As hospitals increase their critical care capacity, they are keeping an eye out for a surge in hospitalisations after the containment is gradually broken.
Hospitals remain vigilant about a second wave of covid-19 hospitalisations and are also making sure they don’t neglect non-covid care.
On the front line as the number of coronavirus contaminations continues to rise, hospitals are taking time to breathe. “We have passed the peak,” says Dr Gregor Baertz, one of the two medical directors of the Robert Schuman Hospitals.
Admissions and the number of occupied beds has indeed begun to decline. Five patients are still hospitalised in ICU at the Centre hospitalier du Nord, but they have also seen patients being discharged: “During the last four weeks, 48 patients returned home, which is a very positive result.”
At the Robert Schuman Hospitals, the same observation. “The number of beds occupied in the hospital is decreasing rapidly, more than in intensive care, since the length of stay in the hospital is around three weeks,” Baertz explained. On Thursday, four covid-19 patients remained in intensive care, and two suspected cases were awaiting confirmation, and 16 were in other beds, with a further 25 suspected cases awaiting confirmation.
The Centre Hospitalier de Luxembourg (CHL) still has 26 covid-19 patients, including five in intensive care. But the field hospital set up outside the CHL may not even be required--that is what prime minister Xavier Bettel (DP) said he hoped, during an inaugural visit on Monday--except to triage patients arriving at the emergency unit.
However, hospitals are being vigilant. “The number of admissions is decreasing, but we will have to continue to observe the situation more,” the Centre hospitalier du Nord warns. “Our strength is to adapt quickly to changes. So, we remain vigilant and prepared for any increase.”
This is why hospitals are keeping staff in reserve, to be prepared for a new peak--the famous second wave, both inevitable and feared. “We estimate that there will still be some sporadic cases starting 2 May,” said Baertz, referring to the reopening of certain businesses and the return to work of certain sectors. “The second wave will depend on the government’s strategy to contain the situation and the scope of the public testing campaign.”
The medical director is closely following the strategies of Asian countries that are a few months ahead and have had feedback that can be exploited. “The testing campaigns, the location of the infected people and the rapid isolation of the sick people and their potentially ill entourage: these are for me the three conditions” to achieve a controlled deconfinement. “And the more tests there are, the better the chances of finding the infected people.”
Praising the early confinement adopted by Luxembourg, the Centre hospitalier du Nord says the evolution of the disease will depend very much on everyone acting responsibly. “We can only support the government’s messages and encourage people to follow safety and health guidelines for the well-being of all. Protecting the vulnerable and the goal of flattening the curve remain relevant.”
Just as not everyone will return to life as it was before over the next few weeks, hospitals are trying to work in “a new normality”, as several of the people we spoke to called it. After the shock of the start of the pandemic, and with the arrival of more suitable equipment--less heavy, less suffocating uniforms, according to the CHL--medical staff have begun working to “a new routine”.
“You have to get used to a situation that will remain until there is enough immunity in the population or until a vaccine arrives,” said Baertz, who does not believe the epidemic will simply cease like the flu, even if some are suggesting it will diminish or disappear in sunny weather.
Another sign of this “new normality” is that hospitals are beginning to see the return of “traditional” patients, many of whom had stopped coming for fear of rubbing shoulders with covid-19 patients, even though flows had been strictly separated.