In the IC department of the Leiden University Medical Center (LUMC), five beds are reserved for corona patients as standard. This means that there are five fewer beds for patients who need other care.
Evert de Jonge, head of the intensive care unit at the LUMC, is ‘greatly concerned’ that more corona beds will soon be needed, because the ICs in the Netherlands get overloaded again. “Many people now think: we no longer have to keep a distance of one and a half meters, the catering industry is open again, so there is no problem anymore,” he says. “But it does not work like that.”
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The numbers
The total IC capacity in Dutch hospitals is 942 beds, according to figures from LCPS (National Coordination Center for Patient Distribution). There are currently 720 people on IC. Among them are 185 corona patients. 535 patients are there for a different reason.
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“We do indeed see that there are far fewer corona patients in the IC than during the waves last year and at the beginning of this year,” confirms Hanneke Buter, board member of the ICU. Dutch Association for Intensive Care (NVIC). But, she says, the situation is still serious and dire, despite the relatively high vaccination coverage.
There are several reasons for this. “If more than 80 percent of the Dutch are vaccinated, that means more than a million” not vaccinated is,” says Marcel Levi, internist and professor of medicine at the University of Amsterdam. According to him, we should not underestimate that number: “It is enough to fill empty hospital beds.”
More chance of infection
People who have not been vaccinated are also more likely to become infected. “That is because there are almost no more corona measures,” explains department head De Jonge. “Society is open again, but the people who are vaccinated can still get and transmit the virus. So the risk of contamination of unvaccinated people is greater than during the lockdowns.” Last week it was already announced that four out of five corona patients on IC have not been vaccinated.
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In addition, hospitals are catching up with regular care, says a spokesperson for the National Coordination Center for Patient Distribution. “Unnecessary operations that were postponed during the first, second and third wave are now done. And then you automatically get more patients who have to lie in the ICU after their operation.”
Organization of care
According to critics, it also has to do with how care is organized. Germany, for example, normally has 34 IC beds per 100,000 inhabitants. And we? Seven. “We have shortened the length of stay of people in hospital in the Netherlands,” said emeritus professor and health economist Guus Schrijvers of Utrecht University. already on RTL News. “Suppose you get a new hip. Then you are often outside again within a day. Then the rehabilitation only starts, it used to take twelve days.”
“In the Netherlands we are used to using the IC as efficiently as possible, and we were proud of that,” says department head De Jonge. “As much care as possible was provided with as few beds and staff as possible. As a result, we have no overcapacity.” Buter: “If there was a shortage of beds in a hospital, it was often of a temporary nature and hospitals from other regions could help. But during the pandemic that was suddenly no longer possible.”
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Just before the pandemic, the Netherlands had 1050 IC beds available. There are now only 925, says Buter of the NVIC. “The main cause of this is the dropout of nurses. Most ICUs in the Netherlands have had to close beds in recent months because there is a very large shortage.”
On some ICs, that increases to 20 percent less staff on the IC. “We try with all our might to keep running the beds that we still have, but that’s just fine.” Earlier, two IC doctors explained to RTL Nieuws what effect the shortage of nurses has on healthcare. Watch the full interview with the two doctors here:
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“The staff is exhausted,” adds De Jonge, department head. “That’s what I’m most concerned about. People often think: if it’s really necessary, those hospitals can probably do the same thing as they did in March last year.”
Scaled up insanely fast
But it is naive to think: those hospitals will make it, says De Jonge. “Last year, hospitals scaled up insanely fast. During that time, we asked a lot of hospital staff. You may be able to put in more beds and equipment, but something like that won’t attract the staff again.”
Buter agrees: “When we talk to nurses, I mainly see fatigue. A lot of fatigue. The prospect of such busy weeks or months gives them a stomachache.”
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’93 percent have antibodies’
In the meantime, almost 82 percent of Dutch people over the age of 12 have been fully vaccinated. Blood Bank Sanquin concludes in a new study that 93 percent of blood donors have antibodies against the coronavirus, in part because they have had corona, and for the most part because of vaccinations.
According to Hans Zaaijer, medical microbiologist at Sanquin, this figure may be too rosy, because donors are not average Dutch people. Yet it comes close to reality, he said in September by News Hour: “You also have a bit of control: RIVM knows exactly how many people have had a vaccination in which age group, and then you see that this corresponds beautifully with what we find in our donor age groups. The actual percentage will be slightly lower, with especially because we have so few donors with a migration background, but it will be close.”
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