Region’s hospitals set for 850 covid deaths by mid-November, says leaked modelling

This would represent around a third of the deaths which took place in the five week period starting on 20 March, which was the start of the first peak of the virus.

The document, leaked to HSJ, is understood to have been circulated and discussed at high level management meetings this week, and is part of the evidence informing leaders’ response to a surge in covid admissions.

It was produced by a team at the University of Manchester, which has been working with public health and NHS officials in Greater Manchester.

It comes as intensive care doctors in the region have raised concerns around rising covid admissions, and want to be able to make local decisions about suspending elective operations.

Liverpool and Merseyside are currently the hardest hit areas of the north west, which has prompted urgent discussions today about cancelling elective procedures. However, the modelling suggests there has been a “slight decrease in the growth rate” in the last few weeks.

It projects around 225 deaths in the wider Cheshire and Merseyside system from 13 October to 17 November on current trajectories, with around 2,400 beds occupied by the end of the period.

Whereas in Lancashire and south Cumbria, the document says, there is “not yet any sign of the growth rate slowing down”, which would result in higher admissions and mortality. It suggests around 480 hospital deaths in the five week period on current trajectories, with more than 3,000 beds occupied by covid patients by the end of the five weeks.

Around 160 deaths and 1,500 beds occupied by covid patients are projected for Greater Manchester.

The document adds: “This model assumes the transmission trends continue at the same level as over the last four weeks. Therefore, this is presenting a scenario if nothing changes. Interventions, either those recently enacted or soon to be enacted, are likely to change these trajectories…

“These should be taken as a potential scenario rather than a likely prediction. In particular, small variations in the last few data points might change the rate of future growth, resulting in large variations in predictions after a month or more.

“The next couple of weeks are already ’in the pipeline’ (unless policies or spontaneous behaviour change that occurred one/two weeks ago have an appreciable effect), but projections beyond that will be affected by actions taken now.”

Meanwhile, HSJ understands there are mounting concerns from intensive care doctors in the region around critical care capacity, with some calling for a suspension of high risk elective cases.

One senior clinician said: “By the end of next week intensive care units in a few North West hospitals will be in surge capacity. We have the equipment and physical resources, but we’re concerned how we will get staff from across the region.”

Ganesh Suntharalingam, president of the Intensive Care Society, said: “At the moment all ICUs are working within normal capacity, but the proportion of ICU patients with covid-19 is on average 12 per cent in England and up to 22 per cent in the North West, with higher figures like one in three in some hotspots. “

He said elective activity should be carefully reviewed with an “emphasis on local and regional decision-making, rather one size fits all”.

A spokesman for the Lancashire and South Cumbria Integrated Care System said: “We all need to be aware of this worsening local situation, and the impact rising covid infections are beginning to have on all NHS services. Hospitals continue to be open, diagnosing and treating patients. We want to be able to continue to do that, but we need everyone to do their bit and to ensure we can continue to provide the services our local populations need.

“All hospitals within Lancashire and South Cumbria have worked to put strong escalation measures in place and we believe we will be able to cope as we head into the busier winter months. Hospitals are following strict social distancing and hygiene measures to allow people to access care safely. It is important people do not hesitate to access emergency treatment if you need it.”