Now that the infections are rising rapidly again, the old specter of full ICs is also looming. If it is up to Armand Girbes, intensivist at Amsterdam UMC, we can only solve this problem by choosing more actively who to treat in the ICU and who not, he tells news hour. Other hospitals also see time for action.
RIVM reported 5,223 new infections today. Despite this, it is now quieter in the ICUs than during previous peak periods: in 2020 there were still 450 people in the ICU around this time, now there are 164.
The question is how long it will stay that way. Not only can more infections lead to more hospital admissions, many hospitals now have to deal with many lost staff.
“We see that the capacity has become smaller because many healthcare staff are sick,” Girbes told news hour. “Those are things that play tricks on us.”
Health damage due to delayed care
The so-called ‘catch-up care’, of interventions that had to wait due to corona and are now being handled, also puts pressure on the already thinned workforce. “There is a lot of talk about catch-up care, but not that much comes of it.”
Meanwhile, many non-covid patients have complaints and problems that they need to get rid of.
Girbes looks at a recent report from the RIVM that shows how much health damage has occurred in non-covid patients. “Perhaps the damage in this category of patients is greater than the damage we have prevented in covid patients.”
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And that is why, according to Girbes, we as a society should start a conversation about a maximum number of IC beds in the Netherlands for covid beds. “We have to look at how we are going to divide the capacity fairly.”
Girbes believes that consideration should be given to how useful an IC treatment is or is not per patient. “You’re going to look at the survival chances of the patient in question, and how that compares to another category of patients,” says Girbes. “What nobody wants to talk about is that if you keep talking about corona, what that means for those other patients.”
‘Conversation we need to have’
Other hospitals are not yet as firm as Girbes, but are open to a discussion about this. Peter van der Voort, head of the Intensive Care department at the UMCG, calls it “a possibility that should also be discussed”.
Iwan van der Horst, intensivist at Maastricht UMC, thinks it is good that discussions are being held about keeping the IC functioning. “In our house, the discussion has not been explicitly discussed, but we do talk about making difficult choices,” he tells news hour. According to him, it would help if the government would think about this. “Not to choose is to choose is not to choose and see how it goes.”
breathlessness
But what if you arrive at the hospital with severe respiratory distress due to covid and there is no room left? “There are many treatment methods for people who are short of breath that do not immediately lead to an ICU admission,” says Girbes. According to him, it must be determined per patient whether or not that IC admission is really necessary.
“Eventually we’re all going to die,” Girbes says. “It’s also time for us to realize that there are limits to what we can do.”
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