Urgent care is now also under pressure at three in ten hospitals

It is not as busy in intensive care as in the spring, but it has been going on for some time.Image Robin Utrecht

The situation in hospitals is now more ‘dire’ and ‘more difficult’ than during the first wave, say various healthcare administrators.

The Dutch Healthcare Authority announced the figures on Tuesday: 29 percent of hospitals can only partially provide the so-called ‘critical planable care’, which must take place within six weeks to prevent health damage. The operating capacity has also been scaled down rapidly in recent weeks: from 74 percent two weeks ago, to 60 percent last week, to 50 percent now.

It shows that the pressure on hospitals has increased much faster than expected. Just a week ago, Minister Van Ark (Medical Care) said that hospitals should ‘make every effort to continue the care that really needs to be provided, because otherwise years of life will be lost or permanent health damage will occur’. With that aim, regular plannable care was discontinued throughout the country. That now appears to be insufficient. Hospitals are still struggling to accommodate covid patients.

“The whole idea was that we would secure urgent care,” says a spokesperson for the National Network Acute Care. ‘That was the reason that Tamara van Ark made that call then. But you can already see that many hospitals are no longer successful. ‘

This is partly because the number of hospital admissions of corona patients has increased rapidly. At the moment there are even as many (suspected) corona cases in the nursing wards of the hospitals as at the height of the first wave, according to figures from the Nice Foundation. In intensive care it is not yet as busy as in the spring, but it has been going on for longer.

‘The lockdown started much too late’, says David Jongen, chairman of the Board of Directors of the Zuyderland hospital in South Limburg. Although the number of infections is declining, this hardly applies to hospital admissions. ‘I live in the south,’ says Jongen. “So I lit a candle, hoping that we will soon notice the lockdown.”

Diederik Gommers, chairman of the Dutch Intensive Care Association, also fervently hopes that the lockdown measures, which took effect two weeks ago, will slowly start to take effect. “If the number of infections does not decrease and we still have to add the effects of the holidays and the ‘British variant’, then things will run out,” warned the intensivist at BNR.

Another problem is that fatigue sets in among hospital staff. “People are getting exhausted,” says Jongen, who is also vice-president of the Dutch Association for Hospitals. ‘If you asked in the spring: who wants to work extra, nine out of ten people said yes. Now it is much more difficult. ‘

Breast cancer surgery

All in all, the situation in the hospital is more ‘dire’ than in the first wave, says Jongen. ‘That first wave rose quickly, but also fell back quickly. Back then we only had two operating rooms open, but that only lasted two weeks. Then we made a restart. ‘

Boy now faces the decision to scale down the number of operating theaters from eight to six. That means breast cancer surgeries cannot proceed. Or colon cancer surgery. ‘A terrible decision’, says Jongen. “But we’re talking about it.”

Wim van Harten, chairman of the board of the Rijnstate in Arnhem, also calls the current situation ‘more difficult’ than in the spring wave. ‘We have scaled up the number of IC beds,’ says the hospital manager. “But we have fewer beds in the nursing ward than we did then.” The hospital was last weekend so full that ten patients had to be relocated. ‘Overloading was imminent,’ says Van Harten.

The operating capacity is now at the same level as during the first wave, says Van Harten. ‘Then we had 6 of the 22 operating theaters in use, now again.’

High absenteeism

The employees in Arnhem are also ‘at the end of their tether’, says Van Harten. ‘Not much needs to be done or they will drop out. Absenteeism is high. I estimate that half will fail due to corona, the other half due to other causes. ‘

One thing both hospital administrators do not understand: why are the hospital staff not also the first to qualify for vaccination? “Incomprehensible,” they both say. Van Harten: ‘This is the way to reduce absenteeism due to illness, because then doctors and nurses no longer get corona. And then there may even be room again to do hip and back operations, which have already been postponed three or four times. ‘

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