen as well, to help his breathing." It is understood Boris Johnson is not on a ventilator.
Dr Clarke added: "Ventilation is a particularly invasive procedure, so just because someone has a bit of oxygen given to them, doesn't mean they're ventilated. Ventilated is much more invasive.
Does Boris Johnson really need to be in intensive care?
Dr Clarke told Sky News: "I'll say this to you, the NHS, particularly at this moment, doesn't give up intensive care beds just for people to be looked over - it doesn't work like that, even for prime ministers.
"He would not be in intensive care unless he needed to be in intensive care, especially not at this time, and I think it's probably about time that the press people in Number 10 started levelling with us about what his condition really is."
Prof Hill added: "One of the features of COVID-19 in all countries seems to be that many more men become seriously ill than women - especially in the over 40 age group. Also we know that people under about 60 seem to have a higher chance of making a recovery from critical illness with COVID-19 than older people. But there is no doubt this turn of events means Boris Johnson is extremely sick."