[ad_1]
743 Covid patients are currently in hospital care, 74 of them in intensive care. With the support of the Statistical Office of the Canton of Zurich, programmer Robert Salzer is looking at the total number of hospitalizations. Over the weekend, the Federal Office of Public Health reported 8,737 new laboratory-confirmed infections and 171 hospital admissions. The troubling question today is: Can the growth of the virus be contained in such a way that hospitals do not reach their capacity limits?
In spring, at the height of the pandemic to date, Covid patients occupied a maximum of almost 2,400 beds at the same time. The health system withstood the pressure. At last Friday’s press conference, Martin Ackermann, head of the federal scientific working group Covid, could not assess when exactly the attack will be now. If the curve for new infections points upward, as before, the task force expects hospital admissions to double every seven to ten days. The Federal Council and the cantons hope to break the trend with restrictions, including the requirement for extended masks and a ban on gathering in public spaces for 15 or more people.
Intensive care units have 1,000 beds nationwide and an additional 500 can be put into operation if necessary. About a week ago, capacity was less than 50 percent full, and Covid patients made up a small proportion. According to information from the federal government, the cantons currently have a good 6,000 free hospital beds.
Sporadic hospitals report bottlenecks. About last week, Schwyz Hospital warned that it would soon no longer be able to cope with the flood of Covid patients. Nursing staff is urgently needed. Meanwhile, the Canton of Zurich health department has announced that hospitals are not currently under attack, but that the situation is being closely monitored. Whether the hospital is able to cope with a possible second wave attack depends above all on whether enough specialists are available.
The hospital association absolutely wants to avoid a treatment ban
Cantons and hospitals are currently preparing to serve Covid patients across cantonal borders if necessary. That means: if one canton reaches its limit, another, which still has resources, intervenes. In spring, the Federal Council imposed a ban on treatment for all operations that are not urgently needed. In late August, H +, the Swiss Hospitals Association, announced that the damage caused by this treatment ban would amount to 2.6 billion francs for the entire year.
Hospitals are now doing their best to avoid a new treatment ban by coordinating with other hospitals and flexibly adapting their capacities, says H + director Anne Bütikofer. The association requires a national information system with up-to-date data on bed, staff and material capacity to better assess the situation in hospitals and improve coordination. “This is the only way to ensure that patients can be well cared for, even as the number of cases and hospitalizations increases,” says Bütikofer.
Starting position different from that of the first wave in spring.
There is also positive news to report from the front of the intensive care units. Because the starting position is different from that of the spring, when Switzerland was invaded by the first corona wave. The staff are more experienced and calmer, says Peter Steiger, deputy director of Intensive Care Medicine at the University Hospital Zurich (USZ).
Furthermore, Covid 19 patients would now arrive at the hospital earlier, which is important: therapies must begin as soon as possible to prevent severe courses. If there is a lack of oxygen, all patients now receive Remdesivir, which was only available to some of the patients in the spring as a study basis. The drug is now approved in Switzerland and, according to Steiger, it is also available in sufficient quantities.
The cortisol preparation dexamethasone is given against severe inflammation. “In one study, patients also received blood plasma containing antibodies from those who had recovered, which looks promising. We still have to wait for the results, ”says Steiger. The length of stay in the intensive care unit has been shortened. Other findings are that the patients were no longer intubated so early. Steiger says:
This also means that fewer places are taken up in the intensive care unit. On Monday, 16 beds in the ward and four in the intensive care unit of the Zurich University Hospital were filled with corona patients. For comparison: At the height of the first wave, 20 patients were in the USZ intensive care unit and 32 in the ward.
The youngest patient in intensive care is 32 years old.
So is the mortality of corona patients in hospitals decreasing? According to Steiger, this trend is not evident in Switzerland. At the Zurich University Hospital, however, which accepted many seriously ill patients from other hospitals in the first wave, mortality is currently only half.
“The growing number still worries me,” says Steiger, “they could be very picky about the system.” Plus, the staff could hardly have recovered from the stressful spring time.
Crown patients are very difficult to treat. And Steiger points out that even if many remained symptom-free, SARS Cov-2 is a serious illness and that when there is a flu epidemic, many people never make it to the intensive care unit. The youngest patient in recent weeks was 32 years old.
