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Many hospital beds have been empty for weeks. Now it is clear: the dreaded overload of intensive care units does not occur either. Therefore, the Federal Council could soon allow more interventions. But there is a new problem: important medications are scarce.
In many Swiss hospitals, separate Covid 19 wards and intensive care beds are underutilized.
Coronavirus patients have long been unknown in Swiss hospitals. They had to expect a sudden attack and, therefore, at the behest of the Federal Council, they did so without many operations that were not immediately vital. But now not only the number of infections is decreasing, but also the number of hospitalizations. The big unknown is becoming more predictable.
On Thursday, the Federal Council announced the plan for the gradual relaxation of the crown measures. Less urgent operations, so-called electoral interventions, could also become a problem. Because hospitals are already complaining about the losses of millions. Many had to file a short-term job for some staff members, and some may even face bankruptcy. Small and medium-sized facilities, in particular, are greatly affected by patient loss.
The more rural, the less Covid patients
“We are half empty,” says Urs Birchler, acting director of Einsiedeln Hospital. He is a member of the board of directors of several hospitals, has directed the Berner Inselspital for years, and is considered one of the best experts in the industry. Einsiedeln Hospital has also reserved a floor for Covid 19 patients. According to Birchler, however, there were never more than three or four people present at the same time. They are sick and can usually go home after a certain period of time. Like other small hospitals, Einsiedeln does not have an intensive care unit.
The situation in Einsiedeln is exemplary, says Birchler. “The more rural a hospital is, the fewer patients Covid 19 has.” There is more and more free capacity. In part, this may be due to the fact that people stayed home despite needing treatment, probably for fear of becoming infected. However, above all, the empty beds are due to the lack of electoral intervention. Birchler, therefore, hopes that the federal government will quickly loosen the ban, especially for rural hospitals. And you’re not alone in this: H + Hospital Association lobbied federal councilor Alain Berset last week to relax.
Less than a third of intensive care beds are occupied
Not only rural hospitals, but also cantonal and university hospitals report on request that most of their beds remain empty, including those reserved for Covid 19 patients. Before Easter, the Federal Council announced that the number of hospitalizations due to the virus crown would decrease throughout Switzerland. According to the Federal Office of Public Health (BAG), about 3,000 Covid-19 patients were hospitalized Tuesday. 400 of them receive intensive medical care. Fortunately, the expected bottleneck in intensive care units did not materialize.
The differences between hospitals are great, but there is no shortage anywhere. The largest number of Covid 19 patients receiving intensive care is still in Ticino. But after beds were scarce, the situation has now eased. The intensive care unit at the University of Lausanne is also relatively busy. There, more than half of the 60 ventilation sites reserved for coronavirus patients are occupied. There are significantly fewer, that is, 19 of the 69 Covid-19 intensive care beds, at the Zurich University Hospital. At the University Hospital of Basel, fewer than 10 patients with coronavirus must be ventilated. The cantonal hospitals of St. Gallen and Aarau are also underutilized. There are 33 patients in Lucerne, where there are 81 intensive care sites across the canton, but only four of them suffer from Covid-19.
Waiting for surgery for months?
If the state compensated hospitals for their failures, they would be huge sums. But financial loss is not the only problem. There are already jams during surgeries and medical check-ups. In a guest comment to the NZZ on Tuesday, Baden’s chief physician Antonio Nocito warned that Anglo-Saxon conditions could emerge in Switzerland, meaning patients would have to wait months for operations.
The current order of the Federal Council is: all non-urgent interventions must be postponed. However, hospitals have some leeway in design. Many say they have already used this and are doing more operations again. Nicolas Drechsler of the Basel University Hospital says this is also due to the fact that the urgency is increasing in oncology, for example: “A patient with breast cancer can wait a few weeks for an operation, but the sooner she is treated , best”. Other interventions would now be carried out again, provided that the planning of the operation allowed it. But make sure the business doesn’t start too fast.
In many places, preparations are already underway for a possible relaxation that could take effect in late April. The University of Zurich Hospital and the cantonal hospitals of Aargau and St. Gallen justify the planning measures with the fact that the preparation or even the resumption of services takes a long time. A spokeswoman for the University of Zurich says the scenarios are only for the moment: the specially built Covid 19 stations have not yet been dismantled.
Drug shortage doesn’t just affect crown patients
While everything is allowed, Covid 19 ventilated patient medications are now in short supply, as Tamedia newspapers reported. This particularly affects anesthetics and pain relievers. The federal government and cantons expect long-term delivery problems. Enea Martinelli, chief pharmacist in the Bernese Oberland, says: “The situation will remain tense for a long time, even if the virus is less active.” This was also confirmed by a media spokeswoman for the Federal Office for Economic Supply (BWL). Due to high demand, world pharmacies and pharmacies would empty. Production increases, but that is not enough.
This is also problematic because delivery bottlenecks not only affect coronavirus patients. Chief Pharmacist Martinelli says the same medications are needed for other patients. That is why it is not possible to postpone elective operations for as long as necessary: ”These interventions are not only enjoyable, but they become more urgent the longer you wait.” Therefore, creativity is required. “Doctors now have to find solutions and switch to other means if necessary.”
Because there have been purchases of hamsters in Switzerland, the business administration has recently coordinated the supply of medicines to hospitals. Right now, every effort is being made to obtain the necessary medication, writes the business administration on demand. Hospitals report that although they currently have enough medication again, some of their deposits are scarce.
