Hungary gears up for 2nd wave of coronavirus with new order for hospitals
Miklós Kásler writes a letter
The minister sent a letter to the heads of all in-patient care providers, ordering them to
keep 20% of all beds ready for the treatment of covid-19 patients instead of the previous minimum requirement of 10%.
He asked hospitals to check whether they have the required number of beds available and if they are suitable for the treatment of coronavirus patients.
He also stressed that
carrying out the az instruction cannot result in discharging patients from the instutions.
Hospital directors need to report back to the ministry by 10 A.M. on Friday morning that they have carried out the instruction, along with the number of avilable beds.
How many beds are we talking about?
According to end-June data by the National Health Insurance Fund Management, there were 69,000 hospital beds in Hungary (curative care (acute) and chronic combined), the 20% of which translates into 13,800 beds.
It's important to note, however, that according to that report 53% of acute and 52% of chronic beds were in use at the end of June, which means that 31,600 hospital beds were empty. Whereas the number has probably dropped since then, the institutions are not expected to face any difficulty securing 20% of their beds for COVID-19 patients. At least on a national average, while on an individual level some might have problems.
Reserving 13,800 hospital beds for COVID-19 patients is excessive, considering that there are currently 100 of them in hospital (seven of whom are on ventilator). The number of hospitalised coronavirus patients is likely to go up, though, given the sharp rise in the number of new confirmed cases per day.
It was expected
During the pandemic in the spring, the ministry instructed hospitals to vacate 50% of beds (down from the original plan of 60%), and as the situation improved the minimum was gradually lowered to 10%. A rule has been in place since May that all COVID-19 patients with severe symptoms need to be transferred to two hospitals in Budapest (Szent László, Korányi) which releived the other hospitals and let them begin medical procedures that had been postponed due to the pandemic.
Over the last few weeks, however, the number of daily confirmed cases started to rise sharply in Hungary and a resurgence of coronavirus started to affect more and more communities. The key difference between the second and the first wave is that the virus is now spreading more among young people, while it had infected mostly the elderly population especially those with chronic diseases.
The average age of recently infected people is around 30. The median age of COVID-19 cases was 69 years in April, but it is now 31, which means that half of the infected are younger than 31.
This difference explains why the number of hospitalised patients has not risen so drastically this time and why the number of coronavirus induced fatalities remains in check. The newly infected people are younger and likely in better health.
Whereas there are only 100 COVID-19 patients in hospital, way fewer than during the peak in the pandemic in the spring, there is a clear ascending trend and the current figure corresponds to a 1.5-month high.
There is a risk, however, that if people do not adhere to restrictive measures the government implemented the spread of coronavirus will get out of hand and the most vulnerable groups will not be protected with such efficiency. The cabinet and health care institutions are aware of that risk and a host of hospitals and nursing homes have recently ordered a visiting ban. Mathematician Gergely Rörst, member of a group of researchers supplying the government with various epidemiological models and analyses, has in an interview with Portfolio on Monday cited Florida as a deterrent. The US state had a rise in confirmed cases but no increase was recorded in the number of hospitalised patients or fatalities. This has made people complacent, but five weeks after the rise in the number of cases, coronavirus started to claim more lives, he said.
Röst highlighted that the age breakdown of the cases shows that it took several weeks for coronavirus to pass over to other age groups and reach the elderly and other vulnerable groups.
Government learns a lesson
Based on Kásler's letter we can draw two main conclusions:
- The government has learned its lesson from the spring pandemic and the forced and out-of-proportion vacating of hospital beds (50%) and its repercussions, and has now taken a more gradual approach apparently (from 10% to 20%).
- It has also learned that thanks to the gradual nature of making hospital beds available to potential COVID-19 patients the measure should not lead to the discharge of patients from hospitals. Turning out patients from their hospital beds in an urgent manner made quite a few headlines in the spring, and not only in Hungary but globally.
Cover photo: Paramedics in protective gear bring an extra playing a patient at a drill by the epidemiological task force at Szent János (St. James) hospital in Budapest on 27 August 2020. Source: MTI/Zoltán Balogh
