No ICU beds to be reserved for COVID patients if omicron causes a torrent of hospitalisations

The country’s hospitals will no longer reserve ICU beds for COVID patients if the omicron variant of coronavirus causes a dramatic rise in the number of hospitalisations. The news that beds would no longer be set aside for patients with COVID-19 appears in articles that appear in Tuesday’s editions of newspapers published by the Mediahuis publishing group. The article also says that the emergency plan that will be sent out to the country’s hospitals today tells them that they should concentrate on emergency care if and when the highest state of alert is reached. 

Although it is still very much uncertain whether it will be necessary to implement the plan, hospitals need to be prepared for a worst-case scenario in which the omicron variant results in a flood of new admissions. This, combined with staff absenteeism resulting from illness and quarantine obligations could cause big issues for the country’s hospitals. With this in mind the Federal Health Department has worked out an emergency plan that is being sent out to hospitals across Belgium today.  

The Chair of the specialist committee that has drafted the plan Marcel Van der Auwera told the papers that "We have discussed this a couple of times, but we had never put anything down on paper. Up until now it had had been more of a theoretical question, but now with omicron we are confronted with a new situation”.  

Beds no longer reserved for COVID patients

The final details of the plan will be completed today. However, Mr Van der Auwera says that the bulk of the plan has already been agreed. For example, the plan tells hospitals to concentrate on emergency care and to no longer reserve beds for COVID-19 patients if and when the highest state of alert is reached. Currently, hospitals have to set aside a certain proportion of their beds for COVID-19 patients depending on the alert level the health service is on at a given time. Currently we are on level 1B and the hospitals must set aside 50% of their ICU beds for COVID-19 patients. As a results some, less urgent, care has had to be postponed for the time being.

However, if and when alert level 3 is reached hospitals would no longer be required to set aside ICU beds for patients with COVID-19.

"If we are confronted with a flood of patients and staff absenteeism we will no longer have the luxury of being able to reserve beds for emergency case that might come in the future. Then it will be a question of put every bed that is available to use as and when a patient turns up”.

However, Mr Van der Auwera hopes that it doesn’t come to this. “Let us be clear. Level 3 is a level of our emergency plan that we will put off implementing for as long as possible. We have a lot of complementary measures as regards HR policy and the organisation of care, which mean that we can put off implementing level 3 and hopefully we will never have to implement it. It is in effect a worst-case scenario”.  

But what would happen if all the hospital beds are full and coronavirus patients continue to arrive?

"These patients would be treated like any other patients. Those requiring the most urgent treatment would be helped first. Patients that could wait would be sent to the waiting room."

Difficult ethical choices

When the emergency plan would be implemented is still unclear. This will depended on the demand for hospital care and the availablity of staff and facilities in the hospitals to ensure that the care can be provided.

Mr Van der Auwera went on to say that "We hope that the boosters will ensure that not too many staff have to take time off. However, the more staff that are off work, the more quickly we will have reached the limit of the care that we can provide. The threshold is not simply a certain number of patients”.

Hospital staff could face difficult ethical choices if the plan ever has to be implemented. 

"But now choices are being made regarding who is given a bed and who isn’t. In our society it’s the done thing to say we have given the patient every chance. For me personally it’s a moral choice: if hospitalisation doesn’t provide an added value, you should let a person die in peace surrounded by their loved ones. Our plan will make decisions like this open to discussion”, Mr Van der Auwera said. 

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