‘We have 4000 spare ventilators, The NHS can cope with a new surge’.
Can I stop you there -its concerning and perhaps I can explain why (being an ICU consultant and all that).

We started covid19 with just over 4000 critical care beds full stop–these were a mixture of ones that we could ventilate in (‘level 3’) & ones that we couldn’t (‘level 2’). We’ve managed to turn of lot of ‘level 2’ into ‘level 3’ beds – but also made new ICUs in Theatres & wards

Each ‘level 3’ bed needs a ventilator- but there are ‘ventilators’ and ‘ventilators’.

This little baby, the parapack, will keep you alive in the back of an ambulance for a couple of hours – but it's the Robin Reliant of ventilators.

This is a theatre ventilator -the Ford Escort of ventilators -basic, ok if not challenged too much (which for people with normal lungs having routine surgery is just fine).

This is a non-invasive ventilator, used for mask ventilation -lightweight, bicycle of a ventilator that at a push can have a motor strapped to it and be used for invasive ventilation.

And this is a real ICU ventilator – the Mercedes Benz (and yes, they are both German) of ventilators – and when you have hard to ventilate lungs because they are full of virus and fluid, this is the guy you want by your side.

Sure, they are all vehicles- but in a race for your life, which one do you want to be in?

But actually, ventilators are not the most important thing - what a ventilator needs (especially a make-do, imperfect, bicycle with a motor strapped to it ventilator) is a skilled operator. We call these guys ICU nurses, in USA respiratory therapists.

That's not all though, ICU medicine needs ICU specialists – you don’t want an orthopaedic surgeon doing your eye operation (or vice-versa). We take 15 years to train.

And specialist physiotherapists to keep your lungs clear and get you back on your feet when you recover. Specialist pharmacists who know how critical illness affects drug handling. Radiographers, biomedical scientists, the list goes on.

And guess what, we don’t have enough ICU nurses to staff every bed, we are all working massive overtime to keep these ersatz ICUs and make-do kit as safe as we can. This is only sustainable in the short term.

So please, don’t use our inventiveness and ability to cobble together solutions as an excuse to take risks.