Load on Hungarian hospitals grows dramatically due to COVID

More and more people in hospital

Based on daily new cases, the reproduction rate of the virus and the positivity rate of tests, we can clearly say that

the fourth wave is raging in Hungary, with case numbers now doubling week on week.

Over 16% of samples taken test positive for the virus, which means the virus is spreading across Hungary with no control and the authorities are just reacting. Based on the latest data, fatalities have also started to rise at an accelerating pace, and if hospital data are anything to go by, this will not end in the near future.

As of Tuesday morning, there were 1,685 people treated in Hungarian hospitals with COVID-related symptoms, some 1,000 fewer than a year ago. The number of people on ventilator was 197, compared to 233 the same time last year. This is clearly a result of vaccination, as vaccines have been proven to be effective against serious progression of the disease even in the case of the newer delta variant.

Worsening hospital situation cause for concern

The load on hospitals in the fourth wave shows a clearly worsening trend. The virus is spreading at a swift pace and is finding not just the unvaccinated but also those who have been vaccinated but have low-level protection (typically the elderly who received the Chinese vaccine) and those whose immunity has decreased significantly (including those who got the second dose a long time ago and its effects are wearing off, and those who got infected during the third wave and lost their immunity).

This means that masses of Hungarians are defenceless or barely protected against the increasingly rampant fourth wave.

According to reports, 5 out of 6 coronavirus patients are unvaccinated, but no official data are available.

Looking at how the situation of hospitals worsened in past weeks, we find that

the load on COVID wards is increasing at the same pace as it did this time last year.

The number of people requiring hospital treatment is growing by 100 a day and an additional 9 people require ventilation each day (based on the seven-day rolling average). This is disheartening as vaccination was supposed to bring great results.

The outlook concerning the further spread of the virus is also rather bleak, which means hospital statistics will likely deteriorate further.

What is coming?

Health professionals working in hospitals are of the opinion that the curve should be flattened so that COVID patients do not overload the health care system in a short period of time. However, all signs point in the opposite direction. According to our sources, EMTs are now taking COVID patients with mild or medium symptoms to hospitals other than the designated central one in each county, although this is not general practice yet.

Portfolio has talked to several active health care workers about the current state of hospitals, and all of them agreed that the current situation was still manageable. Their concern was the increasing load and the fact that there is nothing on the horizon that would slow or stop this trend.  “Virus defence measures are unchanged, and the strategy is still built on vaccination, which is not progressing. The number of newly vaccinated people remains very low (1,000 to 2,000 a day), the coverage of the vulnerable age group is not complete and wearing masks has not been made mandatory even though this could slow the spread of the virus. Although people are taking up the third dose, it is the first two shots that could slow the fourth wave. The immunity certificate also does not play a significant role in Hungary. Moreover, continuous screening and contact tracing would be required in order to contain infection hotspots, but this has not been done even when the spread of the virus was manageable,” one source who wished to remain anonymous told Portfolio.

There was also a paradox as fewer people were registered as contacts than as infected, which also shows the failure of contact tracing. Another source said outdoor vaccination points should be set up high-traffic areas where anyone could get a vaccine without registration, and vaccination buses should also be re-deployed. Also, health workers should receive a third shot as they received the first two among the first (starting last December), and the long time since their second jab means their immunity has decreased significantly. Another source said the current nature of the pandemic indicates that vaccine shots should be repeated regularly, both because the effect wears off in time and due to new variants emerging, so the time for fourth and fifth jabs will also come eventually.

All health workers talking to Portfolio stressed that normal patient care will suffer due to higher COVID loads on hospitals. Sick people will fall out of normal care, their diseases will not be diagnosed or at least not in time, and they will not receive timely treatment. “We are still working off the waiting lists, while the next wave is already upon us,” one source said.

We are running into the next wave with our ranks in disorder,

a health worker said. Hospital workers can see the worsening pandemic trend and the crisis situation that is closing in on them like an express train, but they also know that it is too late to prevent the inevitable and even slowing the impact seems impossible unless strict measures are taken in the near future.

László Szijjártó, head of the Győr-Moson-Sopron chapter of the Hungarian Medical Chamber (MOK), provided a wider context. In his view, the health care system was already a crisis system without quality assurance before the pandemic, the legal status of health workers, and vaccination all complicated the situation further. A large number of professionals have left the public health care system, partly due to the legal status changes and mandatory vaccination, and the entire system reopened this spring after the third wave with a lot fewer trained professionals. This in turn led to another wave of leavers due to high workloads, the lack of any improvement on the horizon, and the fact that patient safety could not be guaranteed under these circumstances.

“If hospitals come under a burden similar to the second or third waves, the system will have to cope with much fewer workers, who are also much more tired and burnt out then they were during the previous waves,” Szijjártó said, adding that the county hospital has just asked for volunteers from his hospital.

Overall, Szijjártó characterised both the current situation and the outlook as tragic. Beaten troops are trying to handle the fourth wave in a system in disarray, with irrational coordination and one-way communications (top down only), so not much good can be expected, he said.

If a soldier is sent to another losing battle, it is hard to improve motivation and morale, especially since no reinforcements are in sight.

He also pointed out that hospitals were already finding it hard to provide care for non-COVID patients for the lack of trained professionals, and the burden of the fourth wave will do little to improve the situation.

Cover photo: MTI/Nándor Veres