In the framework of hospital evacuations in preparation for the mass infections during the coronavirus crisis, hospitals are now – often unexpectedly – dismissing patients who are suffering from chronic diseases or in helpless states. Nurses and social workers are the ones calling relatives to tell them that patients will be dismissed within days. According to the relatives of these patients suddenly being dismissed, there is no guidance and answers to questions in most cases, only “…the ruthless execution of the supreme instruction taking place.”
Hospital directors received a letter from the Ministry of Human Resources (EMMI) last week, which contained instructions on evacuating hospitals and freeing up bed capacity as soon as possible. In the letter, Minister Miklós Kásler instructs all hospital directors to release at least 60% of the publicly funded bed capacity of their hospitals by April 15th. The letter also states that care should be taken to transfer all patients to another institution where the patient’s need for care justifies this measure.
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The government has set the goal of releasing a total of 36,000 hospital beds by the April 15th deadline: all of which should be provided to care for coronavirus patients. According to international statistics, 20-25 percent of confirmed coronavirus patients need hospital treatment, and the 36,000 hospital beds can provide space to at least 150-180,000 patients with confirmed infections, Válaszonline writes. By Wednesday, about 1,500 confirmed virus carriers had been registered in Hungary; this means that they expect the number to rise significantly in the coming days.
Due to the decision, several hospitals have found themselves in a difficult situation- they could not free up enough space in time and they had to dismiss patients who have been staying in hospitals with chronic, but not life-threatening diseases. Miklós Kásler, the Minister of Human Resources, even fired two hospital directors during the Easter weekend because according to EMMI, they could not promise that they would be able to free up the necessary amount of beds or were slow to send data.
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According to Chief Medical Officer Cecília Müller, the country must prepare for a massive increase in case numbers and this is why hospital capacities are being expanded. She said Covid-19 patients who require hospitalization should have “beds, personnel, and ventilators” to avoid “patients lying in hospital corridors as in some EU countries.” The Chief Medical Officer also called for the cooperation of healthcare institutions, professionals, and citizens in the release of the needed number of beds.
Müller also emphasized that “another collaboration is needed” to help family members understand and help with the evacuation process and in taking care of their sick relatives at home, who are not in need of hospital care during these difficult days. She insisted that “not all patients are sent home from hospital,” adding that patients are released based on a decision by their doctors as well as on the basis of health protocols. “Nobody can be sent home with the prospect of damage to their health.” However, at present, only those patients are being admitted to hospital “whose symptoms are so serious that they cannot stay at home.” Otherwise, life-saving operations and urgent procedures will not be canceled.
During this process, most relatives have been suddenly hit by the fact that institutions are practically sending patients home from one day to the next, even though many have already paid for the care or the space. A reader told index.hu news portal that her father had to be taken home two and a half weeks after his leg amputation. The woman said “he was sent home with a barely healing, oozing wound, and sutures. They said it was because of the coronavirus, so they concluded that they needed the space.” The man was about to receive several weeks of rehabilitation treatment and planned to go home with a temporary artificial leg. He is now sitting in a wheelchair, has no chance of rehabilitation or doing the physiotherapy exercises he had been doing with the specialist after the surgery.
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Many other patients also had to go home from one day to the next. The hospitals usually say it is “a higher order and they must send the patients home no matter whether someone is taking them home or not.” Some people even pay as much as 80,000 forints per month for the hospital bed and care, but they were still sent home.
Another man said he had been called from one of the hospitals in northern Hungary on Tuesday at noon that they would have to empty the beds by Wednesday night, so he has to take home his 85-year-old father. The elderly man recently had a stroke and was paralyzed on one side, still lying helpless with an iv. His son lives 200 kilometers from him in Budapest and is currently trying to find a solution for the situation.
Caring for severely chronically ill or bedridden patients at home is usually difficult enough for a family under normal circumstances. It is a job that requires a full-time person and that is why many people hire a nurse to care for the ill relative. However, this is difficult to resolve due to the coronavirus crisis and the very sudden change, and they often do not have the resources to pay 8000 forints per hour for an expert. Caring for patients returning home due to the release of hospital beds will be a difficult task for any family, as family members are forced to stay at home to help curb the spread of the virus and because of curfew restrictions, while children are also learning at home through digital education and also need parental help. Thus, caring for elderly, sick relatives who return home may be a heavy social and financial burden during the coronavirus crisis.
featured photo: Csaba Bús/MTI