“At the beginning of the crisis, a direct colleague from the intensive care unit contracted coronavirus and fell seriously ill”, Aries says. “He spent a few days on the ventilator in his ‘own’ unit. The rehabilitation will probably take months, but he’s on the mend. I’m certain we’ll see him back in the hospital and be able to work together again!”

Their colleague’s plight made a big impression on Aries and his teammates in intensive care. The coronavirus outbreak and subsequent crisis tested them in more ways than one. “We’re used to dealing with very sick people whose condition can be unpredictable, for example due to serious brain injury. And the support we offer corona patients is similar to that given for brain injury. But the corona crisis came with additional challenges, too; debates about unproven therapies, a different work schedule almost daily, a constant flow of new patients as well as deaths, and unusually little telephone contact with families. That gets to you.”

The threat of ‘code black’

“At one point in Maastricht we almost ended up in ‘code black’—that’s an experience I won’t forget quickly. It means there aren’t enough beds in intensive care to treat all patients, which raises many questions. Will you have to stop providing certain treatments? Can you transfer patients to other hospitals elsewhere in the Netherlands, or in Germany? If so, which patients do you transfer? And what if those hospitals fill up too?”

To advise policymakers on what to do in the event of ‘code black’, Aries and his fellow neurologists and neurosurgeons, working with data scientists, created a nationwide database containing information that can be used to build a prediction model for coronavirus. “So far we haven’t had to deal with a capacity shortage, fortunately. But the model will be important if the pandemic flares up again.”