• Tim Cook is a doctor in an NHS intensive care unit

Coronavirus and the disease it causes, Covid-19, have dominated the headlines. Yet the range of expectations and predictions of its impacts have been so wide as to make clear understanding almost impossible. This is perhaps inevitable when we grapple with a fast-moving and previously unknown illness. What is clear, is that as knowledge grows it has become evident that this has the potential to be one of the most fatal epidemics to have hit the world for a century, and it is rapidly increasing in prevalence in the UK.

I work as a doctor in an intensive care unit (ICU). It is a speciality (like anaesthesia its parent speciality) which most of the public have little understanding of unless they have required our services. What is in no doubt is that ICU sits at the centre of all that is necessary for keeping alive what may be a very large number of patients who will develop severe Covid-19.

ICU treats patients whose lives are at risk or whose organs have failed. Severe Covid-19 leads mostly to lung failure but also causes kidney and cardiovascular (heart and blood vessel) failure. All these are rapidly fatal without intense and prompt treatments only available in ICU. In simple terms, treatments include a ventilator taking over the patient’s breathing while the patient is anaesthetised (placed in an induced coma), a dialysis machine cleaning the blood and drugs or machines supporting the heart and blood pressure. The reality of care is, of course, considerably more complex and highly intensive.

So let’s look at some statistics: it is likely that more than 30% of the whole UK population will get Covid-19 – it may be as high as 60% in some estimates. Most will have no or mild illness but maybe one in seven will need hospital admission. Of patients in hospital up to one in five may need ICU care – that would be an unprecedented number of people admitted to ICU. As many as one in 50 of patients known to have Covid-19 may die from it.


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