The National Healthcare Service Center (OKF) has responded to a statement made by the Hungarian Medical Chamber (MOK) saying that not 95, but 80 percent of people who end up on ventilators succumb to their condition. There is no clear answer to the direct cause of these deaths, and there are multiple different speculations from healthcare professionals.
Last October the survival rate for people on ventilator treatment was 50 percent at Szent László Hospital, which Chief Medical Officer Cecília Müller said considered to be an internationally good standing.
One month later senior infectologist János Szlávik said 40-45 percent of people on ventilators pass away, while other estimates said the average was around 60 percent.
In November of 2020, there were 638 people on ventilators. By the end of March 2021, this number had grown to around 1,500.
Two weeks ago, MOK said that in certain hospitals 95 percent of people who end up on ventilators do not recover.
According to Péter Takács, deputy director general of OKF, 80 percent of people on intubation pass away, and four times more people die in a Covid-ward than a normal intensive unit.
Takács said that in the last few days the burden on intensive units has lifted slightly.
According to the OKF deputy director general, Hungary’s healthcare has the capacity to treat 3,000 people on ventilators, which seems a bit unrealistic when considering that the chances of survival for 1,200 people are already so low.
Takács believes the high death rate is not caused by a lack of knowledge among Hungarian specialists, but rather by the nature of the virus. He said these patients receive the same level of treatment as “further west, or in the United States.”
Ágnes Daróczy-Gaál, vice president of the Hungarian Doctors’ Union, told ATV that since the healthcare system is so short staffed, the more people there are on beds the lower each individual’s chances of survival are.
If there are 50 beds in an intensive unit, but there is only enough personnel for 15 people, every extra patient who is taken on to the remaining 35 beds deteriorates the original 15 patients’ chances of survival. […] We can fill up all 50 beds with patients, but that will result in 50 people lying on 50 beds, each with a 2-3 percent chance of survival.”
She stated that every medical institution in Hungary is triaging, operating in a way that focuses aid on those patients who have the highest likelihood of survival, since trying to focus on everyone at once would result in even lower chances of recovery.
An ophthalmologist working at a Covid-ward told RTL News otherwise, saying that nurses and doctors are extremely overburdened, treating significantly more patients in intensive units than they normally would.
Adding to the problem is Hungary’s workforce shortage in healthcare. The doctor, who chose to remain anonymous, said that in many hospitals, nurses are assigned to intensive units from non-related departments and are set to treat patients after two weeks of training. This, according to the doctor, is not enough time to learn how to work in an intensive unit.
The general health of Hungarians is also a factor, since the anonymous source mentions that every fifth Hungarian is overweight, leading them to have more severe Covid symptoms.
According to the doctor, the nature of the coronavirus does have an impact, since in many cases much of what intensive care workers know does not work for Covid patients, and typical ventilator strategies are often ineffective. They added that if someone reaches the point where they require intubation, they will not survive.
There is no clear reason for the large number of ventilator deaths, even as it is an international issue. A report from the United Kingdom said 66 percent of people on ventilators have died, while in New York this number stands around 80 percent or more.
Some health professionals speculate that the ventilators themselves may be the cause of death, as it could be detrimental to force high-pressure oxygen into lungs that are already damaged.
Eddy Fan of the Toronto General Hospital says that “one of the most important findings in the last few decades is that medical ventilation can worsen lung injury – so we have to be careful how we use it.”
Romanian pulmonologist Flavia Groșan believes this to be the case. According to Groșan, the international protocol for ventilation’s 20-liter recommended oxygen dose is too high, since it can cause patients to suffer from fatal edemas.
For patients requiring ventilator treatment, Groșan suggests 2-3 liters of oxygen, saturated above 80%, per minute, 4-5 hours a day.
The Hungarian Medical Chamber believes it would be wise to check whether ventilator treatment is being done correctly, since there are “many irrational or qualitatively unacceptable solutions.”
The Chamber suggests measuring whether invasive ventilation (the delivery of oxygen using endotracheal intubation on an anesthetized patient) or non-invasive ventilation (the delivery of oxygen using a face mask on a conscious patient without endotracheal intubation) is safer and more effective.
Featured photo illustration by Zoltán Balogh/MTI
