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Now it is foreseeable that the system will load to the limit. This is what Bernd Lamprecht, head of the pulmonary medicine clinic at Kepler University Hospital in Linz (KUK) and Jens Meier, head of the anesthesiology and operative intensive care clinic there, said in a crown update from JKU with Rector Meinhard Lukas on Monday.
“The greatest challenge since the war”
Lamprecht spoke of the greatest challenge to the health system since the war. In the spring there were one or two Covid 19 patient rooms at KUK, now there are seven. Two intensive care units are full and a third half full, according to Meier, who emphasized that specialists are not always available. “There have already been bottlenecks in hospitals, patients are being distributed across the country.” You can settle for interdisciplinary medical teams, the challenge for nursing is enormous. Meier surmised 100 additional intensive care beds would come.
The incisions are considerable, but urgent and oncological interventions are still feasible, interventions that can be planned have already been postponed in all departments. “Now it is foreseeable that the system will be loaded to the limit,” Meier said. Lamprecht admitted that he did not want to imagine much and insisted that “very simple measures such as maintaining distance, hygiene and the use of oral and nasal protection prevent the spread of the virus.” “You need to see more patients with fewer people and worse technical equipment,” Meier explained. We are still a long way from “rock-hard triage of disaster medicine”, we want to avoid it “with additional beds and diversification of benefits, but I’m not sure we can avoid it if lockdown measures don’t work. These are necessary to protect the healthcare system.
High mortality rates
Most of the patients are in their 60s, “but we see the full breadth, there are also seriously ill people in their 20s,” Lamprecht said. People between the ages of 30 and 70 would also be treated in the intensive care unit. “More than half survive the intensive care unit, but these are high mortality rates,” Meier says. In terms of medication, “Remdesivir has established itself, we achieve the best effect when used early,” Lamprecht said. In the second phase of the disease, a cortisone preparation would have proven effective. The results of the clinical study with the active principle co-developed by the Austrian geneticist Josef Penninger are still pending. Patients treated with him at the KUK were able to leave the hospital.
Intensive Care Physician – Triage is not currently necessary
In Upper Austria, despite high crown numbers, no classification measures are currently necessary. Jens Meier, head of the Clinic for Anesthesiology and Operative Intensive Care Medicine at Kepler University Hospital in Linz, emphasized this in a written statement on Monday. However, there are cases where intensive medical treatment is dispensed with when palliative treatment is more sensible.
“It is important to me to note that there are still sufficient intensive care capabilities available at this time,” said Meier, who coordinates intensive care beds in the state. At the moment, almost 100 intensive care beds are occupied with crown patients in Upper Austria, there are currently 150 beds available for them. This number could still be increased. Intensive care bed management across the state is also ensured to buffer regional bottlenecks. However, he wanted to point out that “not all patients need extensive intensive therapy in all situations.” Depending on the medical indication and the wishes of the patient, intensive therapy can also be dispensed with, for example if palliative medical treatment makes more sense. “But this is not triage in the strict sense” and corresponds to the “normal procedure”.
