Covid The things we are not being told as lockdown looms

Lockdown 2.0 is on its way, with ministers saying they have been left with no choice if lives are to be saved and the NHS is not to be overwhelmed.

It seems to be an open-and-shut case. But as MPs prepare to vote on the lockdown a number of questions remain to be answered.

How will it be used to fix Test and Trace?
One of the benefits of lockdown, it has been suggested, is that it will provide time to fix England's NHS Test and Trace system.

It is routinely failing to meet its targets to reach people who test positive, and then obtain and contact their close contacts to ask them to isolate.

But solving that is easier said than done.
Councils are now being encouraged to set up their own local contact-tracing teams to try to improve the reach of the service.

About one-third have something up and running, but most are just at the start with skeleton teams and IT struggles.

Directors of public health are frustrated they were only given money to do this as the second wave got under way, rather than earlier in the year when infection rates were lower and it would have been easier to build up.

What is more, very few people appear to be isolating. Research suggests fewer than one in five are doing so fully.

The government is now providing help - those on low incomes are getting £500 support payments. But that, some say, is not enough.

"The government simply doesn't understand the difficulties people face in terms of lost income and job insecurity," says one chief executive who has had in-depth negotiations with the government on the issue.

"We're doing all this work to try to reach them, but then don't help them isolate. What's the point?"

Exactly how close is the NHS to being overwhelmed?
The government presents detailed statistics on Covid. They show more than 9,000 patients are currently in hospitals in England.

But what we are not being told is exactly just how full hospitals are.

The Covid patients take up fewer than one in 10 beds.

So far, both NHS England and the Department of Health and Social Care have refused to reveal the number of available beds once you take into account patients being treated in hospital for other conditions.

Figures obtained by the Health Service Journal, which the BBC understands are correct, suggest just over 80% of beds are occupied.

That's actually a little bit lower than it was last winter, reflecting the fact that despite efforts to do more non-Covid work, such as cancer care and routine surgery, the numbers remain well below pre-pandemic levels.

It provides a bit of wriggle room, but not much. In fact, those areas like Manchester and Liverpool that have seen a significant proportion of the admissions are close to being full.

Health worker tying on face mask
IMAGE COPYRIGHTGETTY IMAGES
But there are a number of options the NHS has to increase capacity. One is to start cancelling non-urgent treatments - and some hospitals have already started to do this.

The other is to use the Nightingale field hospitals. The one in the North West has started taking non-Covid patients to ease the pressure on hospitals in that region.

Could the others be deployed? Possibly, although unions have questioned where the staff are going to come from to care for patients.

But regardless of that it is virtually impossible to assess just how acute the pressures are.

NHS leaders are due to hold a press briefing on Wednesday, which may shed some light on the issue.