Hospital in Breda prepares for 'code black' due to rise in Covid-19 patients

In the Amphia Hospital in Breda, the IC capacity for coronavirus patients has again been scaled up considerably. Since April 19, all beds of the emergency IC have also been occupied. The hospital only has two or three beds available for other emergencies. At the same time, the Dutch public health agency RIVM predicts a sharp drop in the number of corona patients that will be admitted before the end of the month.

ICU medical manager Merijn Kant was "baffled" when he saw last week's press conference announcing some loosening of corona measures. "It is not at all in line with the current occupation in hospitals. Apparently, these choices were made for other reasons. I am just afraid that we will no longer be able to cope with this care."

Kant is preparing his staff in the ICs - also with a view to the May holidays - for 'code black'. In that scenario, doctors select who is and who is not eligible for a place in intensive care. This has not yet happened in the Netherlands during the corona pandemic. Kant: "I hope we don't reach that stage, but we take everything into account."

According to Robert Wagenmakers, who speaks on behalf of the specialists in the Amphia, the pressure is greater than a year ago. "We are running a marathon. We always think that the finish is in sight, but then it moves up again. That has a huge effect on our organization. We expected that we had reached the peak, but now it appears that we are still in full swing and are busy with the ascent."

The Amphia Hospital has increased the number of IC beds from 24 to 39 through the emergency IC. This expansion is only possible because the operating room personnel is supporting the IC staff. One IC nurse does not take care of one bed, as is usual, but two or three beds.

In the regular corona nursing ward, almost all beds are also occupied. Those who can go home with an oxygen bottle go home to create space for a new patient. Every day, between five or six new patients are added. And now and then a patient from another hospital. Pulmonologist Cor van der Leest sees that many people over 70 have now been vaccinated. "We hardly see them here anymore. We still see a lot of people between the ages of 50 and 60. So they are younger than before, but they are just as sick."

The hospital in Breda made the news last week because Rogier Crolla, a doctor from the hospital, raised the alarm because of a festival that had been organized by Radio 538 and Field Labs on a trial basis near the hospital. The doctor collected more than 400,000 signatures with a petition. Mayor Paul Depla subsequently refused to grant a permit for the festival.

But after Tuesday's press conference, in which the cabinet announced step-by-step easing, they are raising the alarm again in the hospital. Wagenmakers: "We understand the wishes of society. But here we are not yet ready for such relaxation. Not only are the ICs full, but we have also had a triage team for some time to assess whether an operation is urgent enough or not. For many of those patients, the surgery had already been postponed."

Medical manager Kant fears for what lies ahead for the hospital. "I'm just afraid that we will no longer be able to provide this care. Partly because of the May holidays. The supply of new patients is still extremely high."

A group of intensive care doctors from several hospitals in Noord-Brabant wrote an urgent letter on Sunday in which they state that the boundaries of the care in their intensive care units have been reached. The letter is addressed to the Ministry of Health, Welfare and Sport and the boards of the National Network Acute Care and the National Coordination Center for Patient Distribution and was sent on behalf of IC teams from hospitals in Uden, Eindhoven, Tilburg, Breda, Boxmeer, Veldhoven, Helmond, Bergen op Zoom, Den Bosch and Weert (Limburg).