Europe’s Public Hospitals in Crisis

Date: 16 January 2022 - 21:52

News ID: ۹۸۹۶۸

STRASBOURG, France (AP) -- A World Health Organization official warned last week of a “closing window of opportunity” for European countries to prevent their health care systems from being overwhelmed as the omicron variant produces near-vertical growth in coronavirus infections.
In France, Britain and Spain, nations with comparatively strong national health programs, that window may already be closed.
The director of an intensive care unit at a hospital in Strasbourg is turning patients away. A surgeon at a London hospital describes a critical delay in a man’s cancer diagnosis. Spain is seeing its determination to prevent a system collapse tested as omicron keeps medical personnel off work.
“There are a lot of patients we can’t admit, and it’s the non-COVID patients who are the collateral victims of all this,” said Dr. Julie Helms, who runs the ICU at Strasbourg University Hospital in far eastern France.
Two years into the pandemic, with the exceptionally contagious omicron impacting public services of various kinds, the variant’s effect on medical facilities has many reevaluating the resilience of public health systems that are considered essential to providing equal care.
The problem, experts say, is that few health systems built up enough flexibility to handle a crisis like the coronavirus before it emerged, while repeated infection spikes have kept the rest too preoccupied to implement changes during the long emergency.
Hospital admissions per capita right now are as high in France, Italy and Spain as they were last spring, when the three countries had lockdowns or other restrictive measures in place. England’s hospitalization rate of people with COVID-19 for the week ending Jan. 9 was slightly higher than it was in early February 2021, before most residents were vaccinated.
This time, there are no lockdowns. The Institute for Health Metrics and Evaluation, a population health research organization based at the University of Washington, predicts that more than half of the people in WHO Europe’s 53-country region will be infected with omicron within two months.
That includes doctors, nurses and technicians at public hospitals.
About 15% of the Strasbourg hospital system’s staff of 13,000 was out this week. In some hospitals, the employee absentee rate is 20%. Schedules are made and reset to plug gaps; patients whose needs aren’t critical must wait.
The French public hospital’s 26 ICU beds are almost all occupied by unvaccinated patients, people ”who refuse care, who refuse the medicine or who demand medicines that have no effectiveness,” Helms said.
She denied 12 requests for admission Tuesday, and 10 on Wednesday night.
“When you have three patients for a single bed, we try to take the one who has the best odds of benefiting from it,” Helms said.
In Britain, like France, omicron is causing cracks in the health system even though the variant appears to cause milder illness than its predecessors. The British government this month assigned military personnel, including medics, to fill in at London hospitals, adding to the ranks of service members already helping administer vaccines and operate ambulances.
At the Royal Free Hospital in London, Dr. Leye Ajayi described a patient who faced delays in his initial cancer diagnosis.
“Unfortunately, when we eventually got round to seeing the patient, his cancer had already spread,” Ajayi told Sky News. “So we’re now dealing with a young patient in his mid-50s who, perhaps if we’d seen him a year ago, could have offered curative surgery. We’re now dealing with palliative care.”
Nearly 13,000 patients in England were forced to wait on stretchers more than 12 hours before a hospital bed opened, according to figures released last week from the National Health Service.
Britain has a backlog of around 5.9 million people awaiting cancer
screenings, scheduled surgeries and other planned care. Some experts estimate that figure could double in the next three years.
Having the capacity to accommodate a surge is crucial, and it’s just this surge capacity that many in Europe were surprised to learn their countries lacked. The people in a position to turn that around were the same ones dealing with the crisis daily.
“Despite the fact that countries thought they were prepared for a pandemic that might come along, they were not. So it’s building the ship as it sails,” said Dr. David Heymann, who previously led the World Health Organization’s infectious diseases department.
But France had been cutting back hospital beds — and doctors and nurses — for years before the pandemic. Building it back up in a matter of months proved too much when the current wave infected hospital staff by the hundreds each day. Even allowing symptomatic COVID-19-positive health workers to report for work hasn’t been enough.
Britain’s NHS Confederation, a membership organization for sponsors and providers, says the public health service went into the pandemic with a shortage of 100,000 health workers that has only worsened.
The first wave of the pandemic pushed Spain’s health system to its limit. Hospitals improvised ways to treat more patients by setting up ICUs in operating rooms, gymnasiums and libraries. The public witnessed, appalled, retirees dying in nursing homes without ever being taken to state hospitals that were already well over capacity.
Dr. Nicolas Lefebvre, who runs the infectious diseases unit at the Strasbourg hospital, said Europe is prepared to handle isolated outbreaks as it has in the past, but the pandemic has exposed weakened foundations across entire health systems, even those considered among the world’s best.