Easing of Restrictions

The Intensive Care Society is calling for vigilance as England moves to no restrictions, with pressures on ICUs increasing daily.

With the Government set to remove all COVID-19 restrictions on Monday 19 July, we encourage the public to remain vigilant and the government to be prepared to re-introduce restrictions.  Cases of COVID are rising rapidly and many members of the public are still yet to receive two doses of the vaccine.

The decision to move to ‘no restrictions’ will not have been taken lightly. This is an extraordinarily difficult decision to protect the safety, livelihood, and wellbeing of our population, with many competing and important factors to consider. To give us the best chance to emerge from this pandemic, there are four measures we feel are now essential and ask for government consideration:

1. Clear guidance is provided on the need for face masks. At this time, anyone in an enclosed space should continue to wear a mask even if not mandated by law to do so, excluding only those who are exempt. Leaving individuals who can wear face masks to make up their own minds will only lead to variation in practice, confusion, and ultimately an increased transmission of COVID-19. Face masks are a simple but effective measure in reducing our likelihood of passing COVID-19 to others, helping to reduce illness, avoid hospitalisation and risk of chronic complications or death.
2. Every Intensive Care Unit (ICU) requires an adequate number of staffed beds. We have insufficient ICU beds in the UK  and currently ICUs are seeing more planned and emergency admissions as well as continued surge demand from COVID-19. Investment is needed urgently. Without adequate staff to care for patients, one or all of the following will happen:
   • As hospitals are faced with reaching winter baseline levels of occupancy in the next few weeks to months, they risk being unable to upscale to full surge capacity as they try to manage the back log of planned surgery. Some ICUs are already over capacity again in several COVID-19 ‘hotspots’.
   • The ability to support planned surgery will be reduced resulting in longer waiting times for patients.
   • Staff to patient ratios become stretched yet again and falling outside the standard outlined by the Intensive Care Society and the Faculty of Intensive Care Medicine in the Guidance for the Provision of Intensive Care Services . This leads to reduced standards of care and a workforce that will eventually break.
   • ICUs will be overwhelmed if further surge demands from other respiratory viruses (influenza and RSV) materialise whilst still caring for high numbers of patients with COVID-19


3. We must be prepared to quickly and decisively re-introduce restrictive measures to protect our loved ones, each other, and the NHS.
4. We must speed up the vaccine roll out to increase the number of those who have received both doses and publish clarity around any potential need for booster vaccines at the earliest opportunity.

We would like to thank all of our multi-professional intensive care health care professionals and colleagues throughout the NHS. The professionalism, commitment, compassion they have provided, particularly in the past 18 months has been remarkable. We thank you all.

We would also like to thank the public for their valiant efforts to reduce the spread of the virus and in supporting the NHS. We urge you to please keep playing your part, protect each other and take opportunities to be vaccinated if able. We understand the desire to return to normal, we stand with you in wanting the same but ask for your continued support at this time. We are committed to looking after each and every one of you.