Europe looks set to face more flu-related deaths than necessary as the H1N1 virus looms large.
Experiences in Australia and Mexico have already shown that intensive care units (ICUs) will be stretched to maximum and beyond as a result of so-called swine flu.
Vital beds are being earmarked for pregnant women, children and young people – such is the nature of the virus - and facilities for the elderly or accident victims will be at a premium.
Now politicians in Europe are being urged to respond quickly – and with hard cash.
The Brussels-based group European Patients’ Forum – which represents associations across the European Union – will tell the European Commission this week that only urgent action to ensure funding nationally and regionally can effectively battle this and future pandemics.
Under added pressure from ESICM – the European Society of Intensive Care Medicine -,the Commission will be told it needs to do more than hold meetings on vaccination policy, such as the extraordinary health council meeting held recently in Luxembourg.
A shortage of intensive care beds affects every member state and ICUs across the continent are already running at 95% to 99% capacity. If the pandemic strikes hard – and global evidence revealed simultaneously this week in Vienna and the USA suggests that it will - a quarter of the beds would be prioritised for young people, leaving the elderly and accident victims at the bottom of the list.
Steve Webb, co-author of a report on the impact of the virus during winter in the southern hemisphere, told ICU experts in the Austrian capital:
“The experience in Australia and New Zealand has been incredible, with professionals who have worked in ICUs for 30 years saying they’ve never seen anything like it.
“Although it was a relatively small proportion of patients who became critically ill, this still occurred in sufficient numbers to have a major adverse affect in terms of stressing the intensive care system.”
Pittsburgh-based Derek Angus, editor of medical journal JAMA, which has just published Webb’s report, alongside Robert Fowler’s similar one on Mexico, added:
 “While it’s a small percentage of patients who get very sick, when they deteriorate they deteriorate very quickly and are cared for with sophisticated rescue therapy.
“Unfortunately, in many European countries, you may have a situation where a person is critically ill in a small hospital that may not be conversant with the more sophisticated technology.”
ESICM president-elect Andrew Rhodes was emphatic, saying: ‘We need ‘cash for saving lives’ - funding for research, training, adequate staffing and equipment. Politicians need to realise that to get funding across borders, the European Commission has a pivotal role to play.
“Every EU country is already short of intensive care beds,” he added. “Every year we have seasonal flu affecting around a million people. This year, with H1N1, it is likely to be two-to-three million who will be mostly young and a percentage of those will need to be in intensive care.”
“Politicians have to be persuaded to take this seriously. We have a fantastic argument for change but extracting money from politicians is always a problem.”
This situation was further clarified by Paris-based Jean-Daniel Chiche, congress chair of ESICM, who revealed that less than 5% of ICUs in Europe are equipped with the necessary computer technology for them to work at the optimum level.

“Imagine,” he said, “that hospital units are different cars in a parking lot. Intensive care is the Formula One car. It is super quick, hi-tech, extremely dangerous and very expensive. Most people, including politicians, don’t really understand what intensive care it is – although they all recognise a casualty ward. So it is no wonder that we are under-resourced.
“We’re already talking about very high cost, but we need even more resources. If these were in place, it would impact very, very significantly on morbidity rates.”
But at least one politician is paying attention. Speaking from Berlin, ironically while suffering a mild dose of flu, German MEP and European Parliament health committee doyenne Dagmar Roth-Behrendt responded to the Chiche’s comments:

“That figure of 5% is astonishing,” she said. “Politicians should be forced to know these numbers. Aside from that, the huge amount of hospital infections is outrageous. We clearly need networks, information and the sharing of best practice [to improve patient safety].’

Declaration signed
 
While in Vienna, worldwide societies from the sphere of intensive care medicine joined with safety groups, the WHO and industry representatives to sign “The Declaration of Vienna” – a pledge to work together to improve patient safety.

ESICM president Rui Moreno said: “We need local solutions to a global problem and, given what we have heard at this congress, there has clearly never been a better time for this declaration.”