With an increase in the number of confirmed corona infections, the number of COVID-19 patients in intensive care in the Netherlands, and especially in North Brabant, is also increasing daily. Is there sufficient IC capacity in Dutch hospitals in the long term?
All told, Dutch hospitals normally have 1,150 places on the ICs. Usually about 70 to 75 percent of this is occupied, which amounts to about eight hundred beds. This concerns patients who need to have surgery or who need acute care.
This means that, in principle, there are approximately 350 places left for seriously ill corona patients. However, this number is currently higher, at 575 beds, because planned interventions that can wait have been postponed.
On Friday, the Dutch Association for Intensive Care (NVIC) reported that there are currently 281 corona patients on Dutch ICs. Earlier this week, the NVIC already announced that they expect five hundred to a thousand new patients in the hospitals in Brabant next week.
That would mean scaling up. But does that work too?
Former minister Bruins: ‘The first step is to scale up to 1,500 IC places’
Initially, patients are distributed as best as possible among hospitals in other regions of the Netherlands, so that hospitals in the most affected areas are not overloaded. For example, dozens of patients have been transferred from hospitals in Brabant to hospitals elsewhere in the country in recent days.
In addition, the cabinet plans to scale up to 1,500 IC places as soon as it is necessary, former minister for Medical Care Bruno Bruins said during the debate in the House of Representatives on Wednesday. To achieve this, ic boxes are used that are normally not occupied. These are existing isolation rooms within which the air pressure is lower than outside, so that pathogens do not leave the room.
This initial upscaling can be accomplished in hours to days.
Enough staff is critical
The next step is to scale up to 2,000 IC places. This step takes more time, because it depends on, for example, suppliers of respiratory equipment and protective equipment. For example, Diederik Gommers, NVIC chairman, said this week in the House of Representatives that the ICs need five hundred respirators for the upscaling. How fast can this be done? “There is varying views, but upscaling is possible within a few weeks,” says Bruins.
Ventilation equipment is vital for corona patients who are on ICU because they no longer have the strength to breathe themselves. In China, it also appeared that patients needed mechanical ventilation for weeks.
Defense is also preparing to help. “Think of our medical capacity. We have the emergency hospital in Utrecht, but we also have an emergency hospital that may be deployed,” said Defense Minister Ank Bijleveld. There are a number of IC places at both locations. In addition, three navy ships jointly have about thirty IC beds. “Commitment has not been necessary until now, but as always we are ready if that is the case. It may not be that we have to prepare again.”
Sufficient personnel is of crucial importance for both steps. This organization is currently under construction. For example, health care workers in the operating rooms are prepared to work on the ICU.
Cabinet wants to check virus in such a way that IC capacity is sufficient
Should it be necessary to scale up to three thousand IC beds, corresponding medical equipment will have to be purchased, Gommers emphasized during the debate. But on these resources is currently a worldwide run.
The cabinet hopes to take measures already taken, such as closing catering and sports clubs and social distancing to check the virus. In this way, relatively few people fall ill at the same time, relatively few people end up in IC at the same time, so there must be sufficient IC beds available for all these people.
In the unlikely event that the number of admissions to the ICs increases faster than expected, Rutte does not exclude taking additional measures to reduce the further spread of the virus and thus the increase in the number of IC patients.
Follow the latest developments around the virus in our live blog.
The coronavirus in short
- The coronavirus mainly spreads through sneezing and cough drops. The virus can be transmitted directly from person to person or (for a limited time) through surfaces such as door handles.
- An infected person infects two to three others on average. Precautions are necessary to contain this.
- The vast majority of patients have mild (flu-like) complaints.
- Nearly all deaths involve the elderly or other frail, such as heart, lung or diabetes patients. If everyone complies with the measures, this reduces their risks.
- Read here what precautions you should take.
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