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World Covid-19 surge in Belgium leads to shortage of doctors, teachers and police

13:26  24 october  2020
13:26  24 october  2020 Source:   washingtonpost.com

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Belgium ’s Covid - 19 situation ‘more serious’ than in France, Netherlands, health minister warns. In a separate open letter to the Belgian government and expert groups, hundreds of doctors , health Almost half a year after the first coronavirus death in Belgium , however, they consider the situation to

Medical materials and other goods shortages caused by the COVID - 19 pandemic quickly became a major issue of the pandemic. The matter of pandemic-related shortage has been studied in the past

BRUSSELS —Well into Europe's second wave of the coronavirus, so many Belgians are sick or quarantining that there aren't enough police on the streets, teachers in classrooms or medical staff in hospitals.

a man standing in front of a building: Medical workers transfer a covid-19 patient at the CHR Citadelle hospital in Liège, Belgium, on Oct. 21. © Francisco Seco/AP Medical workers transfer a covid-19 patient at the CHR Citadelle hospital in Liège, Belgium, on Oct. 21.

In some hospitals, doctors and nurses who have tested positive but don’t have symptoms are being asked to keep working, because so many others are out sick with covid-19, the disease caused by the novel coronavirus. School principals are marshaling secretaries and parent volunteers to replace falling ranks of teachers.

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“The situation is more serious” than in April, Christie Morreale, health minister of the French-speaking region of Belgium, told the RTL broadcaster on Friday, after announcing a “partial lockdown” alongside other regional leaders. “If you are a nurse and you have a few hours to dedicate in a nursing home or a hospital, if you’re a nursing student, a medical student, an educator, they have need of support.”

Unlike in the spring, there are enough masks and gowns to go around. But months of preparation haven’t been able to avert a shortage of people. And a government decision to remove a mask mandate and loosen restrictions on social contacts this month has contributed to an acceleration of the virus.

Belgium’s infection rate is second only to the Czech Republic in the European Union and five times higher than in the United States.

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treating COVID - 19 patients that they may run out of the equipment that protects them from contracting the novel coronavirus that causes COVID - 19 patients are growing increasingly anxious that a surge in COVID - 19 cases in the coming days and weeks will lead to a shortage of protective equipment.

As an NHS doctor , I’ve seen people die and be listed as a victim of coronavirus without ever being tested for it. But unless we have accurate data, we won’t know which has killed more What were we now supposed to do? If an elderly person died in a care home, or at home, did they die of Covid - 19 ?

The country's testing infrastructure is overloaded. As of this past week, Belgium is no longer testing people without symptoms, even if they may have been exposed.

This is what it means to be close to a coronavirus “tsunami” — a word used in northern Italy in the spring and deployed this past week by Belgian Health Minister Frank Vandenbroucke, who said that the virus could soon escape authorities’ control.

Vandenbroucke’s statement came before Foreign Minister Sophie Wilmès — who stepped down as prime minister earlier this month — was admitted into an intensive care unit with covid-19 on Wednesday. Wilmès is 45 and otherwise healthy.

“The situation is catastrophic,” said Philippe Devos, an intensive care doctor at the CHC Montlégia Hospital in Liège, the worst-hit Belgian city. “Liège is now is probably the most affected region in the world. We have a lot of doctors and nurses affected. But, starting this week, positive cases were asked to go back to work if they are asymptomatic.”

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a person standing in a room: Medical workers don protective equipment in the covid-19 ward at CHR Citadelle hospital in Liège, Belgium. © Francisco Seco/AP Medical workers don protective equipment in the covid-19 ward at CHR Citadelle hospital in Liège, Belgium.

He said at some hospitals in the city, between one-fifth and one-quarter of the medical staff is sick or quarantining.

“We are in deep,” said Devos, who is also president of the Belgian Association of Medical Unions.

Daily caseloads, already posting records, are expected to double by next week, according to Yves Van Laethem, an infectious-disease specialist and spokesman for the country’s official covid-19 response. That means 1 percent of Belgium’s 11 million residents could soon be contagious with an active infection.

For a time, hospital admission rates remained relatively low in Europe’s second wave, providing a measure of comfort. But admissions have shot up rapidly, as infections have passed from younger, healthier people to older people predisposed to severe cases and complications of covid-19.

In Belgium, hospital occupancy is up 87 percent in the past week. If it keeps increasing at that rate, next week it will surpass April peaks, when the country led the world in deaths in proportion to its population. Some Belgian hospitals warn they are already as saturated as during the first wave.

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The situation may be especially problematic in intensive care units. Belgium has comfortable ICU capacity for its population, and only a quarter of the country’s intensive care beds are currently occupied by covid-19 patients. But a full team of skilled personnel is needed to keep patients monitored in ICUs. Some hospitals are already warning they may not be able to keep all their ICU beds in operation if their personnel are too sick.

Staff shortages could reduce ICU capacity by more than a quarter, according to projections from Belgian public health researchers, meaning hospitals could reach maximum capacity within weeks.

“March 2020 revisited,” tweeted Marc Noppen, chief executive of the University Hospital of Brussels, one of the biggest hospitals in the Belgian capital, which announced this week that it was expanding its ICU capacity. “ANGRY that we were unable to avoid this predicted scenario.”

Even doctors who are healthy — for now — say they are close to burnout.

“Everyone is just tired. And not only physically exhausted. We are sick and tired of the situation,” said Nicolas Frusch, a pulmonologist at the Libramont Hospital in eastern Belgium.

Belgian nursing homes are also under stress. Seared by the experience of the spring peak, when nursing home residents accounted for two out of every three coronavirus deaths, policymakers pledged to do everything they could to protect nursing homes this time around.

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But infections are shooting upward, and deaths are likely to follow. In Belgium’s French-speaking south, the epicenter of the current wave, cases in nursing homes nearly tripled in the last week, to 22 infections per 1,000 residents.

Belgian Defense Minister Ludivine Dedonder said Thursday the country’s military was prepared to deploy 1,500 troops to hospitals and nursing homes to help out, a measure of the strain.

a group of people standing in a room: Members of M2 Ambulance company prepare to transport a covid-19 patient in Ottignies, Belgium, on Oct. 23. © Johanna Geron/Reuters Members of M2 Ambulance company prepare to transport a covid-19 patient in Ottignies, Belgium, on Oct. 23.

The second wave is testing Belgian schools, as well.

Schools here have continued mostly in-person, the result of a nationwide push to prioritize education over other sectors of society. But the resolve is starting to fray: High schools were given more flexibility this past week to shift partly to virtual instruction, and a fall school holiday was extended by two days to try to nudge infections lower.

“As the pandemic grows, it becomes more and more challenging for us,” said Etienne Michel, the director of the federation of Belgium’s French-speaking Catholic schools, which educate about half of the children in the French-speaking part of the country. The federation recently surveyed its primary schools and found 23 percent of teachers are sick or quarantining, Michel said. Even that could be an undercount, since overstretched schools may not have had the resources to answer the questionnaire.

“It is a mess,” said Isabelle Allelyn, principal of the Communal School of Grand-Rechain, a small village in Belgium’s worst-hit eastern region.

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Half her teachers are sick or quarantining, she said. Of her 225 students, 37 are quarantining and 45 can’t come in because there’s no teacher for them. In one classroom, first the teacher got sick — and then her substitute did, too.

“We are doing our best to cope with the pandemic,” Allelyn said, speaking from home, because she, too, has tested positive for the virus. “But now the situation is pretty unstable and is almost getting out of control.”

In Belgium’s full French-speaking school system, cases among students and staff more than doubled between the second and third weeks of October, according to figures released Thursday by the Office of Birth and Childhood, French-speaking Belgium’s official child welfare agency. (The separate school system in Belgium’s Dutch-speaking north does not maintain similar numbers.)

“Today it is daily fix-it work for the schools and administrations, which need to redo schedules and find replacements,” said Caroline Désir, education minister for the French-speaking region of Belgium, in an interview with the RTBF broadcaster on Thursday.

For now, Belgian leaders have avoided imposing a full lockdown, although increasingly frustrated public health experts say a new one is inevitable. But even more limited measures, such as a month-long closure of restaurants and bars and a regional curfew announced Friday depend in part on police being able to enforce the rules.

a man standing on a sidewalk: A police officer enforces a nighttime curfew in Brussels. In Wallonia, the region hit hardest, the curfew is even stricter, but because police officers are getting sick, it is a challenge to enforce. © Francois Lenoir/Reuters A police officer enforces a nighttime curfew in Brussels. In Wallonia, the region hit hardest, the curfew is even stricter, but because police officers are getting sick, it is a challenge to enforce.

In at least parts of Belgium, that power is increasingly in question — because the police themselves are getting sick.

This month alone, 2,368 police officers across Belgium have tested positive or had to quarantine, according to an internal police document dated Tuesday.

In the province surrounding the city of Liège, “around 50 percent of police officers are not at work,” said Vincent Gilles, the head of the SLFP police union.

For now, many departments are filling the gaps by assigning double shifts.

A handful of police stations are closed entirely, including one in the southern town of Libramont, where at least 10 officers tested positive this month and the other 25 needed to quarantine because they had been in contact with the sick ones.

At a station in northern Belgium, three officers recently tested positive at one time, according to a police official who spoke on the condition of anonymity to discuss sensitive internal affairs. They had no symptoms, so their superiors simply put them together on a single patrol unit — they could keep working without fear of infecting each other.

“People do not realize the situation we are in,” said Thierry Belin, national secretary of the SNPS police union.

Birnbaum reported from Riga, Latvia.

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England could enter a second national lockdown in the coming days, as surging coronavirus infections across Europe trigger strict new rules and violent protests. © Kenzo Tribouillard/AFP/Getty Images A medical worker wearing a protective equipment tends to a patient at the intensive care unit for patients infected with Covid-19 at The University Hospital Centre in Liege, Belgium on October 22.

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