Friday, January 21

Europe’s ICUs are facing another rise in COVID-19. They need urgent support | View

Opinions expressed in View articles are solely those of the authors.

At the end of August, the European Commission announced a fundamental milestone in the evolution of the COVID-19 crisis.

Reaching the EU target of 70% for full adult vaccination was an important step in our shared progress towards a more secure future for all Europeans.

But with winter approaching, we can already see that more effort needs to be done to increase the numbers. ICUs are facing a further increase, comprising mainly the unvaccinated minority.

Both the unvaccinated and those at risk who received their first two doses more than six months ago must urgently receive new COVID-19 injections.

Data on admission to the ICU reveal the consequences of a low uptake of vaccines

In Europe, tens of millions of eligible adults are still not vaccinated. The sad and avoidable reality is that this increases the risk that those who reject the vaccine will end up in an ICU if they contract COVID-19, unnecessarily limiting some of society’s most valuable finite resources: ICU beds and medical staff.

This translates into adverse outcomes for both COVID-19 patients for whom ICU beds may be missing, and non-COVID-19 patients whose medical and surgical care could be delayed or even canceled.

The serious consequences of the low absorption of the vaccine are reflected in the intensive care admission statistics published by many EU member states: at least 80 percent of critically ill COVID-19 patients are not vaccinated.

The average stay of a COVID-19 patient in an ICU lasts about three weeks, which means that a single COVID-19 patient needs an ICU bed and staff for three times as long as the average non-COVID-19 patient.

Many types of surgery require the patient to spend only a few days recovering in an ICU afterward. The unavailability of beds for such short but mandatory stays has forced operations to be postponed in times of COVID-19 surges.

The impact of severe COVID-19 does not end with discharge

For the unvaccinated lucky enough to survive COVID-19 in an ICU, the experience often serves as a stark wake-up call.

The ordeal of ICU COVID-19 treatment is as brutal physically as it is mentally, and it does not end with discharge.

Weeks of sedation and ventilation can leave patients emaciated, making normal daily tasks physically challenging and further complicated by the “brain fog” and mental trauma of a near-death experience.

Post-intensive care syndrome can affect both patients and their families, and post-traumatic stress disorder, in particular, has dramatic medical and socioeconomic consequences.

Adequately staffed ICU beds are necessary to maximize quality of care and chances of survival. They are also necessary to avoid or reduce the development of post-intensive care syndrome.

This is only possible if the rate of serious infections is kept under control with vaccines and public health measures.

Help UCI staff by fighting the ‘infodemic’

Knowing that a vaccine is available to help prevent serious illness in these patients is a deeply sad change in the daily work of ICU staff.

However, medical professionals in intensive care medicine remain committed to helping all patients who require care.

They have shown this by repeatedly going the extra mile to save lives during the pandemic. Meanwhile, 20 percent of ICU capacity is closed due to nursing staff shortages – a persistent problem that needs to be urgently addressed.

We need the support of citizens, the media and policy makers. Misinformation must be fought at every opportunity, with the right support given to people to make the right decision.

We are committed to developing initiatives to fight the ‘infodemic’ and provide clear, truthful and honest information to each person to better inform their choices.

Create a pool of ICU doctors and nurses in the EU, now and for the challenges ahead

In the meantime, policy makers need to pay attention to the evolution of Europe’s ICUs.

It is a positive development that there have been increases in ICU capacity in some countries. But it would be a mistake to think that we can decrease COVID-19 because we have more beds.

Strengthening the strength of the last line of defense is important, but it is not a substitute for broader public health measures.

COVID-19 has taught us that in a globalized society, a pandemic cannot only be fought locally – a lesson that applies so much to our ICUs.

On behalf of the European Intensive Care Medicine staff, ESICM calls on EU policy makers to develop a long-term European strategy for ICUs.

We must establish a pool of doctors and nurses with competencies in intensive care and guarantee the rights of intensive care professionals to transfer their skills beyond their borders to other ICUs in response to public health crises.

Breaking these barriers would not only serve Europe for the duration of this pandemic, but also in all future crises with the potential to threaten the functioning of our health systems.

Professor Maurizio Cecconi is President of the European Society of Intensive Care Medicine (ESICM) and President of the Department of Anesthesia and Intensive Care Units of the Humanitas Research Hospital in Milan. Professor Elie Azoulay is president-elect of ESICM and head of the intensive care department at the Saint-Louis Hospital in Paris.

Leave a Reply

Your email address will not be published. Required fields are marked *