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The number of new infections in Hungary rose sharply on Friday, so the medical chamber called on the competent authorities to take effective action. Miklós Kásler ordered the release of 20 percent of the hospital beds, according to the ministry, it is not necessary to send anyone home for this, because one of the two beds in the system is empty. But it’s a numbers game when we count the beds that can serve Covid patients.
On Friday, the government portal reported more than 459 newly discovered Covid-19 patients than ever before, and with an explosive 25 percent increase in the number of cases over the past week, we have also been at the forefront globally. In light of the latest figures signaling the start of another second wave that threatens disaster, the Hungarian Medical Chamber (MOK) urges the government to act immediately and effectively in a statement.
In its letter to Ministers Miklós Kásler and Sándor Pintér, the organization identifies two main areas. One of them is the reaffirmation of community prevention (promotion and control of the use of masks, mass events, suspension of sporting events, widespread population tests, active government presence and example in communication, strong action against virus deniers and skeptical of epidemics, local measures and not total in high-risk areas) and the other is to prepare the health system to effectively face the second wave of the epidemic.
Much harder numbers can come
Their concerns are not unfounded, experts from the epidemic modeling working group under the auspices of the Ministry of Innovation warned at the beginning of the week of a reproduction rate of 2-2.5 (this shows how many people transmit the virus to an infected person ), that is, even according to the most optimistic calculations, the number of new cases per day could increase in the order of a thousand by the middle of next week.
Emmi’s reaction to the album
Presumably, in response to the MOK’s letter, the ministry responsible for health was quick to announce in a statement on Friday afternoon that Human Resources Minister Miklós Kásler ordered healthcare providers to keep 20 percent. percent of the total number of beds ready instead of the current 10 percent. The Minister specifically drew the attention of hospital administrators to the fact that the implementation of the measure contained in the instruction should not result in the dismissal of patients from the institution, since currently the occupation of beds is around the 53 percent.
According to the ministry, data received from hospitals on Friday morning everywhere ensures that 20 percent of the total number of beds can be included in the care of Covid-19 infected patients if necessary. There are currently no care restrictions and protective equipment is available. Currently, 120 coronavirus patients require hospital care, eight of whom are connected to ventilators.
According to our information, something else happened today: Minister Kásler named the epidemiological hospitals, and the directors of the hospitals involved (probably the county hospitals) received a letter about it. In addition, as far as we know, a Covid care room on the second floor, with approximately 40 beds, was established in the Tömő street block of Semmelweis University as part of the pulmonary clinic. The fact that there are other patient care units below and above the room for infectious patients raises serious logistical problems, experts say, it is not a coincidence that such rooms are placed in separate wings.
The usefulness of 20 percent of the capacity of the bed put on hold in preparation is questionable. If the 53% utilization indicated in the communication was calculated on the basis of total inpatient capacity, i.e. including chronic and rehabilitation beds, this is generally not true: chronic and rehabilitation beds they have not been refilled after the spring evacuation, so 50 their occupancy is below one percent, reducing the average occupancy; no Covid patient can be placed in these empty beds. On the other hand, internal medicine, intensive care units, in which patients with coronavirus are mainly cared for, operate essentially in full use. If 20 percent of the beds in these wards are to be vacated, funding issues will arise in addition to patients left without care after the care system reverted to performance funding starting in September.
Another dilemma is that with the arrival of Covid patients, staff must also be reassigned from departments so that vacant departments become inoperable without merging. According to unanimous opinions, today there is no hospital in Hungary whose extensive department of internal medicine can provide comprehensive care to the remaining 80 percent, as well as the remaining 80 percent of coronavirus patients.
Play with numbers
A general bed occupancy rate is a game with numbers only because, depending on how the hospital operates, active care is essentially limited to 5 business days today and there are hardly any patients in the institutions on the weekend. Therefore, the 75 percent occupancy calculated for seven days, typical of active beds, actually represents 100 percent occupancy with five days of care. Internal medicine, pulmonary medicine, infectious diseases relevant to Covid patients are weak points in the system despite the 53% occupancy of beds in the attractive communication Emmi.
Preparation definitely requires a significant change in the professional structure of hospitals so that the 20 percent reserve is not just a theoretical option if it is a unit capable of caring for the real patient. Covid care is clearly active care, that is, a reserve of 20% must be compared to the number of active beds according to expert calculations.
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