Every effort is made to prevent it, and it happens again and again. The Isala hospital in Zwolle had to cancel twenty people who were about to be operated on last weekend. Other large hospitals have also canceled operations or are seeing waiting lists grow, according to a tour of NRC.
Many hospitals are suffering from the increase in the number of corona patients that has undeniably started after the relaxation at the end of September. The average number of new corona cases in hospitals increased by two-thirds in two weeks, to about 70 per day. In total, there are now more than six hundred people with Covid-19 in hospitals, the same number as in mid-September.
Canceling operations is painful because a large number of Dutch people are waiting for an operation. How much is unknown, calculations from last summer assume a backlog of more than a hundred thousand operations.
Several heart operations had to be canceled at Radboudumc on Monday, according to internist-infectiologist Chantal Bleeker-Rovers. The number of corona patients had increased rapidly last week and this increase could not be absorbed, partly due to high absenteeism.
transfers
In Zwolle, care came to a standstill in part due to a corona outbreak in the municipality of Staphorst, where only slightly more than half of the people have been vaccinated. Five people with Covid-19 had to be transferred from Isala to hospitals in Groningen, Rotterdam and Dordrecht.
Especially in the large and medium-sized hospitals in regions with a low vaccination coverage it is getting busier again. In addition to Zwolle, this concerns hospitals in the Randstad and the Mijnstreek. In the Limburg Zuyderland, a third of the ICU beds are full of Covid-19 patients, a doubling in a week and a half. “We keep it up with pain and effort,” says hospital director David Jongen. “We are very close to the point where we have to cancel operations again.”
Boy feels “so powerless”. “We are training ourselves drowsy, working hard on good working conditions and good cooperation with the region. The only button we can turn is canceling operations. That’s the last thing I want.”
In the Elisabeth-Tweesteden Hospital in Tilburg, 15 percent of the beds are occupied with Covid-19 patients. The number of people waiting is also increasing there. “We try to avoid canceling operations,” says director Bart Berden, “but we are restricting access by only planning operations with a higher urgency. If the IC occupancy goes to 25-30 percent, we will have to cancel operations again.”
This time it feels harsh for staff to work so hard, Berden says, because the majority of Covid-19 patients are unvaccinated. Berden: “Nurses now have to put everything aside, while the solution is within reach.” Boy also notices that the staff is more negative. ICU nurses also have to deal with brutal family members who deny corona, even if their loved one is on a ventilator. Boy: “No, corona does not exist, they say. Just do other investigations.”
New reality
A large number of hospitals can still cope with the increased crowds, or do not even see the increase. In the UMC Utrecht, seven corona patients are in the clinic and one in the ICU. The hospital can admit up to fourteen corona patients in the clinic and three in the ICU. The hospital is preparing for a new reality, says capacity manager Suzan Vernie, in which there is always room for a number of corona patients. After all, nobody knows if and when Covid-19 will disappear. “And if the number gets too high, then scenarios are ready in which we also have to scale down regular care,” says Vernie. “We are holding our breath a bit, because we do not know what the effect of Covid-19 is in combination with the flu wave.”
The Maasstad Hospital in Rotterdam is looking with fear at the coming months when the flu will also be around. “Rotterdam is a region that will follow quite quickly if the number of corona cases increases again,” says hospital director Peter Langenbach.
In general, small hospitals are less affected by Covid-19. This is because they perform simpler operations that require an intensive care bed less often.
Absenteeism is still high in healthcare as a whole. In the Zuyderland, there is a ten percent absenteeism among operating room personnel, as a result of which two of the twenty operating rooms are out of order. According to a study by the National Center for the Prevention of Stress & Burn-out among 189 nurses of the Erasmus Hospital, two thirds of the nurses suffer from stress. This is partly due to the rapid scaling up during the second and third corona wave, says Diederik Gommers, head of the IC. “Nurses are in the risk zone for burnout or PTSD.”
With the collaboration of Tan Tunali.
Is Urk leading the way? pg. 4-5
A version of this article also appeared in NRC in the morning of October 19, 2021
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