Corona alert! High increase in intensive care patients

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The Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) is registering with concern the sharp increase in the number of COVID-19 patients being treated in Austria’s intensive care units. This rose by more than 23 percent in the past two weeks (from Feb. 22 to March 7), significantly outpacing the number of people admitted to hospital treatment with a COVID-19 diagnosis – which saw an increase of just under 11 percent.

“The increasing dominance of the so-called British virus variant B.1.1.7 in particular undoubtedly plays an important role here,” says ÖGARI President Dr. Klaus Markstaller (University Department of Anesthesiology, General Intensive Care Medicine and Pain Therapy, MedUni Vienna/Vienna General Hospital). “The significantly easier person-to-person transmissibility and higher reproductive number of this variant has now been comprehensively proven by scientific evidence. And an increase in infections naturally leads to a greater burden on intensive care units.”

According to Health Ministry data released over the weekend, the original SARS-CoV-2 “wild type” now accounts for only 36.3 percent of all infections in Austria. In parallel, variant B.1.1.7 has reached 58.4 percent.

On the question of whether this variant also causes more severe courses of disease and higher mortality compared with the original virus, the data situation is still very limited. Unpublished studies from the United Kingdom may provide clues.

“The situation is becoming much more tense again, although it definitely varies regionally,” said ÖGARI President Prof. Markstaller. “If the current trend continues, we will very quickly be back to the point where it will be necessary to switch even more strongly to crisis mode. So, for example, intensive care capacities will have to be freed up by postponing planned operations. That, of course, is anything but desirable.”

In addition, there is a certain uncertainty regarding the data situation. “In order to be able to adequately interpret the numbers of intensive care beds occupied by individuals with severe COVID-19, a uniform and clear definition is needed,” Prof. Markstaller said. Currently, it cannot be ruled out that there are different ways of counting COVID-19 ICU patients; for example, whether the admission diagnosis of COVID-19 is relevant for the assignment or the current status of infectiousness.

“We are prepared for all scenarios and contingencies in the intensive care units, even now. But intensive care is, figuratively speaking, the last meadow in this game,” said Prof. Markstaller. “The game-changing accents for the course of the pandemic are set beforehand: Through vaccinations, the known prophylactic measures and the development of new treatment options. Here, everyone has an influence on the further course. Unfortunately, the virus does not align itself with any ‘pandemic fatigue’.”

In the short term, from the perspective of anesthesia and intensive care medicine, it is particularly important to avoid extreme strains on intensive care capacities with all their problematic consequences that could result from a rapid spread of mutated virus variants, says the ÖGARI president. In the longer term, however, he says, it is not enough just to avert extreme strains; it is necessary to be able to move from crisis mode to largely normal care again in intensive care units.

Irrespective of other measures to be decided by policy-makers, the urgent recommendation generally remains that the known prophylactic rules should be consistently adhered to: That is, keep the frequency of personal contact as low as possible, keep your distance, practice consistent hand hygiene, protect yourself with FFP-2 masks, and ventilate regularly.

  • source: heute.at/picture: pixabay.com
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