England’s chief medical officer warns that COVID second wave could overwhelm the NHS.

The NHS has abandoned the 1:1 rule in intensive care as the number of very sick COVID patients soars in England’s hospitals.

Professor Chris Whitty, England’s chief medical officer, told the British Medical Journal that the combination of COVID and usual cold season surge in illnesses will bring “an extremely difficult winter for the NHS – one that I suspect, unfortunately, will be unlike any we’ve seen in recent memory”.

The NHS-wide lack of critical care nurses was a key factor in the decision to increase the ratio in ICUs to 1:2, Dr Alison Pittard, dean of the faculty of Intensive Care told The Guardian.

“The [revised] guidance is needed because we do not have enough critical care staff to support the increase in beds required to care for all the patients with COVID and those with other conditions needing admission,” she said.

“The main issue is the longstanding failure to expand the workforce, and that is doctors, nurses and allied health professionals.”

Susan Masters, the Royal College of Nursing’s director of nursing, policy and public affairs, said: “Reducing the ratio of nurses-to-patients must be a temporary measure and only when it is absolutely necessary.

“This change means increasing the workload of intensive care nurses and there must be consideration of the physical and emotional toll this will take.”