Young unvaccinated people are admitted here

At one of the intensive care units of Oslo University Hospital (OUS), Rikshospitalet, in Oslo, two intensive care nurses are preparing a new intensive care bed to receive another critically ill covid patient. Medicines and respirator are prepared. A very advanced machine, ECMO, is also available. An unvaccinated young patient is awaited.

The person was healthy before she was infected with corona in mid-December. Now the state of health must be so bad that ECMO treatment at Rikshospitalet is the last option.

– We have a prayer that everyone who can should be vaccinated. Failure to do so will increase the risk of serious illness. The youngest we have received so far was born in the 90s, says Camilla Finsand, section leader at the intensive care unit at OUS Rikshospitalet.

Machine like lungs

Four red-clad ambulance personnel come rolling in with the seriously ill patient. The person in question is carefully transferred to a prepared intensive care bed, while the ambulance doctor tells about the medical history.

– Previously healthy and unvaccinated. Been to the hospital since mid-December, is the message from the ambulance doctor.

The normally healthy person is now in an artificial coma, is very seriously ill and unsuspecting about all the hands around, who do everything to save his life.

The patient is not alone. In the same room are two other patients connected to their respective respirators – and to a so-called ECMO machine (extracorporeal membrane oxygenation), the most advanced treatment that covid patients can receive.

– The ECMO machine is used in case of critical lung failure. In practice, this is done by pumping the patients’ blood through a machine that removes carbon dioxide and supplies oxygen, before oxygen-rich blood is returned to the patient, says Andreas Barratt-Due, chief physician in anaesthesiology and assistant section leader at OUS, Rikshospitalet.

He further explains:

– The treatment is accompanied by great risk and is therefore not suitable for everyone. The indication for start-up is therefore carefully assessed in each individual case by the treatment team.

Increasing trend: – Extra resource-intensive

Long sick

The three patients lie completely still and receive strong painkillers and sleeping pills. Intensive care nurses and anesthetists walk around calmly and assess the patients’ clinic and monitor oxygen and heart parameters on the patient monitor.

In the course of a day, physiotherapists, perfusionists (responsible for the ECMO equipment, journ.anm.), Pharmacists, doctors, infectious disease specialists and other specialists visit both the critically ill covid-19 intensive care patients.

– This is not a “quick fix”, it takes time. Those who come in here often lie on rest for 30 days. Others up to 40 to 50 days, says Susanne Haugeto, one of the intensive care nurses who has been on intensive care this day.

Exactly how long it can take before the sickest covid patients actually recover, the doctors and nurses at Rikshospitalet believe that is “somewhat undercommunicated”.

– Not much has been written about how long intensive care stays many covid patients in the intensive care units have. Many people stay on a respirator for four to five weeks and the treatment is often complicated by new infections. Many patients will need a long rehabilitation period after finishing intensive care and struggle for a long time, says Barratt-Due.

Many health problems

Kristin Hofsø is an intensive care nurse and researcher, employed at OUS, Oslo University Hospital and at Lovisenberg Diaconal College. She is leading a research project where they look at survival in covid-19 long-term patients, funded by the Research Council of Norway.

– One thing is to survive the critical phase, in intensive care. The patients here are much worse than others. They often have a long course of illness and a long course of intensive care. Then it is common to have a number of health problems in the first year after admission, she says.

Previous research has shown that people who have been admitted to an intensive care unit may struggle cognitively in the first year, especially with concentration and memory. In addition, some experience fatigue, depression and post-traumatic stress disorder.

Whether this is worse in patients who have been admitted to intensive care due to covid-19 is now being researched by Hofsø and colleagues.

– Most people who have been treated in intensive care will have a long recovery period afterwards, where a customized rehabilitation program will be very important, she says.

Delta tail

It was Friday last week that Dagbladet followed the employees in the covid-intensive departments. At that time, eight patients were here, in addition to two patients being transferred from other hospitals.

– Since the end of October, the majority of those who come to us are unvaccinated. There is reason to believe that those who are here are infected by the delta variant, says Barratt-Due.

Good news about omikron

The patients in the intensive care unit have been in hospital for so long that they became infected before the far more contagious omicron variant came to the country, which is now the ruling one in Norway. 97 percent of new infections in Norway are now omicron. Research from England and Denmark shows that fewer people become very ill from omicron.

– We call this the delta tail, and hope that it is now coming to an end, says Barratt-Due.

– Vaccinate

Unlike most hospitals, OUS Rikshospitalet is not a primary hospital where newly infected covid patients are admitted. In the covid-19 context, this means that Rikshospitalet receives the sickest patients, in addition to being a relief hospital in Helse Sør-Øst.

Barratt-Due and colleague Camilla Finsand emphasize that “they treat all patients equally, whether they have been vaccinated or not”.

– But we encourage everyone to get vaccinated, Finsand repeats.

Of Norway’s around 5.4 million inhabitants, around 4.3 million have now been vaccinated with at least the first dose, shows tall fra FHI. The numbers are clear. Of the patients who are now in the country’s intensive care units, 70 per cent are unvaccinated, 20 per cent have been vaccinated, but have so-called autoimmune diseases – while 10 per cent have been vaccinated.

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