Cabinet must intervene now, or we risk Covid code black: ICU expert

Diederik Gommers, intensive care doctor and head of the Dutch association for intensive care NVIC, again appealed to the government to take measures to limit the spread of the coronavirus. "If policy remains unchanged, we may end up in code black this fall. Policy must be changed now and it is up to politicians to act," Gommers said to RD.nl.

The Netherlands' total ICU capacity is 919 beds, according to patient coordination center LCPS. There are currently 769 patients in intensive care in the country, including 218 Covid-19 patients. And a number of beds need to be kept free for emergency cases. Scaling up the ICU capacity is not possible at the moment, as staff members are sick or overworked at home, or taking much needed vacation, Gommers said.

"We hardly have any fat on the bones. The only option now is to postpone elective - non-acute - operations. That happens regularly," Gommers said. On Friday, Dutch healthcare authority NZa said that Dutch hospitals already have up to 210 thousand postponed surgeries that need to be caught up. 

A major problem is a shortage in intensive care nurses, which preceded the pandemic, but increased during it. Training new nurses takes time - about five years for a nurse on a regular ward, and an additional 18 months for intensive care - so the shortage will remain for the time being, even if there was massive interest in becoming an ICU nurse. 

And the existing ICU nurses are exhausted, Gommers said. "They come to the conclusion that this is not their job, or experience little appreciation from their managers, society and politicians. The discussion in The Hague about finances did not contribute to this either. In addition, they need rest," he said. "We do not want to stretch our nurses any further, at the risk of them falling over."

So "cabinet, please take measures to keep the flow of Covid patients as small as possible," Gommers said. He did not say what measures. "That is up to the [Outbreak Management Team) and the cabinet." But according to him, it is absolutely clear that intervention is needed.