Abstract
BackgroundThe exponential increase in SARS-CoV-2 infections during the first wave of the pandemic created an extraordinary overload and demand on hospitals, especially intensive care units (ICUs), across Europe. European countries have implemented different measures to address the surge ICU capacity, but little is known about the extent. The aim of this paper is to compare the rates of hospitalised COVID-19 patients in acute and ICU care and the levels of national surge capacity for intensive care beds across 16 European countries and Lombardy region during the first wave of the pandemic (28 February to 31 July). MethodsFor this country level analysis, we used data on SARS-CoV-2 cases, current and/or cumulative hospitalised COVID-19 patients and current and/or cumulative COVID-19 patients in ICU care. To analyse whether capacities were exceeded, we also retrieved information on the numbers of hospital beds, and on (surge) capacity of ICU beds during the first wave of the COVID-19 pandemic from the COVID-19 Health System Response Monitor (HSRM). Treatment days and mean length of hospital stay were calculated to assess hospital utilisation. ResultsHospital and ICU capacity varied widely across countries. Our results show that utilisation of acute care bed capacity by patients with COVID-19 did not exceed 38.3% in any studied country. However, the Netherlands, Sweden, and Lombardy would not have been able to treat all patients with COVID-19 requiring intensive care during the first wave without an ICU surge capacity. Indicators of hospital utilisation were not consistently related to the number of SARS-CoV-2 infections. The mean number of hospital days associated with one SARS-CoV-2 case ranged from 1.3 (Norway) to 11.8 (France). ConclusionIn many countries, the increase in ICU capacity was important to accommodate the high demand for intensive care during the first COVID-19 wave.
Highlights
The exponential increase of SARS-CoV-2 infections during the first wave of the pandemic created an extraordinary overload and demand on hospitals, especially on intensive care units (ICUs), across Europe
In many countries, the increase of ICU capacity was important to accommodate the high demand for intensive care during the first COVID-19 wave
Our study indicates that SARS-CoV-2 incidence is not the only aspect when it comes to the burden of hospital care for COVID-19 but rather the utilisation of hospital resources as shown by cumulative hospital days and mean length of stay during the first wave
Summary
The exponential increase of SARS-CoV-2 infections during the first wave of the pandemic created an extraordinary overload and demand on hospitals, especially on intensive care units (ICUs), across Europe. A country level analysis was conducted to compare hospitalisation rates of COVID19 patients in acute and intensive care and the levels of surge capacity for intensive care beds across 16 European countries and Lombardy region during the first wave of the pandemic (28 February to 31 July). The exponential increase of SARS-CoV-2 infections in March and April, 2020, created an unprecedented demand on hospitals in many European countries. In late March, many Spanish hospitals, especially in the capital city of Madrid, reported reaching their capacity limits of acute and/or intensive care beds to adequately treat all COVID-19 patients requiring inpatient care [2]. During the second wave starting in autumn 2020, many countries face again rising hospital admission rates and substantial pressure on hospital wards
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