Posted 31 марта 2020,, 15:53
Published 31 марта 2020,, 15:53
Modified 24 декабря 2022,, 22:36
Updated 24 декабря 2022,, 22:36
European hospitals have traditionally been considered the most reliable and advanced: patients with serious diseases such as cancer, if they had the financial ability, as a rule, sought to get here.
That was before the advent of the coronavirus. Now that European hospitals are bursting with the influx of tens of thousands of patients with COVID-19, it is already obvious: some of the world's best health systems have proven to be untenable. Not just unprepared for the epidemic, but also responsible for the fact that it spread throughout the continent.
Why did this happen? Experts cite several reasons: focus on the hospital system, lack of epidemic experience - since the time of the “Spanish woman” 100 years ago, there were no outbreaks in Europe - and frivolity. This is written in today's material by The Associated Press.
Reason # 1: passivity
Last week, WHO announced that many countries missed their chance to halt the spread of the virus: two months ago it was necessary to respond in the most aggressive way by conducting more extensive testing and strengthening surveillance measures.
In Europe, for example, one of the main epidemiological measures, contact tracing, was neglected from the very beginning. This is a rather time-consuming process, consisting in the fact that health personnel restore all contacts of an infected patient in order to personally monitor who the virus has spread to.
During Ebola outbreaks, including the most recent in Congo in 2018, officials published daily data on how many contacts were made, even in remote villages. When a new coronavirus appeared late last year in Wuhan, the Chinese authorities sent a team of approximately 9,000 medical workers to restore contact with infected people day after day.
In Europe it was different. In Italy, for example, health workers often authorized the sick themselves to inform their loved ones that they had a positive result for coronavirus. Spain and the UK also did not do enough to track contacts. As a result, in the same UK, where doctors have significant experience in treating patients with severe respiratory illnesses such as pneumonia, now there are not enough hospital beds to cope with the exponential increase in the number of patients, and hospitals are working to the limit, although the epidemic has not yet reached its peak.
Reason number 2: unpreparedness for the epidemic
Another point is the unwillingness of European health workers and healthcare systems to function in conditions of limited resources. Before the epidemic, European hospitals were so well equipped with equipment, materials and staff that the need to switch to work in extreme conditions caused a real collapse. Much has been written about how stressful it is for doctors in Italy to quickly make decisions about which patients to be sent to intensive care wards and who to refuse and thereby doom to death. The lack of experience of such a “sorting” negatively affects both patients and physicians.
Experts who are well acquainted with the experience of Doctors Without Borders organization believe that one of the critical problems that COVID-19 has exposed in developed countries has been the inability to treat otherwise than in hospitals, while hospitals can cope during epidemics only with consequences.
Doctors from Bergamo, the city that became the epicenter of COVID-19 in Italy, called the new coronavirus “Ebola of the rich” and warned that health systems in the West were facing a threat of an epidemic comparable in magnitude to the Ebola outbreak in 2014-2016. In an article published by the New England Journal of Medicine, they note: “Western healthcare systems are built around the concept of patient-centered care. However, the epidemic requires a change in point of view - it requires community-oriented care. ”
This model is well known in Africa and some parts of Asia: hospitals here are designed only for the most difficult patients, while the rest are isolated or treated in medical facilities like those field hospitals that are now being quickly built throughout Europe.
If in civilian life the system of family doctors was justified, now that the usual trickle of patients has turned into a stream, a need has arisen for a completely different system, where the emphasis is on less qualified, but owning measures to combat the epidemic, medical staff. In developing countries, they are now better prepared for this, as long as they are used to massive public health events such as vaccination campaigns.
Reason # 3: Underestimating the severity of the outbreak
Some experts believe that European countries have miscalculated in their ability to stop the new coronavirus. Although, of course, no one was ready for the speed with which the new disease spread across the planet. A few weeks ago, and in a terrible dream, it was impossible to imagine what Europe is now observing: doctors and nurses imploring for protective equipment, ice arenas converted into morgues, and military vehicles transporting dozens of coffins.
Before, Italy, France and Spain were “sponsors” of poorer countries and helped them cope with the constant outbreaks of epidemics - now they themselves are forced to receive emergency assistance.