The tool advises clinicians to rate patients according to three criteria: their age, frailty and the underlying conditions
Updated Sunday, April 12, 2020, 10:17 p.m.
A Covid-19 decision tool developed for the NHS by the National Institute for Health and Care Excellence (Nice) advises clinicians to rate patients according to three criteria: their age, their fragility and the underlying conditions, according to the Financial times.
Tool to aid decision
People with a total score of more than eight points should probably not be admitted to intensive care, advises the Covid-19 decision support tool. However, doctors are not obliged to follow this advice and can exercise discretion.
Patients aged 70 to 75 receive four points, while those aged 76 to 80 receive five and those over 80 receive six. Those under 50 get no points, but those 50 to 60 get one point, those 61 to 65 get two, and those 66 to 70 get three.
Patients are also judged on their perceived frailty, a score of one indicating that they are “very fit” while four means that they are “vulnerable” – although they do not depend on others for daily help , they often experience symptoms that “limit [their] Activities ”.
The terminally ill, with a life expectancy of less than six months, are awarded nine points.
The third scale takes into account comorbidity, which applies to patients suffering from several illnesses or diseases at the same time. Anyone who has had a cardiac arrest for any reason in the past three years receives three points, while patients with a chronic illness that resulted in three or more hospital admissions in the past year receive two points.
“There may be situations that go beyond the framework and require special attention, so clinical discretion will continue to apply,” said the document.
“The fragility score is used as an indicator of physiological frailty, which reduces the chances of recovery in ICU [Intensive Care Units], so where the conditions [that] the preexisting impact on physical activity but is stable and inappropriately affects the score, so this situation requires special attention.
G Ageism ’
Caroline Abrahams, charity director at Age UK, said: “There should be no room for arbitrary age criteria when making treatment decisions regarding Covid-19, any more than there should be none with another disease.
“Chronological age is a very poor indicator of a person’s resilience and health status.
“All treatment decisions must be made based on an individual’s ability to benefit, informed by the best clinical evidence. The general age criteria are ageism, pure and simple. “