Increase in corona admissions puts regular care in Leiden and Amsterdam under pressure

Now that the number of coronavirus infections is once again rising sharply and so is the number of covid patients in hospitals, regular care is once again at risk. Things are not as bad as they were during the first wave – when outpatient clinics had to be closed for weeks and surgery could not be performed – but the Leiden University Medical Centre (LUMC) has already rescheduled several planned interventions in patients. According to hospitals in the Amsterdam region, this is also on the way.

To prevent regular care from being further compromised, from tomorrow the network will again be used to spread patients across hospitals in the country, the National Coordination Centre for Patients Spreading (LCPS) announced today in a statement.

Bypass operations

In Leiden, a number of bypass operations have been postponed, says LUMC cardiologist Martin Schalij: We had to scale up the ICUs because of the increasing number of patients After a bypass, a patient is admitted to the ICU, but due to the process of scaling up, there was temporarily no room for this.

Schalij thinks that we are going through a difficult period:

We are still dealing with a small number of patients who are in LUMC with covid-19. According to Schalij they can be counted on two or three hands. And yet regular care is already in jeopardy: It‘s not about the outpatient clinics, but about operations in which we have to admit patients. If the number of coronavirus patients increases, we will have to pick up nurses from other wards to assist in the covid ward

Corona requires specialist care. Not only in the ICU, but also when patients with corona end up on a regular nursing ward. Schalij: You need well-trained nurses for this, but you don’t have an extra hundred such nurses at your disposal. They need to be trained

In the Amsterdam region there are as yet no direct consequences for regular care. But, says Frank Bloemers of the Amsterdam UMC: With the increase we now have, that’s to be expected. The need to scale down regular care will be assessed on a daily basis

According to the RIVM, the second wave can still be reversed, they say, in response to the latest infection figures:

Bloemers also coordinates the distribution of patients in the Amsterdam region. If one hospital has to deal with too many corona patients, they are transferred to another hospital in the region. This has already been the case in recent weeks, says Bloemers.

In the region there are 77 patients in regular nursing wards and 20 in the ICU. 66 patients in the hospital are suspected of having corona. Patients have also been transferred from Leiden to less busy hospitals. A number of patients have been taken to Brabant, says Martijn Schalij.

Nationwide distribution

From tomorrow, a nationwide distribution of patients will also be possible again. Then the LCPS will be active again, chairman Ernst Kuipers said. The starting point for a second wave of covid patients has always been to allow regular care to continue. This means that when the pressure increases, we move patients easily, so that hospitals do not have to scale down regular care

Kuipers has no signals that hospitals outside Leiden and Amsterdam are playing with the idea of scaling down regular care, he says to the CCeit: There may indeed be individual hospitals that do that, but we are now starting up again so that this is no longer necessary nationwide

The Dutch Healthcare Authority (NZa) says it is concerned about the possible consequences for regular care. During the first wave, many people did not have the care they needed. As a result, people suffered health damage, some of it serious. We must all work together to prevent a repeat of the scaling down of regular care at all costs. But if we do not act now, that is a realistic scenario

Staff with infections

According to the hospitals, it is not due to poor preparation that regular care is at stake. Frank Bloemers: It’s because unexpected things happen anyway, such as staff with infections. As a result, there is less room to accommodate patients

Or staff are not infected themselves, but are in quarantine because children or partners have corona-related complaints, Martin Schalij observes: We are going through a difficult period, which demands a lot from the staff. If the number of infections continues to fluctuate around the current numbers, we can cope, but if it really starts to increase, I foresee major problems