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COVID-19: ICU bed shortages will create an ethical dilemma

A doctor in Switzerland, which as of Thursday had 160 ICU beds left, explains what the country is grappling with on the pandemic’s front lines. 

Tom Sullivan | March 20, 2020

Current projections of ICU beds at United States hospitals are bleak. The country, in fact, could be at capacity by April’s end — and that is based on the data we have today, which is changing continuously. 
 
So what’s happening in other countries that are ahead of the U.S. in the COVID-19 spread? 
 
[Health Evolution to host webcast, Pandemic Response: A Public-Private Call to Action, on April 2, 2020.]
 
Health Evolution spoke with a doctor in Switzerland, who requested that we withhold any name or professional affiliation for the purposes of speaking freely, about the situation in that country. 
 
Q: First of all, what’s going on in Switzerland with the government shutting down so much of public life? 
A: We are locked down. The southern border with Italy is closed but our death rate is not as bad as Italy. We are running out of ICU beds as we speak. We are stuck, moved into emergency mode, elective care does not happen anymore, only emergency cases are being taken care of, every single ICU bed will be made available. Only 160 ICU beds remaining.
 
Q: What happens when the country runs out of ICU beds? What are the options? 
A: As unethical as this might sound, we have to start selecting. 
 
Q: How do you select who gets care and who does not? 
A: We could have an ethical debate on that for ages and we will not find the right answers. Within our medical community the criteria we have to apply is quick adherence to what WHO tells us to do. That means the likelihood of survival will determine who gets what. That’s where Italy has been, Spain is getting there soon, France will. We are there. 
 
Q: Are most people in Switzerland cooperating with the lockdown? 
A: No. At this point we’re disappointed.
 
Q: As someone who is ahead of the U.S. and most other countries in that regard, what would you recommend to other countries?
A: Lock down. Stop spread. Flatten the curve. Be as brutal as you can in making sure folks don’t get infected. Don’t care about human rights or personal liberty to move aroundthose do not matter during this pandemic.  
 
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Read all of our COVID-19 coverage 
 

About the Author

Tom Sullivan, EVP & Editor-in-Chief of Digital Content

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website.