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A World Health Organization official warned last week of a “window of opportunity closing” for European countries to prevent their healthcare systems from overloading, as the Omicron variant of the coronavirus produces an almost vertical increase in coronavirus infections. .
In France, Britain and Spain, countries with relatively strong national health programs, that window may already be closed.
The director of an intensive care unit at a hospital in Strasbourg is removing patients.
A surgeon at a London hospital describes a critical delay in diagnosing a man’s cancer.
Spain is watching as its determination to prevent a system collapse is being tested as Omicron keeps medical staff out of work.
“There are many patients we can not accept and it is the patients without COVID who are the collateral victims of all this,” said Dr. Julie Helms, who runs the Intensive Care Center at the University Hospital of Strasbourg in the far east of France.
Two years after the pandemic, with the extremely contagious Omicron affecting public services of various kinds, the effect of the variant on medical facilities has greatly questioned the resilience of public health systems that are considered essential to the provision of equal care.
The problem, experts say, is that few health systems have created enough flexibility to handle a crisis like coronavirus before it appears, while recurring peaks of infection have kept the rest too preoccupied to implement changes during the long emergency.
Hospital admissions are now as high in France, Italy and Spain as they were last spring, when all three countries had isolation or other restrictive measures.
The hospitalization rate of people with COVID-19 in England for the week ended January 9 was slightly higher than in early February 2021, before most residents were vaccinated. This time there is no isolation.
The Institute for Health Metrics and Assessment, a population-based health research organization based at the University of Washington, predicts that more than half of people in the WHO’s 53-nation region in Europe will become infected with Omicron within two months.
This includes doctors, nurses and technicians in public hospitals. About 15 percent of Strasbourg’s hospital staff of 13,000 was out of work this week. In some hospitals, the staff shortage rate is 20 percent.
Schedules are created and restored to close gaps while patients whose needs are not critical have to wait.
The 26 beds of the French public hospital are almost all occupied by unvaccinated patients, people “who refuse care, who refuse medicines or who seek medicines that are ineffective,” Helms said.
She rejected 12 applications for admission on Tuesday and 10 on Wednesday.
“When you have three patients for a single bed, we try to get the one who has the best chance of taking advantage of it,” Helms said.
In Britain, as in France, Omicron is causing cracks in the health system even though the variant seems to cause milder diseases than its predecessors.
The British government this month appointed military personnel, including doctors, to complement London hospitals, adding to the ranks of service members already assisting in the administration of vaccines and the operation of ambulances.
At the Royal Free Hospital in London, Dr. Leye Ajayi described a patient who faced delays in his initial cancer diagnosis.
“Unfortunately, when we finally got to see the patient, his cancer had already spread,” Ajayi told Sky News.
“So now we are dealing with a young patient in his mid-50s, who, perhaps if we had seen him a year ago, could have benefited from a healing operation. “Now we are dealing with palliative care.” , he said.
Nearly 13,000 patients in England were forced to wait in stretchers for more than 12 hours before a hospital bed opened, according to figures released last week by the National Health Service. Britain has a large number of around 5.9 million people awaiting cancer examinations, planned surgeries and more. Some experts estimate that figure could double in the next three years.
In the midst of the first wave of the pandemic in April 2020, the WHO office for Europe issued a guide for health systems to build power in their systems for new outbreaks, including the identification of a temporary health workforce.
“Despite the fact that the countries thought they were prepared for a pandemic to come, they were not. So he is building the ship while sailing, “said Dr. David Heymann, who previously headed the Infectious Diseases Department of the World Health Organization.
But France had cut hospital beds – and doctors and nurses – for years before the pandemic.
Its reconstruction within a few months turned out to be difficult when the current wave infected hospital staff with hundreds every day.
Even allowing symptomatic health workers with COVID-19 to report to work has not been sufficient.
The Confederation of National Health Systems (NHS) of Britain, says the public health service went into pandemic with a shortage of 100,000 health workers which has only worsened.
The first wave of the pandemic pushed the Spanish health system to its border. Hospitals improvised ways to treat more patients by setting up emergency centers in operating rooms, gymnasiums and libraries.
The public witnessed, terrified, retirees dying in nursing homes without ever being sent to state hospitals that were already overcrowded.
After that, the Spanish government vowed not to allow such a collapse to happen again. Working with regional health departments, he drafted what officials call “resilience plans” to deal with sudden changes in service requirements, especially in intensive care units.
The idea is for hospitals to have the equipment and theoretically staff, to increase capacity depending on the need.
“The main thing is flexibility, to have flexible buildings that can be expanded, to have staff that is flexible in terms of accepting shifts, to have flexibility in terms of sharing more loads of a regional structure,” said Dr. Martin McKee, a professor of public health. at the London School of Tropical Hygiene and Medicine.
Ultimately, though, McLee said: “A bed is a piece of furniture. “What matters is the staff around him,” McKee said.
“We are still in the middle of a complex epidemic that is changing every day. “It is difficult to imagine what we should build for the future for other epidemics, but we will have to reflect on the system of how we organize care,” said Dr. Nicolas Lefebvre, who heads the Infectious Diseases Unit in Strasbourg.
He said Europe is prepared to deal with isolated outbreaks as it has in the past, but the pandemic has exposed weakened foundations across health systems, even those considered to be among the best in the world.
Frédéric Valletoux, head of the French Federation of Hospitals, said policymakers at the national level are very aware of the problem now.
For 2022, the federation has requested more resources for nursing staff.
“The difficulty in our system is to shake things up, especially when we are at the heart of the crisis,” Valletoux said.
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