Covid: Why are Swiss hospitals full despite fewer patients than 2020?
Intensive care units are full in several Swiss cantons, despite fewer patients than previous Covid waves. Why?
On Wednesday, news emerged that ICU capacity was completely exhausted in Zurich, Switzerland’s largest canton.
Since then, while Zurich ICU’s have fortunately seen an improvement in available capacity, ICUs have hit 100 percent in Jura and Solothurn, while capacity is higher than 85 percent in five more cantons.
Currently, ICUs across the country are at 78.7 percent. Medical experts, such as Stephan Jakob, from the Bern University Clinic for Intensive Care Medicine, are certain things will continue to get worse as hospital admissions rise.
“Triage will come”, Jakob told Swiss news outlet Watson.
Are there really fewer ICU beds in Switzerland than last year - and why?
The numbers do however raise several questions, some of which have been held up by conspiracy theorists as evidence the government has something to hide.
While Switzerland over the past week has reached record levels of Covid infections, the number of patients in hospitals and ICUs is lower than in previous waves.
Switzerland’s seven-day hospitalisation (ICU and non-ICU) rate in November 2020 was 249.3 per 100,000 people. Currently, it is at 75.
The reason? There are fewer intensive care beds than there were in Switzerland, even as recently as a year ago.
Switzerland had more than 1,100 ICU beds in November 2020, but now has just under 870.
The differences can also be seen at a cantonal level. In Zurich, for instance, there were more than 300 in November 2020, with the current figure approximately 190.
Why are there fewer ICU beds now than last year?
Given that Switzerland has had almost two years to get used to the pandemic and understand how waves of infections lead to surges in ICU demand, many have asked how Switzerland can now have fewer ICU beds than previously.
The two major reasons are staffing, along with fewer ‘ad hoc’ reserve beds than seen earlier in the pandemic.
Franziska von Arx, President of the Swiss Society for Intensive Care Medicine (SGI), told Switzerland’s NZZ newspaper that the current number - 870 - has remained relatively stable throughout the pandemic.
While ICU beds may be a relatively simple way for the media and politicians to discuss the situation in the country’s hospitals, von Arx says that a more accurate way to measure ICU capacities is not in terms of beds but in terms of staff.
The ongoing demands of the pandemic have meant between 10 and 15 percent of staff have quit, von Arx said, while others have reduced their workload.
Of those that remain, many are also required in other areas of the hospital and are already overworked, meaning that the number of available beds cannot be expanded.
"Many have been working for more than a year and a half without interruption under the most difficult physical and emotional circumstances, which saps their energy and strength,” von Arx said.
“In addition, these people are needed on the bed wards themselves, as the occupancy rate on the bed wards is also very high.”
The higher number of beds in the previous autumn wave of the pandemic was due to a greater number of “non-certified reserve beds”, which are sometimes known as ‘ad hoc’ beds.
While earlier in the pandemic staff worked through their holidays, weekends, took on extra hours and worked through sick days so that extra beds could be set up.
Some also returned from retirement to deal with the surge in patients.
Due to fewer workers and the significant strain already placed on those who remain, authorities say there is no scope to increase capacity.
"The limiting factor in intensive care units is the staff, we can no longer increase capacities at short notice," Zurich cantonal authorities told Watson.
Hans Pargger, head of the intensive care unit at the University Hospital Basel, told NZZ setting up extra beds would be pointless, as anyone in those beds would not receive the necessary level of care required of someone in intensive care.
"Anything that goes beyond this already results in lower standards of care or the postponement of planned interventions."