Breathtaking

- Does that feel secure? - Yeah.

'Have you got a grip on the coronavirus?

'How worried are you?

'Will the measures be dramatic?'

So, what I'm gonna do is run you through seven exercises.

'Mr Speaker, with your permission,

'I'd like to update the house on COVID-19.'

I'll start with five pumps.

We're going to do deep breathing now,

so that's with your tongue out.

'As of this morning, 7,132 people

'have been tested for the virus.'

Speak as clearly as possible.

Don't worry about getting the words wrong.

"When the sunlight strikes raindrops in the air,

"they act like a prism and form a rainbow.

"The rainbow is a division of white light..."

'The public can be assured that we have a clear plan

'to contain, delay, research and mitigate,

'and that we are working methodologically

'through each step to keep the public safe.'

No, no, I can still taste it.

Yeah, that's a fail.

These FFP3s are made for wider jaws.

So, lifesaving for men, basically?

Yeah.

You might need a powered respirator when the time comes.

OK.

But we've run out of those.

OK.

To be honest, I think they're being reserved for the staff

who are, you know... What kind of doctor are you?

Acute general medicine. I'll be in the Cold Zone, so...

Yeah, so not you.

Staff in your areas won't need that level of PPE,

but if you really want one, you can get them on Amazon.

I mean, I wouldn't worry about it, but if you want to.

- Amazon? - Yeah.

They're about 300 quid, but...

Great (!)

'We are increasing our stocks of equipment.

'We are accelerating our search for treatments,

'we're pioneering work on a vaccine.'

'How deadly is it? How fast can it spread?

'And how prepared are we in Britain?'

SIREN WAILS

Oh, you can't come through this way, love.

I'm a consultant. I work here.

Oh, well, you'll want the service entrance, then.

That's the new way in.

'And I know the people of this country

'will rise to that challenge,

'and we will come through it stronger than ever.

'We will beat the coronavirus and we will beat it together.'

CHATTER

BANGING AND WHIRRING

Thank you.

- Morning, Abbey. - Morning.

Hiya.

Hi, Abbey. You all right?

Yeah.

How are we looking?

So, 26 overnight, 12 in the corridor,

a couple in resus, eight still waiting to be seen,

and two pre-alert ED have told me about.

"Cold Zone." LOL (!)

Aye. Nice mitral stenosis in three for Emma, though.

- Yeah? - Yeah.

- Can you come and help me, please? - Yeah.

OK. What do you need, Emma?

I have a patient really sick in the cupboard.

- I don't know what to do. - OK.

Hello, sir.

I'm Dr Henderson, I'm one of the consultants.

I'm just gonna pop you a bit more upright.

HE GASPS FOR BREATH

OK, great. OK, what's the story?

Erm...

He has ischemic heart disease, a CABG in 2011,

erm... but well since.

Walks every day with his wife.

Start with ABC, Emma.

You seem very breathless, Mister...

Williams.

Stats and obs? Where's the monitoring?

I don't know. They just told me

to come and look at him in the cupboard.

OK. Emergency buzzer and call for help, please, Emma.

I'm just gonna have a little listen to your breathing. Emma!

- Yeah. - Yeah, yeah.

OK.

OK, we're going to take very good care of you, Mr Williams.

I'll be right back.

I'm just gonna pop this mask on for you.

It's gonna help your breathing.

OK, can you pop your head forward?

Morning.

- Hi. - Resus?

Yes, please.

81-year-old male, no travel history,

flash pulmonary oedema, CABG 2011.

Otherwise well, walking three miles a day till last week.

We're gonna need suction, please, then non-rebreathe, 15 litres.

Neil, could you do an ABG?

- Yeah. - Frusemide, GTN?

If his BP can take it, yes, please. Have you got this?

- Yeah. Go, go. - The take's wild. Thank you.

Hey, Emma.

Could we please stop using that bloody cupboard?

Complaints go up, not sideways.

Emma, have a doughnut.

Hey...

Hey, you did really well, OK?

That shouldn't have happened.

- Yeah, but it always happens. - Abbey?

Can we use you?

Yeah. What's up?

It's happening.

Just had a call from LAS.

Might be the first one.

Blue-lit from Heathrow, flew in from China.

OK.

Could you tell Ant, please?

Yeah.

OK?

Yeah.

Failed my first fit-test a week ago.

- Oh? - Yeah. Thanks.

Failed my second one as well.

Oh, well done (!)

EXHALES SHARPLY

SIREN WAILS

Straight to this one, please.

OK, tell me about the patient, please.

This is Tony. DOB 3/12/65,

picked up from Heathrow, blue-lighted here.

- Get ready to move. - Airway open, no airway assists in.

- Ready, steady, roll. - Rest rep rate is high at 40 pm.

- Ready, steady, slide. - Sats low throughout on oxygen.

Let's make some room.

He's completely obtunded.

ABG, please, and can we get some monitoring?

Yeah.

Do we have access?

Just a pink. He's completely shut down.

Not shifting much air.

OK, can we do an urgent chest X-ray in here, please?

On their way.

Crep throughout. Neil, do you have an airway?

Yeah, but I'm having to help. Sats are in the 70s.

OK, he's tiring. We need to get on and intubate.

Yeah, agreed.

Drugs from the fridge, please.

- Jo? - Sats are 52.

- He's barely breathing now. - Suction's there.

Are ITU on their way?

On their way.

OK, drugs going in, bougie ready, please.

We're gonna need that ABG as soon as we can, guys.

Gonna need suction. Tube, please.

He's arresting now. MONITOR BEEPS

Chantelle.

Abbey, you and the team have got to let me know

if you're sending unstable patients up to the wards.

I know, I'm sorry. I wanted to give you a heads up,

but the take's been crazy.

Archie Williams. He should really be in ITU, but no beds.

We just lost the first one in resus.

Shit.

- He doesn't have it, does he? - No, he's flash pulmonary edema.

Are the ITU outreach team still gonna come and see him?

Yeah, I know it's not ideal, but they're rammed.

The whole network is.

We just can't be taking high-dependency patients

onto the general wards. I mean, it's not safe.

I know, but he's got to go somewhere.

'All over Lombardy, we are overwhelmed.

'Emergency full, intensive care full,

'theatres, corridors.

'It arrived so fast, we were not prepared.

'You must prepare and find a way to double, triple,

'more than triple the beds you have.

'All the ventilators you have,

'you will need more than that number.'

By how much more, would you say?

How many more ventilated beds?

'Mine is a small unit here, 15 beds,

'but we need we need 60-80 more,

'so you can do the sums.

'We're working 18-20 hours,

'our medical students are manually ventilating patients.'

'Prime Minister, just two weeks ago in Italy,

'there were 153 cases of coronavirus and just three deaths.

'Now, 16 million people have been quarantined.

'A reflection, if you like,

'of the public health challenge we are all facing globally.'

'We are rationing the ventilators.

'At the moment, we have no choice.

'Over 65, no ventilators at all.

'Oxygen, too, we are struggling with our supply.