The head of the intensive care unit at the Amsterdam UMC, location VUmc, rings the alarm for patients who do not have a corona. Because the focus now seems to be exclusively on corona patients, other patients are at greater risk, Armand Girbes warns. Other doctors express opposite News hour similar concerns.
“The entire health care system is flat and revolves around Covid-19 patients,” said Girbes. “I am now also busy making a lot of extra IC beds available for Covid-19 patients. But who thinks of the regular patients?” He fears that people may die because they are not helped in time.
“Procrastination can be fatal”
Almost half of the regular care is canceled due to the coronavirus outbreak. Yesterday, researchers in the Financieele Dagblad warned that this would lead to increasing waiting lists and therefore possibly also to health risks.
From a survey of News hour and the Patient Federation has already shown that the majority of patients whose care appointments have been canceled by corona are concerned. Two in three believe that delaying treatment or surgery has consequences.
Emergency operations continue as normal, but postponing non-emergency care can also have major consequences, Girbes sees. “If you are in a precise chemo trajectory with a planned operation and the operation has been postponed, it does not immediately seem urgent. But in the long run, it can be fatal.”
“What we do not realize is that in this way people from regular care, who are not being helped on time, have worse chances and even die.”
Hidden dead
VUmc radiologist Martijn Meijerink is also concerned. “Acute treatments continue as usual. But then there is a group of patients who actually cannot wait, but do not yet have acute problems.”
For example, Meijerink mentions the example of a patient whose blood vessel is about to burst. “You know that there is a significant chance that this will happen within two to three weeks. We cannot help these people now, but are put on the top of the waiting list and then you are dependent on the limited anesthesia and surgical sites.”
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Dramatic decisions need to be made to distribute scarce capacity, says Girbes. “We have to think about these dilemmas now: do I help in IC this covid-19 patient who has also had heart failure and kidney problems in the past and who has a very high chance that he will not survive after three weeks of IC? Or help we a non-corona patient who is on the waiting list for open heart surgery? “
Meijerink: “These are choices that we have not made before. Some procedures you postpone to a dangerous date. With these kinds of choices you do not always make the right choices. There will be patients that I can no longer treat.”
“What I really mind is that we now seem to be making these choices passively,” says Girbes. “We don’t really choose: apart from acute cases, we let all covid-19 patients precede. This will soon lead to hidden deaths. We will soon have a major disaster. I don’t want to panic, but I do worry . “
“This is just the reality”
Meijerink is also alarmist. “Certainly, a number of people will die as a result. That is a fact. The care was already understaffed.” For example, according to him, the six-week period within which patients with a growing tumor must be helped is well exceeded. And that can have fatal consequences.
Yet he does not see how things should be done differently. “When I see how many people die from corona and how much IC beds are needed, this is just the reality.”
According to Girbes, there is a need for a ‘helicopter view’: how long will care continue in this way? How will we distribute care again in the future? “Everyone is very fanatic and focused on covid-19. I understand that, but there must now be someone who has the overview.”
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