Corona: Patients spend less time in hospitals during second wave of infections

People who test positive for the coronavirus in the second wave appear to have less serious symptoms compared to the people treated during the first wave of infections, AD newspaper reports based on an inventory published by the Dutch Association of Internists (NIV) containing data from 180 patients in nine hospitals in the Netherlands.

The length of stays in hospitals has decreased by a third and the percentage of patients who have to go to intensive care (IC) has dropped by half. The results of the inventory are in line with the recent findings from the Dutch Association for Intensive Care. The total length of the IC stay for corona patients has dropped drastically: in March and April, patients spent on average 22 days in IC, now this has dropped to an average of 8 days. NIV director Samara de Jong-Jaber says that the data confirms the prevailing feeling within hospitals around the country. “There’s a difference between the first and second wave.  But this is a first official observation, which for further research is necessary.”

Specialists say the reduction in length of hospital stay is happening partly because more elderly people were ill in the first wave, while the second wave so far has mostly hit younger people, who are less likely to get sick and develop serious symptoms from the virus. “That plays a role, but it cannot be attributed to the population alone,” says De Jong. She suspects corona patients leave hospital earlier because treatment methods have been improved in recent months, to great advantage for the people infected in the second wave. “In the beginning everyone was searching for answers, so new insights not only play a role in the effectiveness of treatment, but it’s also important for capacity planning in hospitals.”

Pressure on the health system remains
Even with the faster discharge from hospital, this does not mean that the corona virus is not causing problems. According to the NIV, regular hospital wards are currently filling up faster than the ICs, because corona patients now have less serious symptoms. As a result, the Dutch health system remains under pressure, says internist Robin Peeters. “The burden on hospitals remains high because the pressure is shifted to a different place in the hospital than during the first wave.” In fact, many hospitals have already scaled down regular care for other diseases.

Peeters emphasizes that measures must be taken to guarantee sufficient capacity in the nursing wards for both corona patients and regular care. “This requires, among other things, adjusted planning and fast recruitment of personnel in the event of a possible capacity problem on the IC,” the NIV concludes.

Breathing problems
Furthermore, even those who do not end up in hospital at all are feeling the effects of corona virus. In July, pulmonologists concluded that corona patients who had not been hospitalized at all seem to experience more long-lasting problems than those admitted to hospitals. The Dutch Association of Physicians for Pulmonary Diseases and Tuberculosis (NVALT) sees many former corona patients with breathing problems and fatigue in the outpatient clinic. “We’re surprised by the high number of former corona patients who come to us with complaints,” said Leon van den Toorn, chairman of the pulmonologists’ association. This group of patients wasn’t initially admitted to hospital, but is now referred by general practitioners because their symptoms persist.

Their acute complaints seem to pass at first, but then persist or even get worse. “We see that almost all these patients complain about persistent breathing difficulties and poor capacity for physical exercise – they get out of breath very quickly. However, there are only minor abnormalities visible in their lung scans,” said Van den Toorn. “It’s not clear how this is possible and more research is necessary.”

For these patients, the continued availability of hospital care is extremely important; one more reason to ensure that regular hospital care is able to continue during the second wave of corona infections.

Written by Raphael Perachi