Intensive care beds – when sorting out patients

To protect against infection, virologists would prefer to lock people up, Salzburg Governor Wilfried Haslauer (ÖVP) said the week before. Shortly afterwards he rowed back that he was by no means anti-science, as he said, but had only made a pointed statement – this is all the more serious in view of the current development in Salzburg: The Salzburg State Clinics (Salk) are threatened with complete overload, it was announced on Tuesday known.

Their management has already turned to the State of Salzburg as the hospital operator. The treatment of further patients in the clinics according to the applicable medical standards and standards of care could soon no longer be guaranteed, says Salk when asked. There are currently 80 non-Covid-19 patients and 31 Covid-19 patients in the intensive care unit. There are still 24 free beds, but there is a threat of an emergency situation in which intensive medical triages have to be carried out.

Critical decisions

This means: If the extra-tour requirement by Covid-19 patients exceeds the 50 percent mark, a critical decision will be made as to who will get the intensive care bed, the President of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine, Walter Hasibeder, told the ” Wiener Zeitung “. So it comes to “triage”: The term is derived from the French word “trier”, which means “to sort out”. Even before that, with 15 to 30 percent additional occupancy by Covid 19 patients, measures were taken to counteract the staff shortages. That is associated with overtime. Because even in normal operation, 75 to 90 percent of all intensive care beds are occupied.

Hasibeder therefore calls for a “general lockdown” for the high incidence federal states of Upper Austria and Salzburg. According to the health holding, every third planned operation in Upper Austria has to be postponed. A six-person triage team has already been nominated in Salzburg, which consists of five doctors from various fields and one lawyer. This team then has to decide which patients can still be treated in intensive care, according to Salk.

Third stitch from the fourth month

Due to the current situation, it is to be feared that the legal obligation “to treat patients only according to the principles and recognized methods of medical science, can no longer be fully and consistently fulfilled despite all the measures taken,” writes Salk managing director Paul Sungler in the “overload indicator”. This is a kind of instruction manual that describes 15 escalation levels. The Salk says that escalation level 12 has been reached: the level that provides for the owners, the supervisory board and politicians to be contacted.

Salzburg’s health officer Christian Stöckl (ÖVP) and governor Haslauer were therefore informed. In the course of a press conference called at short notice, Haslauer said on Tuesday that the third booster vaccination could now be received from the fourth month. Furthermore, rehabilitation facilities are to be closed and primarily occupied with patients from non-Covid areas who no longer need to be cared for in the hospital, but for whom there is a lack of nursing beds and, above all, staff.

Negotiations are also taking place with the private hospitals that these operations will take over, added Stöckl. A so-called Covid transfer station in the area of ​​the Christian Doppler Clinic is supposed to bring additional relief for corona patients, who are still positive but no longer need to be cared for as comprehensively. As far as the PCR tests are concerned, the laboratory capacities must also be expanded, according to Haslauer. For a closer follow-up of the contacts, 50 more people will be trained. “In any case, the hospitals must remain capable of acting and treating.” Haslauer still rejects a lockdown for everyone.

In Vienna, the situation on the Covid (intensive) wards is tense, but there is still enough capacity, according to the Vienna Health Association. It is similar in the other federal states. Across Austria, there were 2,568 Covid-19 patients in the hospital and 458 in the intensive care unit on Tuesday. There are around 2,100 intensive care beds in total.

From or with Covid-19, 11,807 people have died in Austria since the beginning of the pandemic in March 2020, according to the Ages figures. On Tuesday there were 61 more deaths within 24 hours – the highest in nine months.

If you look at the number of all deaths in Austria, according to Statistics Austria, this has been rising steadily in all age groups since mid-October. For those over 65 years of age, the curve shows a steep upward trend. For comparison: In 2019, when the pandemic had not yet arrived in Austria, around 1,300 over 65-year-olds died in one week, compared to around 1,530 in the previous year. This year there are 1,600 people.

Contrasting demands

Politics in times of the pandemic is becoming more and more hectic. It is a back and forth of opposing demands, a tugging about the assignment of blame – in a situation the development of which is more uncertain than seldom before. Most recently, Health Minister Wolfgang Mückstein (Greens) spoke out in favor of night exit restrictions, including for vaccinated people, and called for a decision for Wednesday. The ÖVP refused. Chancellor Alexander Schallenberg (ÖVP) countered that there would be no summit.

SPÖ leader Pamela Rendi-Wagner again criticized the government’s dispute at the height of the Corona crisis on Tuesday. “Pull yourself together,” she said, “and work together to deal with this great crisis.”

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