{"id":250658,"date":"2020-03-31T20:12:46","date_gmt":"2020-04-01T00:12:46","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=250658"},"modified":"2020-03-31T20:12:46","modified_gmt":"2020-04-01T00:12:46","slug":"europes-hospitals-among-the-best-but-cant-handle-pandemic","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/03\/31\/europes-hospitals-among-the-best-but-cant-handle-pandemic\/","title":{"rendered":"Europe’s hospitals among the best but can’t handle pandemic"},"content":{"rendered":"
\"\"<\/a>
Outbreak experts say Europe’s hospital-centric systems, lack of epidemic experience and early complacency are partly to blame for the pandemic’s catastrophic tear across the continent. (Pexels photo)<\/figcaption><\/figure>\n

LONDON \u2014 As increasing numbers of European hospitals buckle under the strain of tens of thousands of coronavirus patients, the crisis has exposed a surprising paradox: Some of the world’s best health systems are remarkably ill-equipped to handle a pandemic.<\/p>\n

Outbreak experts say Europe’s hospital-centric systems, lack of epidemic experience and early complacency are partly to blame for the pandemic’s catastrophic tear across the continent.<\/p>\n

\u201cIf you have cancer, you want to be in a European hospital,\u201d said Brice de le Vingne, who heads COVID-19 operations for Doctors Without Borders in Belgium. \u201cBut Europe hasn’t had a major outbreak in more than 100 years, and now they don’t know what to do.\u201d<\/p>\n

Last week, the World Health Organization scolded countries for \u201csquandering\u201d their chance to stop the virus from gaining a foothold, saying that countries should have reacted more aggressively two months ago, including implementing wider testing and stronger surveillance measures.<\/p>\n

De le Vingne and others say Europe’s approach to combating the new coronavirus was initially too lax and severely lacking in epidemiological basics like contact tracing, an arduous process where health officials physically track down people who have come into contact with those infected to monitor how and where the virus is spreading.<\/p>\n

During outbreaks of Ebola, including Congo’s most recent one, officials released daily figures for how many contacts were followed, even in remote villages paralyzed by armed attacks.<\/p>\n

After the new coronavirus emerged late last year, China dispatched a team of about 9,000 health workers to chase thousands of potential contacts in Wuhan every day.<\/p>\n

But in Italy, officials in some cases have left it up to ill patients to inform their potential contacts that they had tested positive and resorted to mere daily phone calls to check in on them. Spain and Britain have both declined to say how many health workers were working on contact tracing or how many contacts were identified at any stage in the outbreak.<\/p>\n

\u201cWe are really good at contact tracing in the U.K., but the problem is we didn’t do enough of it,\u201d said Dr. Bharat Pankhania, an infectious diseases physician at the University of Exeter in southwestern England.<\/p>\n

As cases began picking up speed in the U.K. in early March, Pankhania and others desperately pleaded for call centres to be transformed into contact tracing hubs. That never happened, in what Pankhania calls \u201ca lost opportunity.\u201d<\/p>\n

Pankhania added that while Britain has significant expertise in treating critical care patients with respiratory problems, like severe pneumonia, there are simply too few hospital beds to cope with the exponential surge of patients during a pandemic.<\/p>\n

\u201cWe are already running at full capacity, and then on top of that we have the arrival of the coronavirus at a time when we’re fully stressed and there isn’t any give in the system,\u201d he said, noting years of reductions in bed capacity within Britain’s National Health Service.<\/p>\n

Elsewhere, the fact that health care workers and hospital systems have little experience with rationing care because European hospitals are generally so well resourced is now proving problematic.<\/p>\n

\u201cPart of the issue is that Italian doctors are getting very distressed to make decisions about which patients can get the ICU bed because normally they can just push them through,\u201d said Robert Dingwall, of Nottingham Trent University, who has studied health systems across Europe. \u201cNot having the triage experience to do that in a pandemic situation is very overwhelming.\u201d<\/p>\n

In a departure from their normal role as donors who fund outbreak responses in poorer countries, countries including Italy, France and Spain are all now on the receiving end of emergency aid.<\/p>\n

But Dr. Chiara Lepora, who heads Doctors Without Borders’ efforts in the hot spot of Lodi in northern Italy, said the pandemic had revealed some critical problems in developed countries.<\/p>\n

\u201cOutbreaks cannot be fought in hospitals,\u201d she said. \u201cHospitals can only deal with the consequences.\u201d<\/p>\n

Doctors in Bergamo, the epicenter of Italy’s outbreak, described the new coronavirus as \u201cthe Ebola of the rich\u201d in an article in the journal NEJM Catalyst Innovations in Care Delivery, warning that health systems in the West are at risk of being as overrun by COVID-19 as West African hospitals were in the devastating 2014-2016 Ebola outbreak.<\/p>\n

\u201cWestern health systems have been built around the concept of patient-centred care, but an epidemic requires a change of perspective toward community-centred care,\u201d they wrote.<\/p>\n

That model of community care is more typically seen in countries in Africa or parts of Asia, where hospitals are reserved for only the very sickest patients and far more patients are isolated or treated in stripped-down facilities \u2014 similar to the field hospitals now being hastily constructed across Europe.<\/p>\n

Even Europe’s typically strong networks of family physicians are insufficient to treat the deluge of patients that might be more easily addressed by armies of health workers \u2014 people with far less training than doctors but who focus on epidemic control measures. Developing countries are more likely to have such workforces, since they are more accustomed to massive health interventions like vaccination campaigns.<\/p>\n

Some outbreak experts said European countries badly miscalculated their ability to stop the new coronavirus.<\/p>\n

\u201cBut I think the fact that this is a new disease and the speed at which it moved surprised everyone,\u201d said Dr. Stacey Mearns of the International Rescue Committee.<\/p>\n

Mearns said the current scenes of desperation across Europe \u2014 doctors and nurses begging for protective gear, temporary morgues in ice rinks to house the dead \u2014 were unimaginable just weeks ago. In Spain, 14% of its coronavirus cases are infected medical workers, straining resources at a critical time.<\/p>\n

\u201cWe saw hospitals and communities get overwhelmed like this during Ebola in West Africa,\u201d she said. \u201cTo see it in resource-wealthy nations is very striking.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

LONDON \u2014 As increasing numbers of European hospitals buckle under the strain of tens of thousands of coronavirus patients, the …<\/p>\n","protected":false},"author":44,"featured_media":249499,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,17],"tags":[],"class_list":["post-250658","post","type-post","status-publish","format-standard","has-post-thumbnail","category-news","category-news-w","mauthors-maria-cheng","mauthors-the-associated-press"],"_links":{"self":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/250658","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/comments?post=250658"}],"version-history":[{"count":1,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/250658\/revisions"}],"predecessor-version":[{"id":250659,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/250658\/revisions\/250659"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media\/249499"}],"wp:attachment":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media?parent=250658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/categories?post=250658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/tags?post=250658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}