The head of the Intensive Care Unit of the Amsterdam UMC, Armand Girbes, is not in a jubilation. “I’m quite worried. The load on the ICs is still high. Patients have been in the ICU for a long time, an average of three weeks. That means you get full very quickly.”
Girbes is responding to the relaxation of the corona measures announced by the cabinet yesterday. “I cannot foresee the effect of these relaxations. But we are more likely to have patients in the hospital, and more likely to be in the ICU. As a citizen, I understand that there are more things than the medical aspects of COVID care. But if you as a government decide to throw the case open, then I hope people understand that care must include people, protective equipment and respirators. “
Estimates
RIVM director Jaap van Dissel spoke to the House of Representatives today and discussed the expected effects of the relaxations. RIVM estimates that these will not again cause major pressure on the ICs. “But much is uncertain, so it is really an estimate,” says Van Dissel.
In the parliamentary debate, Prime Minister Mark Rutte emphasized today that yesterday’s timetable is not fixed. Relaxations are only possible on the basis of advice from the Outbreak Management Team, which looks at the number of infections and IC recordings. “If we can’t, we have to do it later. We don’t take unnecessary risks.” He did say that upscaling the number of IC beds – to 3,000 as announced by the cabinet in a letter to parliament – is possible if the virus flares up again. “That is a buffer and only for when accidents happen.”
But Girbes calls that assumption a “mirage.” “We have now furnished 1100, 1200 beds according to current standards. The improvised IC beds, which are beds where the care met the requirements, but not according to our old standard.” Furthermore, there is a lack of good preparation for a second wave, says the intensivist. “In the first place with protective material such as masks, glasses, overalls, but also respirators. There is still a shortage of everything and protocols have to be adapted.”
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In recent months, the ICs have received help from nurses from many other departments. “We have gone to the edge with that,” says Girbes. “ICU nurses who normally supervise one or two beds now had to coordinate and care for three or four, helped by other nurses. They had to do things they weren’t used to. Intensive care is more than just a ventilator. If you have a COVID patient only breathes, he dies. “
The staff is experiencing great psychological pressure, he explains. “There is a big difference between people who are new and people who are used to working at the IC. It is part of my profession that I see people die. That has a lot of impact. And talking to families. That is very stressful. new employees are not used to people dying. For that I brought in extra psychological help. “
Front soldiers
The government thinks that the restrictions can be relaxed and that the virus remains under control in the meantime. Today RIVM director Van Dissel was unable to answer the question as to which increase in infections will be braked again.
“Rule one of the first aid is: take care of your own safety. A large number of people have contracted COVID, a nurse has died from COVID, one has been admitted to IC, a few others have been seriously ill.”
Perspective
For the mayor of Dordrecht and chairman of the South Holland South security region, Wouter Kolff, it is a matter of easing “earning”. “We are going to try to translate the guidelines of the national government into practical measures. This requires people to understand what it is necessary for. Nobody is waiting for a new peak in infections. I think it is good that the government is working on perspective. keep the courage in it. “
As far as he is concerned, the emphasis is less on strict enforcement and more on understanding. “We appeal to responsibility. I’m not going to measure a terrace. But where excesses happen, where people deliberately cross borders, there we will be strict. This will only succeed if everyone cooperates.”
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