“We are not equipped well” – An insider’s perspective on Hungarian hospitals
More and more doctors are sharing their experiences of what conditions they need to work in. They report something other than government propaganda or even what the prime minister says.
“We don’t want to give up on anyone; all life matters to us, even the elderly. We want to fight for all people,” said Viktor Orbán in a public statement to the public radio on Friday. He also talked about how the chances of the healthcare system staying functioning are over 99 per cent, and all Hungarians will receive decent care. Minister of Humanities Miklós Kásler told Magyar Hírlap that the difficulties are still far away and that the number of infected people is expected to increase significantly by mid-December. “A total of 26-28 thousand hospital beds may be needed, as well as about 4,500 intensive care beds. This can be ensured by the Hungarian healthcare during this period.”
Little has been known so far about what the healthcare workers themselves think about hospital conditions and prospects. The government has long banned them from speaking to the public about it. Now, however, this dam seems to be breaking, in which the actions of the Hungarian Medical Chamber (MOK) play a major role. A few weeks ago, they asked their colleagues to report on their own experiences of the emergency. The second summary of Tamás Svéd, the secretary of MOK, was published on Friday based on the doctors’ reports. This makes it clear that care in most Covid-19 intensive wards is already highly compromised, writes Népszava.
The specialist, who starts the visit in the morning, will finish setting up the machines of the patients, ordering their medication by the afternoon – unless a sudden event interrupts the process. The number of professionals and support staff is just enough for medication, nutrition, and keeping the airways clean. There is little capacity left for labour-intensive interventions, such as rotating patients and ventilating them while lying on their stomachs.
Because there are few nurses, the rules of sterility are violated, there are frequent dangerous nosocomial infections, bacterial pneumonia in ventilated patients, cannula sepsis, and bloodstream infections, which significantly impair the chances of recovery.
Transitional wards are reportedly lacking in most places, so very little attention is paid to patients discharged from the intensive care unit. Those who are unable to eat on their own have no one to feed them, and the central cannulas in the patients remain unattended. “The mortality rate of these patients is also very high,” said the MOK secretary.
As for the difficulty caused by the lack of specialists, Tamás Svéd cites the example of a county centre, where an intensive care unit with 20 beds was originally planned, but even before the epidemic, there were only enough staff and equipment for 14 beds. Since then, the remaining six beds have been taken into use, as well as an additional 24 at the site of a former surgery department, creating a Covid-19 intensive care unit with more than 40 beds. In addition, a 12-bed section reserved for non-Covid-19 patients is operated there. In the end, while they were just ready for 14 beds, they now have to supervise about half a hundred patients. “Well, this centre is required by these rules to build a total of 103, that is nearly another 50 intensive beds,” writes the chamber secretary. In summary, the proportion of patients to be treated and professionals is similar elsewhere. On average, a qualified nurse has 6-10 patients in an intensive care unit, even on a ventilator. “All in all, it seems that although there would still be some trade-offs between bed and equipment to create additional intensive care units, no significant improvement in patient survival can be expected from them in the absence of additional mobilised specialists,” wrote Tamás Svéd.
Other sources also report shocking conditions, such as the recent web conference of the Anti-Coronavirus Translational Population Support Action and Research Group. In Orosháza, the first covid patient was admitted to the newly formed intensive care unit with several organ failures a few days ago. According to chief doctor Gábor Bencsik, they have known since then that they have to re-learn everything about intensive care. Officially, they have to operate 29 intensive beds, but they cannot do so yet because neither the staff nor the infrastructure is available for this. Circumstances allow healing on six beds at this time.
Zoltán Ruszkai, the chief doctor of the Kistarcsa hospital, reported that they had 22 Covid-19 intensive care units in the preparation phase, which had to be expanded to 34 from the beginning of this week. “We’re not very well equipped or staffed,” he said. Although people were sent from other institutions, people were also taken from them to other hospitals. Thus, there is not enough staff for the 34 beds. He added:
“We didn’t get respirators, we got sleeping machines, we read how to breathe with them permanently; hopefully, it won’t go wrong.”
“We didn’t expect so many and so severely ill patients,” said Lajos Bogár, head of the Institute of Anaesthesiology and Intensive Care at the University of Pécs. One-third of the clinic’s fifty nurses have dropped out of work, which means fewer people are able to cure twice as many patients. He asked his partner clinics for help in resolving the crisis. University students have also come, but those who are not accustomed to classes that care for Covid-19 patient are frightened by what they see. Often people weigh 140-180 pounds, we try all sorts of therapies, the mortality rate is 50 per cent. And there are patients with whom we are in a stagnant standing war. We don’t see the end”, he said.
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Source: Népszava