Health 'At the next peak, the approach must be different,...

‘At the next peak, the approach must be different, point to corona hospitals’

In the event of a second peak of corona infections, the Dutch corona approach will have to change. Ernst Kuipers, chairman of the board of Erasmus MC, says this News hour. “That virus will not go away for the time being. You have to prepare for us to peak again, and then it must be different from what we have done so far.”

As chairman of the National Coordination Center for Patient Distribution, Kuipers is responsible for the distribution of all corona care. He believes that this should no longer be at the expense of other care. He argues in favor of expanding IC capacity, for example by designating a hospital per region “doing covid-19”.

‘We had no choice but to absorb the blow’

In March, many hospitals had to free up capacity for the rapidly growing number of corona patients. Regular care was crowded out. This probably took many healthy life years from non-corona patients.

“We had to absorb the peak of covid patients with art and flying work,” says Kuipers. “You couldn’t help but stop operations, and population screenings for cancer. Couldn’t we have known that up front? No, this happened to us, it was a completely new disease. We saw the images from China and northern Italy, you can’t help but absorb the blow. “

But now healthcare can prepare for a possible second peak of infections. “In March it was all hands on deck. Certainly in smaller regional hospitals, a lot of surgery equipment and rooms were used for IC treatments of covid patients, which meant that a lot of regular care, such as breast cancer surgeries, was lost.”

“Soon we can say: patients with covid come to a number of designated hospitals, they can scale up and down the IC capacity, while you do not burden the other hospitals. Only if the need is man will you have the other hospitals again required.”

According to Kuipers, this also means that the IC capacity in those designated hospitals must be structurally expanded. Most nurses don’t like that, but “as long as we don’t have a vaccine, it’s a necessity.”

Hundreds of thousands of years of life lost

It is unclear how many deaths the loss of regular care has led to in recent months. It’s about 100,000 to 400,000 years of life lost, research firm Gupta wrote in a report this week. Much more than the 13,000 to 21,000 healthy years saved through the care of covid patients.

These figures have been calculated with models, “and it will have to show in the near future whether these figures will also be realized in practice,” emphasizes Kuipers. There are some major uncertainties in the models. “For some cancers, a diagnosis three months later, for example, is not directly detrimental, while figures like this have been included in the report’s calculations.”

In addition, for many treatments, missing them has little or no effect, while those treatments have been included in Gupta’s calculations. Kuipers: “Part of the people thinks, ‘those complaints, I will wait a while’, so unnecessary treatments are prevented in this crisis.”

Halving cancer diagnoses

But Kuipers agrees with the core of the report. “I subscribe to the fact that the number of healthy life years that are lost is at least of the same magnitude as the number of those saved, with the probability that the number of years lost is significantly greater.”

He points to the data from the Cancer Registry, which shows that the number of diagnosed cancer patients is normally around 3,500 a week. In the past two months, there were only 1,700 a week. “So that’s cut in half, and as far as I know, covid is not a cure for cancer.”

It shows that maintaining regular care is “really relevant” in preparing for the next corona peak. “Regular care must now be made up for. If a peak comes again and you flatten that care again in October, November, you will no longer make up for it. And we really shouldn’t want to.”

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