Intended for healthcare professionals


Challenges for NHS hospitals during covid-19 epidemic

BMJ 2020; 368 doi: (Published 20 March 2020) Cite this as: BMJ 2020;368:m1117

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  1. John Willan, consultant haematologist1 2,
  2. Andrew John King, consultant haematologist3,
  3. Katie Jeffery, consultant microbiologist2,
  4. Nicola Bienz, consultant haematologist1
  1. 1Frimley Health NHS Foundation Trust, Wexham Park, Slough, Berkshire, UK
  2. 2Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
  3. 3Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to: J Willan john.willan{at}

Healthcare workers need comprehensive support as every aspect of care is reorganised

Delivery of every aspect of care by all clinical and non-clinical departments in the UK’s NHS is being reassessed and fundamentally reorganised in the expectation of an imminent surge of patients with covid-19.1 Modelling of the outbreak assumes an infection fatality ratio of 0.9% and a hospital admission rate of 4.4%, with 30% of those admitted requiring critical care or extracorporeal membrane oxygenation.23 The increased demand on healthcare services will be compounded by the apparent increased risk of infection among healthcare workers,4 and staff absences because of illness or self-isolation may be as high as 20%.11 The government has made recommendations for case isolation, social distancing, and household quarantine intended to reduce the peak of the epidemic and the resulting pressure on NHS hospitals.56


Over the next four weeks thousands of medical students are likely to graduate early and be allowed to begin work as junior doctors. Doctors who have retired within the last three years are being asked to consider returning …

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