Surfing a second wave: sense and nonsense

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‘It’s been Corona lately,’ my neighbor spoke to me recently, ‘and that shit is making us less and less allowed. But doesn’t it make sense that when they test more, more cases are discovered? What a shit… ‘It is not the first time that we have heard similar sounds. Doesn’t it make sense that more cases are discovered when the testing capacity is increased? Is there also an increase in hospital admissions? Is there a second wave? We learned our light at various hospitals.

Antwerp

We start at the epicenter of the second wave: Antwerp. Tom Van de Vreken, spokesperson at Hospital Network Antwerp (ZNA): ‘The health inspectorate has asked not to disclose detailed figures on the number of admissions. This also applies to all Antwerp hospitals. I can tell you that the number of admissions has been increasing since mid-July. But that fluctuates daily and in terms of admissions it is not yet comparable to April. ‘

Another hospital in the province of Antwerp is Imelda in Bonheiden. There we get Kathleen Vermeulen on the line. ‘Indeed, we have been banned from communicating numbers related to covid 19 hospital admissions. This applies to the entire province. I can inform you, however, that there is no increase in admissions with us, neither in the regular ward nor in Intensive Care. Let’s hope it stays that way. ‘

Brussels

From Antwerp we go to Brussels. In the traditional and social media we could follow how the situation in Antwerp was laughed at first and how certain French-speaking politicians used this to conclude that Wallonia had to pay the bill for the Antwerp (and Flemish) incapacity. This was quickly nuanced by the chief physician of the Saint John Clinic in Brussels. He saw that an Antwerp situation in Brussels was closer than politicians could hope for.

However, Florence Feys, spokeswoman for Clinic Sint-Jan, tells us that the admissions figures for covid-19 have been stable since the peak of the first wave and no increase is noticeable. At UZ Brussel (VUB), Pascal Herreweghe confirms this trend to us: there, too, no increase since the end of the first wave. He refers us to a page on their website where the figures are published daily. We find an interesting graph and clear figures. The UMC Sint-Pieter, located in the heart of the Marolles, refuses to provide data and refers us to Sciensano.

The evolution of covid-19 admissions at UZ Brussel (status: August 10, 2020).

Rest of Flanders

In the rest of Flanders (contacted hospitals: Mariaziekenhuis Noord Limburg, OLV Aalst and UZ Gent) nothing appears to be going on either. No upward trend in the recordings here either. Nor is there an upward trend in the intensive care units. The only exception is AZ Delta (Roeselaere-Rumbeke-Menen-Torhout). Barbara De Jonckheere speaks to us. ‘The tendency for us is that the figures have been falling back in the last two weeks. We have had rising numbers a little earlier. Now we are back in a downward trend. We still have eight patients and none of them are in Intensive Care. ‘

At the peak of the second wave, we had 30 patients on the covid ward and seven on intensive. My impression is that there are far fewer withdrawals in the second wave than in the first. There is also a difference with regard to fatalities. Now there are none with us. In the first wave it was about seventy deaths. Apparently there is a second wave for the number of infections, but we don’t see that in the hospital admissions. ‘

Second wave of infections

So that’s where the monkey comes up. It is in itself about a ‘second wave’ of infections. On this basis, the government has imposed stricter measures. The experts have used these figures to sound the alarm. The current freedom-restricting measures and sometimes very daring mouth mask obligations are the result of this. In certain municipalities, the population is only allowed to take to the streets in masks.

However, it should be clear that the rising rates for infections are directly correlated with the increasing number of tests. When we look at the hospital admissions figures, there is nothing wrong in most of the country. Except where we are not allowed to receive figures about, being Antwerp and – maybe? – the Sint-Pieter hospital in Brussels. The graphs on the Sciensano site meanwhile show that hospital admissions are generally okay. There we see the same curve as on the website of UZ Brussel: flat and stable. Then what’s going on?

About infections, hospitalization and death rates

We address this question to Hendrik Cammu, professor and gynecologist associated with the VUB and UZ Brussel. He has previously published about covid-19. ‘There are many more positive tests and that is of course due to the increased test capacity compared to the period March-April. What is of course objective is the increase in the number of shots. Last week we were on 42 shots a day, before it was 20. It’s probably a mix of two things. On the one hand, you have a higher number of positive tests that make everyone panic. This is probably due to the increased testing capacity. On the other hand, there are, of course, people who are objectively ill and who meet certain criteria that cause them to be hospitalized. Hospitalizations have increased. You cannot ignore that. What, however, does not change is the number of deaths. I would like to hear from the specialists about this: has the virus become less virulent? ‘

We contacted a number of hospitals to inquire about hospitalization rates and – with the exception of ZNA and AZ Delta – there is a flat line everywhere since the first wave. So there is no general increase in hospital admissions there.

Cammu: ‘I knew that was the case with us in Jette, but I didn’t know about the other hospitals. Then you have to ask yourself the question about the value of Sciensano, because I have my data from them. There they are talking about an increase in hospital admissions. Well, there are 150 hospitals in Belgium. 42 admissions a day, that’s only one admission per three hospitals … But it’s more than immediately after the calving of the first wave at the end of May. I think things are being dramatized a bit to keep people aware, in order not to return to an ‘olé-olé, anything is possible’ situation and then end up in the next peak. ‘

Better treatment

Professor Cammu confirms that the death rates are not increasing. He would like to know if the virulence of the virus has declined in recent months. You don’t hear about that. No one can answer that. ‘

‘Another factor – and I know this from numerous reports – is that in the beginning they really gave everything in terms of medication because nothing was known about the virus. In the meantime, there is more or less a protocol about what is and what is less useful. One of the items now routinely administered is anti-coagulant drugs, as the virus has been found to cause masses of small thromboses in the fine branches of the lungs. This appears to be efficient in combination with cortisone to counteract the cytokine storm – a devastating immune response. Much more is now known about how to treat the disease. That is certainly the case. ‘

Cammu continues to insist on information from the virologists; ‘I would really like to have the top virologists answer the question whether the beast has become less virulent now. Because that is typical for a virus: in the long term it will decrease in strength. ‘

What is to come …

Another point, besides the death rates, is the impact of the virus on survivors. More and more stories are emerging of people who recover only slowly after the illness. There are even fears of permanent injuries.

Cammu: ‘I wrote this about covid-19 weeks ago: I am waiting for the moment when it will be absorbed by the chronic fatigue syndrome (CFS). The physiopathology is the same. It is about an overreaction of the own immune system. That continues to simmer for weeks, even months. Those people then risk being fools and carrotier to be blamed. ‘

‘It is still too early to say anything about that now, but by winter you will see publications appearing that will talk about the long-term effects. Because they will certainly be there. Sure!’

Dr. Hendrik Cammu asks himself whether the virus is decreasing or not, but does not receive an answer from the ‘top virologists’.

Mondmaskers

Cammu closes on a positive note. ‘I think it is very positive that people in general are still complying with the measures. In my environment I see that the mouth masks are worn and that everyone is more or less in step. As long as we do not have this completely under control, this is extremely important. You might be better off getting sick now than at the start of the pandemic, but it is still a bad idea ‘.

‘On the one hand, I think it is good that the population can be sensitized in a way that a huge proportion of them take it seriously. On the other hand, our policymakers, the people who represent us in governments and parliaments, have messed up from the beginning until now. It is surprising that there is so much citizenship right now and people are not falling into incivism. Because when you see what the policymakers have made of it in recent months, that is – Aalsters – to show your nakedness. And Flanders really did not do better than Belgium in this respect! It would have been better if there had been a single mouthpiece, as in other countries. But despite this enormous fumbling from the various authorities, you have to say that the Belgians, the Flemish, are fairly dutiful. ‘

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