Covid-19: How will a priority triage system in Swiss hospitals work?
As Switzerland’s medical facilities are near their saturation points, medical authorities are preparing a triage plan to decide who will get priority for beds in intensive care units.
According to Virginie Masserey, head of the infection control department at the Federal Office of Public Health (FOPH), “the limit to intensive care units could be reached in five days”.
In response, the Swiss Academy of Medical Sciences (ASSM) and the Swiss Society for Intensive Medicine (ASSM) are working out the emergency protocol for triage of patients in intensive care units (ICUs).
The two organisations say that triage system should be based on equity — that is, resources must be made available without discrimination of any kind, in order to avoid any arbitrary decisions.
“The guidelines provide assistance to ICUs, so that any triage decision can be made according to the same criteria across Switzerland," regardless of whether patients have Covid-19 or another critical condition that requires immediate treatment, said Franziska Egli, communications officer at the ASSM.
“The objective is to save as many lives as possible, but the short-term prognosis is the deciding factor for the decisions”, she added.
This means that patients whose prognosis for recovery or improvement is favourable with intensive care therapy, but unfavourable without this treatment, have top priority.
Age in itself is not a factor, but it is indirectly taken into account in the context of the ‘short-term prognosis’ criterion, since the elderly often suffer from pre-existing chronic conditions, defined as two or more diseases.
Official directives list illnesses that are deemed to be incompatible with hospitalisation if there is shortage of beds. They include advanced cirrhosis, cancer with a limited life expectancy, and severe heart or neurological problems.
"So far, this directive has never been applied in Switzerland," said Philippe Eckert, director of the Vaud University Hospital (CHUV).
If it becomes necessary to implement it, “the decision would be taken at the national level”, by the group of experts specialising in medical and ethical questions, Eckert added.