Hospitals in some European countries are warning that ICU beds are fast approaching full capacity as coronavirus continues to spread. Some ICU units have been hit worse than they were during the peak in spring. It's as the global total of cases surpassed 50 million on Sunday.
Intensive care is the last line of defence for severely ill coronavirus patients and Europe is running out of beds and the doctors and nurses to staff them.
Health officials, many advocating a return to stricter lockdowns, warn that adding more beds will do no good because there aren't enough doctors and nurses trained to staff them.
Portugal's situation 'very serious'
Portugal became the latest European country to issue restrictions amid an aggressive second wave of the pandemic.
"The situation that Portugal is going through is very serious. Everything must be done to control the pandemic," said Portuguese Prime Minister António Costa after President Marcelo Rebelo de Sousa issued a state emergency.
In all, 391 coronavirus patients were in Portuguese ICUs as of Monday, when the country imposed a curfew. During the worst week last spring, the ICUs had 271 coronavirus patients.
“There’s no end in sight,” Maltez said at the infectious disease ward he oversees at Lisbon’s Curry Cabral Hospital, where 20 ICU beds set aside for coronavirus patients are now all occupied. “No health service in the world ... can withstand a deluge of cases that just keeps coming.”
Portugal has had more than 170,000 confirmed cases since the beginning of the pandemic and like many other countries in Europe, has a rising incidence rate.
Meanwhile, in the US, COVID-19 is the subject of a presser from president-elect Joe Biden.
Many European countries have issued more restrictions, while attempting to balance the economic fallout of a full lockdown.
United Kingdom: scaled-down Remembrance service
The United Kingdom entered its second national lockdown on 5 November and has been recording around 20,000 new cases of COVID-19 per day.
The UK recorded more than 400 deaths due to COVID-19 over the weekend, bringing the country's total to 49,044 on Sunday.
Remembrance Sunday was marked with a scaled-down service amid the pandemic.
France: intensive care units reaching full capacity
France is one of the worst-hit countries in Europe, with 125,414 new cases and 270 new deaths recorded on Sunday according to JHU data.
Rates are beginning to fall according to JHU, but ICU's are under immense pressure. The government coronavirus tracking app says intensive care capacity taken up by COVID-19 patients is at 92.5 per cent and rising.
More than 7,000 health care workers have undergone training in intensive care techniques since last spring. Nursing students, interns, paramedics, all have been drafted, according to Health Minister Olivier Veran.
“If the mobilisation is well and truly there, it is not infinite,” he said last week, when the ICU units were filled to 85% capacity. “It is not enough.”
In something of a plea on French prime time television last week, Rémi Salomon, the president of the medical commission at the Paris Hospitals (AP-HP), begged people to respect the country's lockdown. The AP-HP is the largest public hospital system in Europe.
Salomon said that soon they would have to decide who they could treat and who they couldn't as intensive care units continue to fill up.
He added he was very worried and hoped that his words would change the behaviour of at least some of the people watching.
Greece: SMS authorisation reintroduced as country enters strict lockdown
Greece entered its second national lockdown on 7 November, as 14 new deaths and 2,448 new cases were recorded - bringing the number of confirmed cases to 52,254 with 715 fatalities.
People are only allowed to leave their homes for work, exercise, shopping for essentials or visiting a doctor. A text messaging system has been put back in place to grant people permission to leave their homes.
Greece is credited with responding quickly to the spread of the virus - it imposed an early lockdown in the spring when it still had just a handful of cases.
Italy warns not enough doctors to go around
In Italy, Filippo Anelli, the head of the national doctors' association, said that at the current infection rate, there soon won't be enough physicians to go around.
Recently in Naples, nurses started checking on people as they sat in cars outside emergency rooms, waiting for space to free up.
Italy has a total of 11,000 ICU beds, but only enough anaesthesiologists for 5,000 patients, Anelli said. As of Monday, 2,849 ICU beds were filled nationwide — up 100 from just the day before.
Italy has instituted local lockdowns in four regions and a nationwide curfew in an attempt to stop the virus from spreading. Many countries have closed businesses or issued partial lockdowns.
The governor of an autonomous Italian Alpine province famed for its ski resorts has declared it a “red zone,” shutting down as of Monday most non-essential shops, barring cafes and restaurants from serving meals and forbidding citizens to leave their towns except for essential reasons like work.
Croatia: protests in Zagreb as tighter restrictions are imposed
Hundreds of protesters gathered in central Zagreb on Sunday to demonstrate against measures imposed by the government to tackle the coronavirus, claiming that the pandemic was a scam.
It's as the country reached a record high in COVID-19 cases over the last week - 15,752 cases and 232 according to JHU.
In total there have been 64,704 infections and 752 deaths, according to Johns Hopkins University.
Similar COVID-19 protests took place in Zagreb back in September. AP/Copyright 2020 The Associated Press. All rights reserved.
Much of Eastern Europe, spared the harrowing wave last spring, is in the same position. Hungary warned its ICU would run out of space by December under the worst-case scenario, and hospitalisations in Poland have risen to three times the levels seen in the spring.
Late last month, American National Guard troops with medical training headed to the Czech Republic to work alongside doctors there, and the mayor of Prague took shifts at a hospital.
A glimmer of hope in Belgium
Belgium, proportionally among the worst-hit nations in Europe when it comes to coronavirus cases, is seeing increasing indications of a turning point in the crisis after a partial lockdown.
Hospital admissions seem to have peaked at 879 on Nov. 3, and fell to about 400 on Sunday, virologist Yves Van Laethem said.
There were fears that the 2,000-bed ICU capacity would be reached last week, but Steven Van Gucht, a virologist with the Sciensano government health group, said the pace was slowing there as well.
“The high-speed train is slowing down,” at least for now, he said.
EU cuts economic forecast
As a result, the European Union recently cut its economic forecast, stating that the economy would not return to pre-pandemic levels until 2023.
"The forecast projects the unemployment rate in the euro area to rise from 7.5% in 2019 to 8.3% in 2020 and 9.4% in 2021, before declining to 8.9% in 2022," the Commission said.
"This forecast comes as a second wave of the pandemic is unleashing yet more uncertainty and dashing our hopes for a quick rebound," said Commissioner Valdis Dombrovskis.