Capacity of Intensive Care Beds is Reaching its Limit in the Czech Republic
The bed capacity of intensive care units in the Czech Republic continues to be under great stress and is reaching the point of absolute exhaustion. Hospitals are having to deal with a lack of qualified staff and are not able to comply with the usual standards of care provided.
The epidemic situation in the Czech Republic is continuing to worsen, which is having an effect, inter alia, through the spread of COVID-19 among people over 65 years of age. In the last three days, 3,238 patients over 65 have been newly diagnosed, which is reflected in the situation in hospitals. 6,543 patients are hospitalised in the Czech Republic as of 23 February. There are 1,318 patients in intensive care units, 662 of them require artificial lung ventilation.
“The impact of the current epidemic situation on hospital capacities is enormous.Capacities are strained to the limit and they are not far from being exhausted.As of today’s date, 15% of the intensive care unit beds that we have in the Czech Republic are available.In the case of standard beds with oxygen, 24% of them are available,” said Deputy Minister of Health, Chairman of the Czech Society of Anaesthesiology, Resuscitation and Intensive Medicine and Head of the COVID Clinical Group Vladimír Černý of the situation regarding inpatient care capacities.
The Ministry of Health, in cooperation with individual regions, is trying to deal with the situation primarily by transferring patients to hospitals with currently-available capacity through the National Inpatient Care Dispatch Service. At the current time, dispatchers are dealing with dozens of transfers a day.
“A total of 400 patients have been transported between regions.The most frequent transfers were of patients from the Karlovy Vary Region; generally they were taken to Prague and the Ústí Region,” said Petr Kolouch, a representative of the National Inpatient Care Dispatch Service, of its activities. “In the autumn, there were eight thousand patients in hospitals, now there are six and a half thousand, but this trend is increasing.In Prague, we can increase capacity by fifty beds for the most specialised care and this is working as a consequence of maximum cooperation and help from doctors in hospitals,” added the Regional Intensive Care Coordinator for Prague Tomáš Vymazal.
According to a representative of the Czech Red Cross (CRC), Richard Smejkal, in hospitals it is possible to make use of specially-trained teams of CRC volunteers sent for 72 hours; they can boost the capacity of a facility and lighten the load on staff: “We can focus trained teams on assistance for a patient – help him/her with eating or hygiene.”
Despite the maximum effort and hard work by healthcare professionals, it is not possible, due to the extreme number of patients, to comply with the usual standards of care, in particular personnel and treatment. In a number of regions the maximum capacity of ICU/ARW type beds is nearly full and there are no options for increases.
The Hradec Králové Region is one of the worst-hit regions. According to its intensive care coordinator, younger patients are also being hospitalised. “It’s a genuinely new phenomenon.It’s common to have forty-somethings, patients on ventilators with serious illness.The virus is behaving differently and affecting younger people,” said Pavel Dostál, the regional intensive care coordinator of the situation in Hradec Králové hospitals.
“Based on predictive models of trends in the epidemic situation, we unfortunately cannot expect that the burden on hospitals will soon start to develop positively.Numbers of newly-infected vulnerable patients are high, approx. 500-600 patients are accepted every day for hospitalisation.The usual period of a patient’s hospitalisation with a light clinical course of COVID-19 is approximately seven days, patients in intensive care are hospitalised for a number of weeks, some for a few months – such patients could account for up to 20% of the total number of those requiring intensive care with artificial lung ventilation,” explained Ladislav Dušek, Director of the Institute of Health Information and Statistics, of the reasons for intensive care capacities being full.
So that the inpatient intensive care system in the Czech Republic does not reach its limits, it is necessary to lower the burden placed on hospitals. It is therefore fundamental to reduce the number of social contacts and to comply with the anti-epidemic measures that are currently valid. This concerns, for example, wearing respirators, compliance with distancing and avoiding larger groups of people.
“One of the options of putting off the exhaustion of hospitals’ capacity for COVID patients is the involvement of out-patient specialists in care for patients in hospitals, which would enable a slight increase in bed capacities.There is also the option of foreign assistance, specific offers are currently limited, but negotiations are ongoing,” said Deputy Minister of Health and Head of the COVID Clinical Group Vladimír Černý.
“The primary aim is that in all circumstances we provide appropriate assistance for patients in an acute condition.We cannot allow them not to get the necessary basic care and for hospitals not to be able to treat a patient with an acute condition of any etiology,” added Deputy Minister of Health and Head of the COVID Clinical Group Vladimír Černý.