Covid hospital care: “Brussels is a goner”

Just under a thousand patients are currently being treated for Covid in a Belgian hospital. 195 are receiving critical care.  Elisabeth De Waele (pictured), the head of critical care at Brussels University Hospital (VUB), is sounding the alarm. “Our hospital is getting saturated” she says.

During the first wave up to 6,000 patients were hospitalised at the peak with 1,300 receiving critical care, but there is an important difference says De Waele.

“At that point we took in all patients because we didn’t know how the disease develops.  Now with interventions by the authorities and new scenarios patients are spread out more efficiently.”

A distribution of Covid patients over different hospitals is an important plank in Belgium’s efforts to be able to continue to manage the flow of new corona patients and treat non-Covid patients too.

“Our ambition during this second wave is greater than in March” explains internist Geert Meyfroidt of Leuven University Hospital. “In March we were inundated.  This meant we stopped regular treatment.  This we do not wish to repeat because many patients were victims of this policy. As a result patents are being spread out over different hospitals from the minute we reach lower Covid occupancy thresholds.  This ensures there is less impact on regular care.”

In the scenario hospitals are supposed to set aside no more than 15% of critical care beds for corona patients in Phase One, but in Brussels hospitals have already reached the next phase and up to 40% of critical care beds are occupied by corona patients.

Elisabeth De Waele of Brussels University Hospital says she felt it was “particularly unpleasant” that the Brussels regional health minister said occupancy levels were “not yet alarming”.

“At this moment there is already a knock-on effect on regular care.  People with brain tumours are having to wait because we don’t have critical care beds.  We nearly can’t cope.  When a government minister signals reassurance like that people think it won’t be too bad.”

“The number of patients in critical care jumped 260% in only two weeks.  That’s an exponential increase and comes despite enormous efforts by the A&E and the hospital network to spread out patients.  We’ve got the feeling we are saturated.  When we got the daily briefing last weekend I thought “Brussels is a goner”.  We’re really going to have to do something”.

On Monday the Mayor of Aalst said he would be taking initiatives to prevent too many beds in his city being occupied by Brussels patients to allow local people to receive care in their city.  Geert Meyfroidt has little time for people who bandy about “the limits to medical solidarity”.

“It’s not about Brussels or Aalst.  Hospitals in the same network will help each other out including the one in Aalst. If there are problems in Aalst other hospitals will help out.  The aim is exactly to prevent any hospital from having to stand alone.  I wonder if the mayor is aware of the arrangement that has been reached.”

Increasing capacity of Covid wards isn’t the solution either argues the internist:

Geert Meyfroidt: “In that case other planned, non-Covid care would have to be stopped.  That would impact on heart and neurosurgery that also require critical care.  These patients won’t be able to go to Aalst either, so their care would simply be postponed.  That’s not our aim.”

Elisabeth De Waele: “Last summer we were already aware that this would be the most difficult phase because we need to combine two types of care with the same number of staff.  There will be victims among patients you drop.  We have to prevent this happening.”

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