As virus rises, Europe lacks ICU beds and hospital staff

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PARIS (AP) – In Italy, lines of ambulances park in front of hospitals awaiting beds, and in France, the government coronavirus monitoring application prominently displays the intensive care capacity occupied by COVID patients. 19: 92.5% and increasing. At the Barcelona ICU there is no end in sight for the doctors and nurses who have endured it once before.

Intensive care is the last line of defense for critically ill coronavirus patients and Europe is running out of beds and doctors and nurses to fill them.

Country after country, the ICU burden of COVID-19 patients is approaching and sometimes exceeding levels seen at the peak of last spring. Health officials, many of whom are advocating a return to tighter lockdowns, warn adding more beds will be pointless as there aren’t enough trained doctors and nurses to staff them.

In France, more than 7,000 health workers have been trained in intensive care techniques since last spring. Nursing students, trainees, ambulance drivers, all have been recruited, according to the Minister of Health Olivier Veran.

“If the mobilization is indeed there, it is not infinite,” he said last week, when the ICU units were filled to 85% of their capacity. ” It is not enough. “

Within days he had jumped another 7 percentage points and he warned he would continue to rise. And, unlike the first wave last spring, the virus is now everywhere in France, making transfers from one region to another by high-speed train less convenient. A hospital in the southern city of Marseille recently rolled around in refrigerated rental trucks before a feared rise in the number of ICU deaths.

In Italy, Filippo Anelli, the head of the National Association of Doctors, said that at the current infection rate, there will soon be not enough doctors for everyone. Recently in Naples nurses have started monitoring people sitting in cars outside emergency rooms, waiting for space to become available. Italy has a total of 11,000 ICU beds, but only enough anesthesiologists for 5,000 patients, Anelli said. As of Monday, 2,849 intensive care beds were filled across the country – 100 more than the day before.

For the average coronavirus patient with severe symptoms, it takes seven to 10 days to go from infection to hospitalization. Those admitted often have to stay for weeks, even as more and more patients arrive. The math is inexorable as the infection rates increase.

Patients from France and the Netherlands are being evacuated to German intensive care units, but German doctors say they are seeing the number of free beds dwindle rapidly.

Dr Uwe Janssens, who heads the German Interdisciplinary Association for Critical Care and Emergency Medicine, said some urban areas were reaching precarious levels.

“When a city of millions of people has only 80 or 90 beds left, it can be a critical mass, because you not only have COVID-19, there are also road accidents, heart attacks, pulmonary embolisms, etc. .

In the past two weeks alone, the number of coronavirus patients treated in ICUs in Germany has nearly tripled from 943 to 2,546. Yet Janssens acknowledged that the situation in Germany is better than that of France, from Belgium, the Netherlands and Great Britain.

Germany has about 34.5 intensive care beds per 100,000 inhabitants, not counting the emergency reserve. Italy has 10, France has 16, he said.

“But a bed, a ventilator and a monitor doesn’t mean the patient can be treated. When it comes to nurses and specialist staff, Germany is far behind, ”he said. “We have a lot of beds but we don’t have enough staff for them.”

Spain has the same limitations, but has already suffered coronavirus deaths on a scale that Germany has yet to see.

“On the one hand, health workers are tired; on the other hand, the number of people working on the front line is limited, ”said Dr Robert Guerri, head of the infectious diseases department and COVID-19 hospitalization coordinator at the Hospital del Mar in Barcelona.

Her coronavirus unit filled in October, then the intensive care unit filled up. Even though the infection rate drops slightly, he doesn’t know when one of those beds will be free.

In neighboring Portugal, Fernando Maltez has 40 years of experience in preparing emergency plans for health threats as one of the country’s leading infectious disease experts. This one is different.

In the seven months from early March to late September, Portugal officially counted more than 75,500 cases of COVID-19. In October alone, it numbered nearly 66,000.

A total of 391 coronavirus patients were in Portuguese ICUs on Monday, when the country imposed a curfew. During the worst week of last spring, ICUs had 271 coronavirus patients.

“There is no end in sight,” said Maltez in the infectious diseases department he oversees at Curry Cabral Hospital in Lisbon, where 20 intensive care beds reserved for coronavirus patients are now all occupied . “No health service in the world … can withstand a flood of cases that keeps happening.”

Much of Eastern Europe, untouched by the terrible wave of last spring, is in the same situation. Hungary has warned its intensive care unit will run out of space by December in the worst case, and hospitalizations in Poland have risen to three times the levels seen in the spring. At the end of last month, medically trained US National Guard soldiers traveled to the Czech Republic to work there alongside medics, and the mayor of Prague took shifts at a hospital.

There are some signs of hope. Belgium, which proportionally still remains the most affected country in Europe when it comes to coronavirus cases, sees more and more indications of a turning point in the crisis after a partial lockdown. Hospital admissions appear to have peaked at 879 on November 3 and fell to around 400 on Sunday, virologist Yves Van Laethem said.

There were concerns that the intensive care capacity of 2,000 beds could be reached last week, but Steven Van Gucht, a virologist with the government health group in Sciensano, said the pace was also slowing.

“The high-speed train is slowing down,” at least for now, he said.

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Associated Press writers Frank Jordans in Berlin; Renata Brito in Barcelona, ​​Spain; Danica Kirka in London; Lorne Cook and Raf Casert in Brussels; Frances D’Emilio in Rome; and Barry Hatton in Lisbon, Portugal, contributed to this report.

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