BUDAPEST – Doctors in Hungary are warning that a lack of medical staff qualified to treat coronavirus patients in intensive care units could soon lead to soaring deaths and a breakdown in the country’s fragile health care system despite the government’s expensive medical equipment purchases.
Hungarian Prime Minister Viktor Orban last week announced the country's strictest pandemic restrictions to date to combat rapidly rising coronavirus hospitalizations and deaths, predicting that without the measures Hungary’s health care system had only a “50% chance” of coping with the pandemic.
The government has ordered hospitals to expand ICUs to accommodate the rapid rise in COVID-19 patients and earlier this year purchased 16,000 ventilators at a cost of 842 million euros for the expected surge this fall.
“All the technical equipment needed ... is available,” Orban said last week.
But Hungarian Chamber of Doctors has warned that the number of ICU beds and ventilators are overshadowed by a lack of qualified doctors and nurses to treat ICU patients.
“Government communication pushes that we have 16,000 ventilators and are capable of creating 4,000 intensive care beds, but this is just not true,” said Peter Almos, vice-president of the Hungarian Chamber of Doctors. “You have the beds, but you don’t have the nurses and doctors who can treat (the patient) on the bed, so they just lie there."
New restrictive measures that took effect last week — including an 8 p.m. to 5 a.m. curfew, mandatory mask-wearing in public, a 10-person ceiling on family gatherings and remote learning for high school and university students — were taken “too late,” Almos said.
Hungary has 2,000 specialists for ICU wards and a similar number of ICU nurses. But the recent sharp rise in hospitalizations has led to a patient-to-doctor ratio of 20-to-1 in some ICUs, which Almos said will “obviously lead to a high mortality rate.”
“The (patient) load we see now has resulted in suboptimal treatment of coronavirus patients. The mortality rate in some ICUs was 30% in springtime and now it’s 50%, and it’s going to climb higher in the coming weeks,” he said.
As of Tuesday, 7,477 COVID-19 patients were being treated in Hungarian hospitals and 576 were on ventilators. The country of nearly 10 million people has seen 3,281 confirmed coronavirus deaths, half of them in the last three weeks.
Intensive care units across Europe are struggling to cope with spiking patient loads that are nearing and sometimes surpassing levels seen at last spring’s peak. In France, Italy and Spain, hospitals have struggled with dwindling ICU beds, and last week, France’s coronavirus tracking app put the ICU capacity taken up by COVID-19 patients at 92.5% and rising.
Hungary’s government has faced criticism for purchasing more ventilators than can be realistically deployed and for paying China much more per unit than other European countries. While Hungary purchased 567 tons of respiratory equipment from China for 482 million euros ($564 million), Germany purchased nearly twice that weight for less than 31 million euros ($36 million.)
Foreign Minister Peter Szijjarto says Hungary has permission to sell some of the county’s ventilator surplus to potential buyers.
In the United States, some doctors now don't see ventilators as the best hope for coronavirus patients and are trying many other interventions to avoid keeping patients off them if they can.
Hungary’s shortages of health care workers predates the coronavirus pandemic: doctors have emigrated in large numbers since the country joined the European Union in 2004.
Figures from the OECD show that around 1,400 new doctors were licensed in Hungary in 2017, but nearly 1,000 left the country the following year. Many others have left the public system to practice at private clinics due to low public salaries.
Despite recent pay raises to doctors and nurses, Hungary remains near the bottom in the EU on investments in its health care system relative to GDP. Additionally, patients often pay tips or bribes to doctors in exchange for better treatment despite efforts to end the practice.