Feeling the strain in Israel

Hat tip to @Crof via Twitter.

Hospitals not prepared for swine flu epidemic, IMA warns

Sep. 27, 2009
Judy Siegel-Itzkovich , THE JERUSALEM POST

The Israel Medical Association’s Intensive Care Society demanded over the weekend that the Health Ministry allocate money to prepare the hospitals for coping with an H1N1 flu epidemic – especially for the shortage of intensive care facilities.

In an emergency meeting on the implications of the flu, the society called on the ministry to issue guidelines that would cancel nonemergency surgery if beds needed to be freed up. Today, there are only 300 intensive care beds in the public hospitals.

The intensive care specialists, headed by Prof. Charles Sprung of Hadassah University Medical Center in Jerusalem’s Ein Kerem, said that “already, we see people dying due to the shortage of intensive-care beds. In the event of a serious flu outbreak, there will be hundreds and even thousands of patients who will need such beds and won’t get them due to the lack of such facilities.”

The society said that according to official ministry predictions, about 2,200 patients will need to be attached to a respirator at any one time this winter – twice last year’s figure.

Nearly half of these patients will suffer multiple systems failure. Thus the number of kidney dialysis machines and other vital equipment must be significantly increased, as well as the number of staffers who run them, the doctors continued.

Seven of 10 patients with H1N1 flu complications need intensive care, and the amount of hospitalization days necessary is unusually long, as those who recover require more days than most other patients.

Prof. Mervyn Shapira, head of infectious diseases at the Tel Aviv Sourasky Medical Center (Ichilov Hospital), said that the anti-viral Tamiflu drug helps prevent complications mostly when given early to the patient and that there was no clear medical evidence that it saves patients at a more advanced stage of illness.

It’s hard to know if there is genuine cause for concern or whether this is someone “running the numbers” and figuring that statistically – and based on “official projections” – need will exceed the existing critical care capacity.  Without a magical crystal ball we cannot know with certainty.  But how tragic it will be if people die due to a simple lack of ability to care for them.

What I found the most surprising was in a country that lives with the major threats that Israel does, and has for a long time, that they have only 300 critical care beds in their public hospitals.  I wonder how many the private hospitals have… or how many private hospitals there are for that matter.  Perhaps there is significant capacity, and that would explain the relative [seemingly] dearth in the public system.

Fortunately, we are not expecting a serious pandemic… we are learning that even a mild one presents us with challenges we may not be able to handle very gracefully.

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