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Czech hospitals under pressure as coronavirus cases surge

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Healthcare workers attend to a COVID-19 patient in an intensive care unit (ICU) at Na Bulovce hospital in Prague, Czech Republic
Healthcare workers attend to a COVID-19 patient in an intensive care unit (ICU) at Na Bulovce hospital in Prague, Czech Republic   -   Copyright  AP Photos
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There are growing concerns about how prepared the Czech Republic’s healthcare system is as the central European nation enters an expected 30-day state of emergency to combat rising coronavirus infections.

The number of new COVID-19 cases rose by 50% in September, Europe’s second-largest spike in cases and last Friday saw the second straight record for the highest daily count, of 3,793 new coronavirus cases.

Milan Kubek, president of the Czech Medical Chamber, said that as of October 5 around 1,200 patients are hospitalised with COVID-19 and 280 of them are in a serious condition, which is now putting pressure on hospitals to reallocate already-sparse intensive care beds for coronavirus patients.

The Czech Republic responded earlier than most European states in March by imposing a nationwide shutdown, banning travel in and out the country and mandating facemasks must be worn at all times when outdoors.

However, infection numbers began to soar after regulations were greatly eased from June onwards. On September 21, Adam Vojtech stepped down as the health minister following criticism from opposition parties and some healthcare organisations.

Later the same day Roman Prymula, an epidemiologist and army colonel who had been critical of the Czech pandemic responses, was named the new health minister.

At the time of Vojtech’s resignation in mid-September, daily new cases were near the 2,000 mark. Last week, however, they exceeded more than 3,000, in spite of new restrictions on bar opening hours, public events and face-mask wearing imposed after Prymula took over the health ministry.

On September 30, the government issued a new 30-day state of emergency that began on Monday, which further restricts social activity.

The country's chief hygienist, Jarmila Razova, noted in a press conference last week that the ever-higher case numbers are “mainly” due to younger people catching the virus, especially those of school-age, local media reported.

During the same press conference the chairman of the Czech Society of Anaesthesiology and Intensive Care Medicine, Vladimir Cerny, stressed that “the capacity of hospitals is currently sufficient”, although some are recalculating the number of beds that might be needed for coronavirus patients at the possible expense of other patients.

Prague pressure

In Prague, the worst affected area, only 10% of the intensive care unit beds were empty last week, “which was too few,” said Kubek. “Hospitals have begun cancelling scheduled operations or procedures to save the ICU beds for people with COVID-19,” he added.

Outside the capital, infection case numbers are rising slower and hospitals appear more confident of being able to tackle this second-wave of infections. Adam Fritscher, a spokesperson for the Olomouc University Hospital, the biggest health care facility in Olomouc region, said it “is prepared” for the rising number of cases.

The European Commission’s “State Of Health In The EU” report for the Czech Republic last year found generally positive outcomes. Health spending as a share of GDP (7.2%) was below the EU average of 9.8% in 2017, it noted, though public financing of healthcare was the highest among the newer member states that joined after 2004. It also found that the Czech Republic had one of the highest hospital bed ratios in the EU, with 6.6 beds per 1,000 population.

However, while the number of health professionals was slightly higher than the EU average – 3.7 doctors per 1,000 population compared to 3.6 – the report warned of problems in geographic density, with the capital region having 2.4 times more doctors than rural regions.

Healthcare services may be “threatened by the lack of the qualified staff even more than the lack of ICU beds,” said Kubek. In September, the number of infections amongst doctors rose six-fold, and seven-fold amongst nurses, according to a Czech Medical Chamber statement last week. At least four medical workers have now died of the virus, according to local media reports.

A report by the Institute of Health Information and Statistics found that only four doctors had been infected with COVID-19 by August 20, but this rose to 259 by mid-September. The number of infect nurses rose from 3 to 433, it added.

One doctor working in eastern city Brno, who asked not to be named, said a sudden spike of infections amongst medical staff could leave hospitals severely short-staffed, or force doctors and nurses to put their own safety at risk in order to remain at work.

“What a shame that the politicians ignored the experts’ recommendations and didn’t react to the deteriorating situation already at the end of August when the spread of the epidemic could have been stopped,” said Kubek. “The politicians in charge must not be guided by public opinion, but by the information received.”

Fresh lockdown?

The health ministry is expected to publish a new plan later this week looking at possible next steps and what further restrictions can be taken if case numbers don’t decrease quickly enough. However, there is doubt whether that would include another full-scale lockdown, a move that will severely affect the economy and frustrate sections of the public.

In May, the former health minister Vojtech stated that “if there were another massive increase in cases across the Czech Republic, then we would have to bring in nationwide measures again”. This opinion may have been a reason for his dismissal last month, since Prime Minister Babis vowed in June that there will not be another blanket lockdown.

There have been accusations by columnists in the Czech media that less-than-severe restrictions were imposed last month, despite the massive surge in new cases, because Babis wanted to ensure the senate and regional elections go ahead as planned in early October, and so as not to make his own ruling ANO party unpopular ahead of the ballot.

His ANO party topped last weekend's polls with almost 21% of the popular vote and won the vast majority of locally-elected seats.

On October 2, health minister Prymula lashed out at critics who claimed the government’s pandemic response is politicised, especially against accusations that new restrictions are designed to “establish a police state.”

“Many measures are far more lenient than in other democracies,” Prymula noted during a press conference.