Intervention measures against the crown are necessary



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We don’t want to face an even bigger wave.

Nine professionals from the Haukeland University Hospital oppose their colleague Halvor Næss. Photo: Bjørn Erik Larsen (archive)

  • Trond Bruun, Section Chief Physician, Infections Section, Medical Clinic; Bjørn Blomberg, Chief Physician, Infections Section, Medical Clinic; Stig Gjerde, Section Chief Physician, Intensive Care Section, Surgical Services Clinic; Siril Sagstad, Head of Section, Intensive Care Unit, Surgical Services Clinic; Per Espen Akselsen, Chief Physician, Patient Safety Section; Dorthea Hagen Oma, Director of Infection Control, Patient Safety Section; Kristin Stenhaug Kilhus, Director of Infection Control, Health West Regional Center of Competence for Infection Control; Kristin Greve-Isdahl Mohn, Infections Section and Influenza Center; Rebecca Cox, Flu Center

    Haukeland University Hospital

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This is a discussion post. The post is written by an external contributor and quality assured by BT’s discussion department. Opinions and analyzes are those of the author.

Still relatively few patients admitted with covid-19 at Haukeland University Hospital. The same applies to our neighboring hospital Haraldsplass. With so few seriously ill at this time, is it really necessary with strong infection control measures in our area?

It is understandable that many feel insecure. Chief Physician Halvor Næss has a position at BT on November 9, where the main message is that politicians have introduced measures in society that are too strong in relation to the risk and mortality associated with the coronary pandemic. He worries that the measures will lead to loneliness and isolation. We share that concern.

These measures cost a lot: financially, medically, and mentally. And therefore, they should not last longer than necessary. But we agree with our authorities that strong action is needed right now.

The position of Chief Medical Officer Halvor Næss has attracted great interest among readers. At the time of writing, it has been shared 18,555 times and read by more than 160,000 people. Photo: facsimile

The number with proven infection in and around Bergen it has increased rapidly in recent weeks. Relatively many have an unknown route of infection and the infection has spread to older age groups as well. If we can’t reverse the trend, we could have many serious illnesses and many hospitalizations and deaths in winter and spring.

Næss is right that mortality is very low for young and healthy people. You’re also correct that even healthy 60-year-olds are at low risk.

The problem is that a large proportion of the population is not completely healthy, especially among people aged 60 and over. Many belong to a risk group, by age, chronic disease, or both. Furthermore, we know that young, healthy people can also get very sick from the virus. If the total number of infected people becomes very high, the number of young and healthy people with severe covid-19 cannot be neglected either.

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Næss makes a relevant compared to the experiences of a flu epidemic in 2000, which was stronger than usual. They handled it well at Haraldsplass without intrusive measures on society.

The problem is that the experience base that is drawn is too limited. In such an influenza epidemic, we also have a vaccine for risk groups and there are drugs (Tamiflu). The main problem with covid-19 is not that the death rate is much higher than that of the flu, although it is much higher.

The challenge is that the immunity of the population is very low and we do not have an effective drug against the virus itself. Most of the population is susceptible and therefore the potential for the number of patients is very great.

The corona pandemic has created huge problems for hospitals in many countries, like here in Belgium. In the photo, a deceased crown patient is transported to the morgue in the city of La Louviere on November 10. Photo: Yves Herman / Reuters / NTB

No less we fear that many fall ill in a short time, causing health systems to become overloaded and in the worst cases collapse. This potential is what they are now painfully experiencing in countries like Belgium and the Czech Republic, as they did in northern Italy this spring. In several countries, intensive care units are now under great pressure and the capacity for planned procedures such as cancer surgery and cardiac surgery has been greatly reduced.

We will not go beyond Sweden until we see that they are struggling with this. The Swedes have opted for less intrusive measures than Norway, perhaps precisely an approach that Næss advocates. But the experiences in our neighboring country are not particularly good, they have more than ten times more deaths than Norway in relation to the population.

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We have done it too own experiences. Even during the moderate wave we had here in March, we had seven patients in the intensive care unit at the same time. They were all very sick. Most survived, but remained on a respirator for a long time. This was very demanding on both patients and staff. We haven’t come close to anything like this during a seasonal flu epidemic in modern times.

We don’t want to face an even bigger wave. We are not so concerned about the capacity of beds in general. We have good reservations there, as they also had in the Haraldsplass example mentioned in 2000. But with a high number of COVID-19 patients, a large proportion will require intensive care. Reserve capacity in Norwegian hospitals is significantly lower.

Intensive care places great demands on the appropriate areas and equipment, but especially on personnel with competence in intensive care. This is a highly specialized treatment. Not in vain, those of us who work in hospitals worry if society’s measures become half-hearted and are not effective enough. Therefore, we are pleased that politicians and most people are taking it seriously.

The results are promising for a vaccine developed by the pharmaceutical company Pfizer. According to the company, it will provide about 90 percent safe protection against the coronavirus, and senders hope that vaccination can begin in 2021. Photo: Given Ruvic / NTB

The infection has increased considerably. in our region this fall. In Bergen alone, about 900 cases have been detected in the last two weeks. Relatively many have an unknown route of transmission. To regain control of the pandemic, we have to act.

The way to do this is to limit the number of close contacts, in addition to basic infection control measures where distance, hand hygiene and staying home when sick are the most important.

We have also learned a lot since last spring, and in this round, fortunately, the youngest are saved from most of the measures. Therefore, we believe that the measures are now generally proportionate. They are in reasonable proportion to the seriousness of the situation. This severity does not apply to the number of critically ill patients here and now, but this can happen without strong measures. Of course, we do not want a culture of fear or condemnation of others, but charity for the good of the community.

Just arrived Promising results for one of the new coronary vaccines. If the final results confirm a good effect and few side effects, we will be able to start vaccinating in early 2021.

The benefits of preventing infection and death this fall and winter will be even more important from that perspective.

  • What do you think of the measures against the crown? Do voice your opinion in the comment section further down the page!
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