(Bloomberg Opinion) -- During Covid-19’s first wave, locked down families gathered on their balconies every evening in Paris, Madrid and Rome to applaud exhausted nurses and doctors risking their lives to save others. The U.K. had a similar “clap for our carers” in honor of the country’s National Health Service.
So far, the second wave of the pandemic has been less rapid, less severe and less fatal than the first — but intensive care wards are filling up regardless. With Europe’s hospitals facing a shortage of beds and staff, and the winter flu season looming, health workers will need more than a few public cheers this time around. There are steps the authorities can take to ease the burden, on top of more restrictions on citizens’ activities, but they’ll need to move quickly.
In France, which is mulling a full one-month lockdown after its biggest number of daily deaths since April, there are more than 2,900 Covid-19 patients in intensive care units. That’s the same number as the last week of March, at the height of the first outbreak. Almost half of France’s ICU capacity has been taken up by new coronavirus cases.
In neighboring Belgium, where former Prime Minister Sophie Wilmes was admitted recently into intensive care, the government expects hospitals to reach saturation point within two or three weeks. In the Netherlands, overwhelmed ICUs are airlifting patients across the border to Germany, which may also take in Czech patients.
This alarming scenario is exactly what policy makers hoped to avoid by trying to halt the coronavirus’s spread through testing, tracing and isolation as well as mandatory face masks. Yet that only delayed the inevitable. While hospitals have more knowledge and treatments than they had during the first wave, ICU patients are still mostly over 60 with underlying health conditions. And doctors lack real game-changer drugs.
So governments are being forced to impose ever tougher lockdown restrictions to protect their health-care systems, despite the natural reluctance to wreck their economies.
Ideally, adding more beds would be enough to relieve hospitals; in reality, every new bed means more medical staff have to be hired. Intensive care is complicated, requiring six or seven years’ training, and tasks such as turning patients face down can’t be done by one person. For France to hit its target of 12,000 intensive care beds (double current capacity), one estimate suggests it would need an extra 24,000 nurses and 10,500 caregivers.
Thankfully there are other things we can try to support the health system. Non-specialist tasks such as washing and feeding hospital patients or keeping them company could be done by trained volunteers who’ve suffered a bout of Covid-19 and have antibodies. Israel has tried this. Philippe Juvin, a French emergency doctor, has proposed a three-week training plan for caregivers and nurses to take on support roles, and for doctors with past intensive and emergency care experience to help.
Obviously, there are limits to retraining and refresher courses when it comes to critical care. We should also think beyond borders by sharing trained surplus staff within Europe, or the world, provided there’s spare capacity. The airlifting of Dutch patients to Germany, while a last resort, is heartening — as is Sweden’s offer of help to other nations. The politics of accepting assistance from places like China is dicey, but Europe can do more by itself.
Priority must also be given to protecting staff and patients from cross-contamination. Temporary pandemic hospitals like the U.K.’s “Nightingales” — mothballed for lack of use — could be used to monitor non-severe Covid-19 patients, an approach that’s helped South Korea contain outbreaks. And even if we lack a vaccine for this coronavirus, getting flu shots for everybody is essential.
None of these is a magic bullet, unfortunately, and winter will be grueling. Longer term, policy makers will need to think differently about investing in health care, which had been seen as an unproductive investment vulnerable to cutbacks: One ICU bed costs upward of 2,000 euros ($2,367) per day to run.
Yet a pandemic turns that investment case upside down. More hospitals and beds, more staff, more decentralized care centers for testing and treatment, and more research for therapies and vaccines all looks expensive. But that’s nothing compared to the economic ruin of lockdown.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Lionel Laurent is a Bloomberg Opinion columnist covering the European Union and France. He worked previously at Reuters and Forbes.
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