Leading doctors today warned that the swine flu pandemic could put extra pressure on intensive care beds in England especially in children's units. They said in some regions the demand for intensive care beds could exceed supply by 130% while the need for ventilators could exceed supply by 20%.

According to the researchers from the University of Cambridge, the Intensive Care Society and St George's Healthcare NHS Trust in London pediatric facilities are likely to become "quickly exhausted", while hospitals could face "massive excess demand". Hospitals on the South East coast, in the South West, East of England and East Midlands are likely to be worst hit, they said. London would fare the best and should have enough intensive care beds and ventilators.

As a result of the swine flu Concord Hospital, which is networked with Royal Prince Alfred Hospital and is treating many of the state's sickest swine flu patients, has opened extra intensive-care beds to accommodate the number of critically ill patients. Gary Miller, the hospital's acting general manager, yesterday confirmed that two additional intensive-care beds were in use.  

Miller said the two hospitals operated as "an integrated group to meet demand when needed", and due to the number of urgent intensive-care cases now at Concord one person with less urgent surgery was rescheduled so as not to take a bed in the unit.                                                                                                                

Michael O'Leary, the vice-president of the Australian and New Zealand Intensive Care Society, who works at Royal Prince Alfred, said demand for beds was still high, after the outbreak worsened two weeks ago. "But there doesn't appear to have been an exponential increase, as we had feared."

It was possible the return of students to school next week would accelerate the epidemic again, said O'Leary. "Everyone comments about children being super-spreaders of the influenza virus. We can only wait and see if that occurs."

The researchers said the demand for beds could be 130% above supply in the South East Coast Strategic Health Authority (SHA) area, and 120% above supply in the South West and the East Midlands and East of England.  

Across the whole of England, demand for beds could be 60% above the number available, all based on a hospital admission rate of 0.25%. The experts warned that intensive care units were already running at high bed occupancy rates.

Although the Government has insisted that it can cancel non-emergency operations to increase the number of beds available but today's experts said, "Only 10% of critical care beds in England are in specialist pediatric units, but best estimates suggest that 30% of patients requiring critical care will be children.

"Pediatric intensive care facilities are likely to be quickly exhausted and suggest that older children should be managed in adult critical care units to allow resource optimization."

Dr Ari Ercole, study researcher from the University of Cambridge said, "Any predictions need to be based on the most accurate information available at the time and we recognize that we are in the early stages of the pandemic.
 
"However, based on figures provided by the 10 regional health authorities and using the FluSurge model developed by the Centres for Disease Control and Prevention in the USA, we can see that hospitals would face massive excess demand even if the pandemic lasted an optimistic 12 weeks.

"Pediatric intensive care facilities for children under 15 would be quickly exhausted, as they make up 10% of current provision but could face 30% of the demand for pandemic related beds.

"Early experience of the present strain suggests that the attack rate is particularly high in the young and that this virus may severely compromise the immune systems of people who contract it."

The research was published in the journal Anaesthesia.