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If the explanation is that hospitals have improved in the treatment of covid-19, it is good news.
The death rate from corona in Norway has been low so far, but it has always been feared that there are too few places for respirators. In the event of a shortage, not all seriously ill patients will be able to receive the treatment they need.
– If intensive care units are overloaded, the fatality can worsen, writes FHI in its latest risk report on the low mortality rate.
Ensuring the capacity of intensive care units has therefore been one of the top priorities in the fight against the coronavirus.
Also read: The Norwegian Medical Association supports the Norwegian Nurses Association: – These are not respirators
Sharp increase in the number of hospitalized patients
At most 99 corona patients received respiratory treatment at the same time in Norway, but the number declined rapidly when the society was closed.
During the summer, the infection in Norway was at a low level, but since the outbreak in Hurtigruten in late July, the number of hospital admissions has pointed in one direction: up.
On July 31, three patients were admitted to hospital with covid-19 in Norway. On Wednesday of last week, there were 28 people. This is the highest number in four months.
But while the number of hospital admissions points in one direction, almost no patient receives respiratory treatment.
The number of people hospitalized with corona has multiplied since last summer, but there is no increase in respiratory patients.
Photo: (Norwegian Health Directorate)
In fact, Norway has recently gone through the longest period without covid-19 ventilator patients since the pandemic began, at the same time that infection has increased: for 16 days, ventilators were not used for corona patients.
The big question is why this is so and what it may mean for the Norwegian hospitals’ ability to handle a further increase in infections.
I’m not sure what the cause is
– It is true that the number of hospital admissions has increased slightly in recent weeks, while the number of transfers to the intensive care unit has not increased correspondingly. However, there are very small numbers and therefore great uncertainty in interpretation. These may be coincidences, chief physician Preben Aavitsland of the National Institute of Public Health tells Nettavisen.
Preben Aavitsland, chief physician at the National Institute of Public Health.
Photo: Tor Erik Schrøder (NTB)
– If there is a real effect, it may have two explanations: it may have to do with the occurrence of a serious disease in the population, or it may have to do with the treatment given in the hospital to prevent the need for intensive care, he says .
– I think the first explanation is included. It may simply be that those affected are currently so young that very serious diseases are still rare, says the superior of FHI.
Hospitals have gained more experience
After the big spike in infection earlier this year, Norwegian hospitals, among others, stopped investigating whether the antimalarial drug hydroxychloroquine has an effect against the disease and put it completely out of use:
– We have now reviewed our data and made a formal decision to remove hydroxychloroquine, an antimalarial drug, from the study, said Research Council Director Arne Røttingen in mid-June.
Also read: Norway stops using the antimalarial drug hydroxychloroquine against covid-19
This time coincided with the recent decline and flattening in the number of ventilator patients.
At the same time, doctors have documented that the Ebola drug remdesivir, as well as steroids, have an effect on hospitalized patients.
Also read: – I ask God that this treatment works
Has changed treatment, but numbers are uncertain
Chief physician Vibecke Sørensen of the Ahus intensive care unit confirms that treatment methods have changed somewhat, but they currently have too few patients to be able to establish that this has had an effect:
– Ahus has had few hospitalized covid-19 patients and therefore few for intensive care in recent months. Previous experience is that 20-25 percent of hospitalized patients need intensive care. The same has happened with few hospitalized patients. Recently, we have had patients in intensive care who have not required ventilator therapy, but who have received ventilator support by mask therapy (NIV – non-invasive ventilator therapy), Sørensen writes in an email.
Chief physician Vibecke Sørensen (left) in Ahus’s intensive care unit.
Photo: (Ahus)
– It is true that currently more patients receive steroids, that is, those who worsen the airways and are at risk of needing respiratory treatment. Ahus still has too few patients and little data to say for sure that this has reduced and will reduce the need for ventilators for our patients. Otherwise, we have had very low mortality in our patients, both in the hospital in general and in patients who have been in intensive care, so it is also uncertain whether steroids now will be able to reduce mortality in the future, he notes. .
Nakstad: – Lower average age of those infected than before summer
The online newspaper has asked Deputy Health Director Espen Rostrup Nakstad what assessments they make of low respiratory rates and whether this affects the Norwegian Health Directorate’s concern about the capacity of hospitals in the event of a strong infection.
Nakstad tells Nettavisen that he believes few respiratory patients are largely related to the age of those who have recently been infected:
– During the pandemic, the proportion of hospitalized patients needing intensive care has been around 20-25 percent in many countries. Most of these have required respiratory treatment. In Norway, we have had low infection rates since last summer, with an average age of those infected significantly lower than before the summer. Young people don’t get as seriously ill as older people. Therefore, the number of admissions has been low in recent weeks and the need for intensive care somewhat less, although in some days it has been up to 25 percent of all hospital admissions, says Nakstad.
Deputy Director of Health Espen Rostrup Nakstad at a press conference on the status of the crown. Photo: Jil Yngland / NTB
Photo: (NTB scanpix)
Therefore, you are not sure if this means that the capacity of the fan seats is safe:
– If the infection in Norway becomes very high again and spreads to larger parts of the population, we should expect a greater need for hospitalizations and intensive care units. Changes in the pathogenic properties of the virus can also occur. Therefore, it must be taken into account that the need for hospital treatment may once again be high, also in intensive care units, she concludes.
Also read: It has discovered more than 12,000 mutations of the coronavirus, so a more contagious variant may be good news
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