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Hungary's public hospitals received a letter last week from Minister of Human Resources Miklós Kásler giving them eight days to evacuate at least 60% of their publicly funded hospital beds. The minister's order required that some 36,000 of Hungary's 60,000 hospital beds be vacated by April 15 to make room for new coronavirus patients, requiring current patients, some with chronic illnesses or injuries, to be transferred to other institutions or sent home.
The order threw hospitals into a frenzy to relocate their patients, many of whom required 24-hour care. Reports emerged of family members being told their loved ones would soon be evicted from hospital: one 73-year-old woman was told she must bring her 93-year-old mother, who requires constant care, home from the chronic illnesses ward of a Budapest hospital within 72 hours. Another patient, a recent amputee with an oozing, sutured wound, was also sent home.
Some hospitals struggled to fulfill the ministry's order by the deadline. On Easter Sunday, director of the National Medical Rehabilitation Institute (OORI) Péter Cserháti learned from a strongly-worded statement by the Ministry of Human Resources (EMMI) that he had been dismissed from his position for failing to free up enough beds. EMMI claimed that Cserháti "did not provide for the relocation of rehabilitation patients" which "seriously jeopardizes successful epidemic control and patient care".
The next day, doctors and medical staff of the OORI held a protest demanding Cserháti's reinstatement. They disputed EMMI's claim that not enough beds had been vacated, and argued that many of the top-tier hospital's patients were receiving special treatment that, if interrupted, could result in the death of the patient. One hospital employee told 444 that Cserháti's dismissal may have been the result of his administering coronavirus tests to patients brought from other hospitals on his own authority, some of whom tested positive.
Some suspected similar motives for the dismissal of a hospital director in Székesfehérvár, who was reportedly fired for an administrative error. The director, István Csernavölgyi, said that the hospital was late in reporting digital data to EMMI, but that it had reported the data by phone and immediately sent the data after being alerted of the delay by the ministry. Csernavölgyi said that despite the extraordinary pressures facing the hospital, it had successfully reported its data on time in every other case, and added that "I will take the necessary legal steps to defend the truth".
At a government press conference on Thursday, PMO chief of staff Gergely Gulyás said that while he holds Cserháti in high esteem both personally and professionally, EMMI determined that he had committed an error for which he had to be replaced.
"The government's goal is to ensure effective defense against the virus," Gulyás said. "Everyone must follow and execute the measures put forth by the Emergency Task Force. Someone must bear the responsibility."
As hospitals struggled to vacate thousands of beds within a few days, patients with chronic diseases were transferred or sent home regardless of their condition. "They're literally kicking him out," one Index reader said of her father, who was being treated in the Szent Margit Hospital in Budapest. "A lady called in the afternoon to tell me to pick up my father by 11 am the next day. I told them it would be difficult to solve in such a short time, but she didn't care. Her answer was, 'this is an order from above, and we're definitely sending him away whether you come for him or not.'"
One head doctor at a hospital told 444 that interruptions in care caused by the sweeping order could ultimately cause more deaths than Covid-19 itself, and that while there is a need to free beds for potential coronavirus patients, doing so without regard for the types of hospitals, wards and patients was dangerously disruptive.
Speaking to Index, health economist Csaba Dózsa said that current trends in coronavirus infection in Hungary "do not justify the need for so many hospital beds".Global statistics show that around 20-25% of those infected with Covid-19 require hospitalization. Based on that data, the government's requirement to vacate 36,000 beds for infected patients would be proportional to 150,000-180,000 cases of coronavirus in Hungary, about 100 times more than are currently confirmed.Of all of Hungary's 60,000 beds, only 1,000-1,500 can perform specialized treatment using ventilators on infected patients, according to health economist Balázs Rékassy. He told Index that not all hospitals are equipped to accept coronavirus patients, and that from an epidemiological point of view, it would be better to separate those hospitals which are.
Karácsony: government has not kept its promise to administer more tests
In an open letter to Prime Minister Viktor Orbán, 42 opposition mayors, including Budapest Mayor Gergely Karácsony, called on the government to begin administering coronavirus tests to all retirement home residents and staff across Hungary. The mayors worried that cases of the disease were being confirmed with increasing frequency in retirement homes, where residents are particularly vulnerable to its effects.
According to Karácsony, the government has not responded to the letter, nor to requests for more testing he made during a Parliamentary assembly he attended last week. At the assembly, Orbán promised government help in testing at Budapest retirement homes, but that "the promise has not been kept, and a slander campaign has been launched," Karácsony said.
A bitter conflict emerged between the government and City Hall after dozens of residents at the Pesti út retirement home in Budapest tested positive for Covid-19. Government communication insisted that city leadership was responsible for the explosion of cases, while Karácsony argued that it is the legal responsibility of the central government to provide protective equipment and administer tests. The mayor also repeatedly asked the government not to allow retirement home residents to return to the homes following hospital visits before receiving a negative Covid-19 test, a request the government ignored.
So far, 204 residents at the home have been infected with the virus, while ten have died.
Karácsony accused the government of ignoring the need to increase testing, and said that communication between the government and City Hall had come to a near standstill.
"There is no systemic cooperation, and this is a very big problem because it does not improve the effectiveness of defending against the virus," he said. The mayor has spoken to Chief Medical Officer Cecilia Müller only once since the beginning of the coronavirus crisis. "It was very difficult to reach her, and I indicated to her that the flow of information was not perfect," he said. "I've quit calling her since then because she never calls back."
Iranian students to be deported
The Budapest Capital Court has denied an appeal by 13 Iranian students after they received deportation orders for allegedly disobeying quarantine orders in March. Hungary will begin expelling the students on Thursday April 16, police Lieutenant Colonel Róbert Kiss said on Wednesday.
The 13 students were taken to the Szent László Hospital in Budapest on March 7 after they came into contact with a person who had tested positive for Covid-19. According to allegations by the Health Ministry, the students left their hospital rooms without permission and acted aggressively toward hospital staff.
None of the students tested positive for the coronavirus.
One of the students is being legally represented by the Hungarian Helsinki Committee, which said the 33-year-old pharmacy student "did not commit any violation of law, and the authorities did not present any evidence on her alleged unlawful behavior". The HHC called the accusations "absurd", and said their client, who has lived in Hungary for nine years, is "the victim of a politically motivated show trial".
A summary of the case against their client can be found here.