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At the Valais Hospital, the number of hospital stays is doubling every day. Photo: trapezoidal
Interview
“I’m not very optimistic” – Valais doctor about the situation in hospitals
The number of Covid patients is doubling every day in Valais hospitals. Nicolas Troillet, the head of infectious diseases there and deputy cantonal doctor, says in an interview how things are going to continue and what we have learned from the first wave.
On Sunday, Wallis Hospital made a dramatic statement to the public. He said the number of hospitalizations had doubled every day since October 16. “The speed and increase in the number of complications is alarming.” The French-speaking Valais hospital center has already been forced to change from level one to level two (out of four) of its emergency plan in just three days.
Nicolas Troillet, Head of Infectious Diseases at Wallis Hospital and Deputy Cantonal Physician, observes the development with concern. Four of a total of 13 operating rooms at the French-speaking hospital had to close in order to increase bed capacity. In an interview with Watson, Troillet tells what the next days and weeks will be like for Valais and what other cantons can learn from the situation in the mountainous canton.
Mr Troillet, the number of hospitalizations in the Canton of Valais has doubled every 24 hours in recent days. What happened?
The increase in hospitalizations is a reflection of what is happening outside of hospitals: many people are infected with Covid-19. We have looked at these numbers over the past few weeks and have calculated that sooner or later more people will have to be hospitalized again.
Nicolas Troillet, Head of Infectious Diseases at Valais Hospital and Deputy Cantonal Physician. image: zvg
Why are the numbers increasing so rapidly in the canton of Valais? In the last 14 days, 799 people were infected for every 100,000 inhabitants. There were 321 in all of Switzerland.
We have many new cases at this time. I cannot say why this is so. There was no specific event that was considered the trigger for this situation. In the last few weeks, we have seen how quickly a region can become a hotspot. First it was the canton of Geneva, then that of Vaud. And now we are. After all, it’s good that we tested a lot and discovered a large number of cases. The positivity rate has surpassed 25 percent in recent days.
Daily admissions and admission capacities are monitored on the Valais Hospital website. Why did you choose this transparent communication?
Because it is an important message for the population: see what the current situation is like. We depend on people to recognize the seriousness of the situation and adhere to the measures. This is the only way we can prevent the number of hospitalizations from increasing further. That transparency is a good thing. Why hide these numbers? I would also recommend this follow-up to any other canton.
In the first wave, Ticino suffered the most from the high number of Covid patients. Will the Valais become Ticino’s second wave?
It is true that at the moment there are very many cases in Valais. But it is not the case that the disease is spreading from our canton. In general, the numbers are increasing throughout Switzerland and there are also clusters elsewhere, in the canton of Schwyz, for example, or Neuchâtel. That is why you can hardly point a finger at a place and say that it is worse there.
A group was discovered at the Saint-Amé clinic. One patient infected seven others with the corona virus. How did that happen?
A patient became infected with Covid-19 at the hospital. How exactly is very difficult to figure out. It could have happened to a visitor or someone who works at the hospital, despite the security measures in place.
In French-speaking Valais, hospitals are already in the second stage of the emergency plan. What does that mean?
We check every day how many people have already been hospitalized and how many are recently admitted. Above a certain number, more beds and capacity adjustment are required. The second stage means that we had to expand the bed capacity in the French-speaking Valais hospitals. In addition, we have already had to close some operating rooms.
This is what happened with the first wave: hospitals suddenly needed more beds and planned operations had to be postponed. Are we going back to the same point as in spring?
No. We now know more about the virus and we have better treatment options. There are two medications in particular that we can use to better treat patients. It is still not the miracle medicine, but it seems that fewer people will need intensive treatment and may be discharged from the hospital sooner.
What kind of drugs are these?
One is an anti-viral drug and the other is a corticosteroid. They are considered very promising in the medical world and are increasingly used not only in Switzerland but also around the world.
During the first wave, it was mainly the elderly and people at risk who needed intensive care. Has that changed?
We suspect that similar patients need intensive care as in spring. Therefore, older people and people with a previous illness. But we can’t say for sure yet, as we currently only have five people in the intensive care unit.
Will it ever happen again that hospitals have to classify patients? Or is there a shortage of fans?
I neither expect nor believe it. Even during the first wave, we were able to treat all the patients who needed intensive care. It was even possible that we could bring Covid patients from France to our hospitals. Now there is also a national coordination of intensive care units. If there is not enough space somewhere, the patient can be treated elsewhere. In general, we are better positioned than a few months ago.
During the first wave, there was a shortage of masks in hospitals. How are you now?
In spring we had to save material. But that is no longer a problem. We have a supply of protective equipment that lasts for three months. And we can order new material continuously.
Are there enough medical staff in the hospitals? This can also be due to illness or quarantine. Or lie in bed for the next several weeks due to the seasonal flu.
When it gets tight in hospitals, that means our specialists withdraw from their regular treatments and can help us with Covid patients. Of course, we also recommend that our staff get a flu shot. If too many people are quarantined, we have permission from the Cantonal Council to allow them to work anyway, as long as they are not sick.
In a message, Wallis Hospital writes that you need to prepare so that you don’t feel overwhelmed. Is there a risk of feeling overwhelmed?
When I look at the numbers developing outside of hospitals, I’m not exactly optimistic. Now the new measures that the Federal Council communicated on Sunday must be applied. We will only see in two weeks if they are useful. Until then, I assume that the number of hospitalizations will continue to increase. We and the hospitals of other cantons must be prepared for this.
