Blackpool Victoria Hospital has more beds taken up by Covid patients than any other hospital in England - as top doc says operations could be axed unless cases stop rising rapidly

Around a quarter of the Whinney Heys Road hospital's approximate 800 beds are now occupied by people battling the virus, with 18 in the intensive care unit, which usually has 16 beds but has the capacity for 32.

The number of Covid-positive patients has doubled every week for the past five, leading to concerns medics could soon be overwhelmed.

Dr Jim Gardner, medical director at the NHS trust which runs the Vic as well as the Clifton Hospital in St Annes, said operations and appointments could be scrapped unless Tier Three restrictions - introduced in Blackpool and across Lancashire last weekend - are successful in slowing the spread of the disease.

He said: "If the numbers keep rising at this rate, we would have to start to step down other elective activity," including orthopaedic, neurological, and general surgery work.

"The very last people we would want to step down are the people who we think are at most risk, so they would be the high risk cancer patients and perhaps high risk cardiac patients."

"We would step down surgery for people we think are at the lowest risk first."

Dr Gardner, who gives a Covid-19 briefing every Wednesday but spoke to the The Gazette exclusively this morning, said some patients in the Vic with Covid are being transferred to the Clifton Hospital in Pershore Road for rehabilitation.

And he said talks are ongoing about using the temporary £10.25m Nightingdale Hospital in Manchester, which reopens this week after being mothballed in June.

He said: "The unit in Manchester is warming up again, isn't it, so we would look to find other ways to create capacity."

There is no set numerical tipping point, Dr Gardner said, with the situation carefully examined day-to-day, while he said high levels of staff absence - blamed on illness and self-isolation - were also a concern.

"It's half-term this week so some people quite understandably are taking a well-earned holiday," he said.

"They really need to do that to keep their batteries charged.

"But we do have a sickness rate that has crept up a little bit. It's probably seven or eight per cent."

Last November, the sickness rate was 6.23 per cent - which was described at the time as the "highest on record" by workforce director Jane Meek.

The number of patients in hospital on the Fylde coast with Covid-19 hit 200 late last week, according to a source, but, after several discharges and negative tests, that figure dropped to 196. Today, that number was 195. Five weeks ago, it was just six.

A total of 281 people have now died in hospital here after testing positive for the disease, with 15 deaths announced in the past week: none last Monday, three last Tuesday, two last Wednesday, three last Thursday, five last Friday, and one each on Saturday and yesterday.

The typical Covid patient on the Fylde coast is still elderly but medics have also been treating children and mums-to-be, some of whom didn't show any symptoms.

Every person admitted is tested.

Dr Gardner said: "We've got a large group of elderly patients who are Covid-positive who need to stay with us probably for a bit longer than we'd really like because care homes, residential homes, and maybe even their own homes are frightened about having these people back because of the risk of spread.

"Under other circumstances we would be able to discharge them sooner."

Asked whether the percentage of people dying from Covid has fallen in the face of better treatment, Dr Gardner gave what he called a "guarded answer".

He said: "I think it might be too soon to say but it looks as if the mortality rate has reduced somewhat, and that is probably because we can quickly get people on treatment pathways which are more evidence-based and more refined than they were back in March."

Those advances include the better use of oxygen, steroids including dexamethasone, which cuts the risk of death, the anti-viral drug Remdesivir, and blood-thinning medicines.

And more could be on the horizon, with medics "learning all the time", Dr Gardner said.

Local patients continue to be enrolled on studies including the Recovery trial, which helped with the dexamethasone break-through, which has had global significance.

US President Donald Trump was even given the drug while battling Covid recently.

"There are studies using antibiotics, there are studies using plasma, there are all manner of approaches being worked through all the time," Dr Gardner said.

Blackpool's infection rate continues to grow, according to Public Health England figures.

It now stands at 445.3 per 100,000 people, up from 314.8 the week before, with 621 new cases confirmed in just seven days.

Fylde's rate has grown to 313.2 from 222.8 with 253 new cases, and Wyre's has risen to 335.4 from 246.2, with 376 new cases.

The whole of Lancashire is under the most severe restrictions currently possible, but Dr Gardner said he doesn't know if they will work.

He said: "I think we are hopeful, like everybody else is.

"We are managing the situation on a day-by-day basis and, because we saw such a rise over the past few weeks, I honestly feel it's too early to say for sure."

Dr Gardner praised hospital workers for their resilience but said: "I think everyone would really like it if the numbers would go down and Covid would go away in the end."

He said staff are "clinging onto hope around ever-improving treatments" and potential vaccines, one of which is being tested at the Vic.

The phase three trial, run by US biotech firm Novavax, signifies the last testing hurdle before the jab can be officially classed as safe and effective.

And Dr Gardner said: "We are hoping we will be in a position to begin mass vaccination before the end of the calendar year.

"We are certainly planning for that.

"All of us have to do this. We have to hang onto some positives about the things we are doing whilst acknowledging how tough it is."

One of the numerous vaccine candidates, from the Oxford University and AstraZeneca trial, shows a "strong immune response" among older participants, experts said.

Data on the safety and immune responses among those taking part in the phase two vaccine trial has been submitted for peer review in a medical journal.

But the findings have been discussed before publication, prompting more excitement about the vaccine – considered one of the forerunners in the Covid-19 vaccine race.

Experts have predicted that the data from the trial could be presented to regulators within weeks.

It comes as the Health Secretary said that the “bulk” of the rollout of a coronavirus vaccine could happen before next summer.

Matt Hancock said that his “central expectation” was that the majority of the roll-out of a vaccine could be under way in the first half of 2021.

Dr Gardner said: "A vaccine has to be part of us reaching a new accommodation - a new steady state with Covid - just as the vaccine for flu is part of us reaching a steady state with flu, so I think it's a really important part and it should give us much more confidence to go about our business collectively as citizens.

"But it's an enormous number of people to vaccinate so I don't think we'll be really getting into the whole population until well into next year."

Health care workers and very high risk people would be at the top of the list, which "makes sense", Dr Gardner said, though he said the trust will follow Government guidance.

He added: "The NHS is quite good at coping with high demand and flexing its capacity, so of course we will cope.

"The real hard day-to-day challenge for us to make sure we manage patients who are poorly with Covid and help them, but also carry out looking after people who are poorly with all sorts of other things.

"And, in the end, if we find we are struggling to do that, then we will seek mutual support from our neighbouring trusts across Lancashire and, I suppose, if we were all struggling across Lancashire, we would seek support from trusts across the north west."

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