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In his Facebook post published yesterday, Prime Minister Viktor Orbán spoke, among other things, that in mid-December, the Covid supply would reach the capacity limit. And of course we are world leaders and minimal podiums in terms of fan and number of beds. But what do these numbers mean? And what will happen in the second half of December? And how will we know that we have reached some limit?
According to the latest data, the system registers almost 70,000 active infections. Although the actual number of infected people is many times higher, the exact value is now of little importance, so let’s not exceed 70,000. Of these 70,000 infected, nearly 5,200 are in such a serious condition that they need to be treated in a hospital, and the number of people already in need of ventilation is slowly increasing to 400.
Where can it end?
The number of people infected and, consequently, the number of patients who become seriously ill, depends on the protection measures and the degree of adherence of people to these measures. And how much the system can hold in many ways depends on what we want, how much it can support.
In general, both the effectiveness of defense and the capacity of the health system depend on the price we are willing to pay.
In defense, one extreme is the total closure -whose undoubted effectiveness was demonstrated in spring- and the other is not loose. At the moment, the balance tips towards nowhere loose in Hungary. We tend to think that wearing a mask alone is enough, but this is not the case.
The mask is important, but far from being sufficient, it does not stop the spread of the virus on its own
– Said to our newspaper András Csilek, president of the Borsod-Abaúj-Zemplén county regional organization of the Hungarian Medical Chamber.
He added that the austerity measures now introduced are not worth much overall – a nightly curfew or free parking is unnecessary, and in itself it is only false security if cinemas and theaters are operated with a third house. These may improve the situation only slightly.
The result would be if the government banned all mass events.
Also, once they’re open, it would be worthwhile to seat people at every second or third table in the catering units and bring back the shopping times for the elderly. And this is still only a partial closure – András Csilek added.
Based on European examples, the partial shutdown has not stopped the virus anywhere, so more and more states are being forced to introduce full shutdown. However, the school closings and the total closure are already having a serious direct impact on the economy, so this is not easy to achieve, even more so because the spring closure has hit a large hole in GDP, dropping a 13.6 percent year-on-year in the second quarter. base – said the Hungarian Medical Chamber B.-A.-Z. president of the county territorial organization.
December estimate
Based on all this, on a purely theoretical level, the following can be expected. If the number of active infections continues to rise steadily, but now at a slower rate through mid-December, the number of infected people has risen by more than five percent a day in the last week with almost the same number of tests In mid-December, the number of active infections could approach 160-200 thousand. If the growth rate slows down significantly, this order of magnitude can still be expected, and this is not yet the period when the number of infected people is less day by day.
According to data from the last few weeks, about six percent of active infections require hospitalization and about one in fifteen of them require mechanical ventilation. If we have 160-200 thousand infections in mid-December, this will mean 10-12 thousand hospitalized covidium patients and 650-800 ventilators. Importantly, if the government announced a total closure or even just the closure of schools next week, this estimate would no longer be worth much. But this is not the case today. At the moment, according to our previous calculation, the situation is changing, which is not at all reassuring.
What does all this mean for the healthcare system?
For now, it is certain that all Covid patients still have space and attention. According to the chamber, the system for the care of covid patients can be expanded in several rounds, that is, there are still reserves. The question is at what price. Gergely Gulyás, the minister in charge of the Prime Minister’s Office, said in the government briefing that deferred, that is, elective, surgeries are expected to stop, so significant capacity can be released.
If all these surgeries are stopped, even the magical 32,000 hospital beds mentioned in the spring could be available. At the same time, of course, there will be additional capacity for intensive beds. Here, however, András Csilek pointed out, the same dilemma arises as in the case of the closure of the country: at what cost.
The Prime Minister cites hospital beds and the number of ventilators respectively as examples, but shamefully avoids the question of human resources. Gergely Gulyás also referred only to the fact that up to ten thousand machines can be implemented. However, it does not matter how many and who are next to them next to the beds and machines. According to information from Népszava, there are approximately two thousand specialists in intensive care, the same number of specialized nurses, and half of the 1,800-2,000 intensive care units are already occupied by other diseases and accidents, regardless of the coronavirus.
Can thousands or tens of thousands of patients now be ventilated at the same time?
Cannot pull out the capacity limit. Because even
many patients can be cared for, just the question of at what level.
The more patients there are, no matter how much equipment is available, the standard of care will definitely drop beyond a point. In other words, it can be seen from there that the system has reached a kind of limit in terms of human resources, that the level of care is deteriorating suddenly and drastically. This means that daily death rates will rise suddenly, precipitously and brutally.
Instead of a shower announcer
There is no central and uniform information on how many covid patients are cared for in each hospital and how the patients’ pathways are remodeled. The press comes to the information mainly through individual reports and written instructions from the institutions, but the chamber does not see it clearly either. To find out the seriousness of the situation in each hospital, the MOK has created a channel to guarantee anonymity. Through this, hospitals, doctors, nurses can inform the camera and secondly the public about their experiences.
According to information in our article, patient pathways are also being rebuilt at St. Imre Hospital in Budapest, but in vain we asked the hospital about this, they directed the Index to operational staff, and the latter did not respond to our request. According to reports from the Index, the situation is chaotic, with patients constantly moving in and out of a room. In one ward, patients from several different wards are housed and followed by doctors and nurses, so it also happens that a nurse bandages a patient for surgery after a biopsy. We know that not only is there a redistribution between individual wards, but patients who do not receive the crown also come from other institutions. Whether the covids were admitted to the hospital and, if so, how many crowned patients were treated, was not disclosed by the operative tribe.
(Cover image: MTI / Zsolt Czeglédi)
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