Europeans are enjoying the gradual easing of coronavirus lockdown measures, but in hospitals they are already preparing for the next wave of infections.
Some intensive care specialists are trying to hire more permanent staff. Others want to create a reservist "army" of medical professionals ready to be deployed wherever needed to work in wards with seriously ill patients.
European countries have been giving medics crash courses in how to deal with COVID-19 patients, and are now looking at ways to retrain staff to avoid shortages of key workers if there is a second wave of the novel coronavirus.
"We need a healthcare army," said Maurizio Cecconi, president-elect of the European Society of Intensive Care Medicine (ESICM), which brings together medics from around the world who work in wards with extremely ill patients.
Cecconi, who heads the intensive care department at the Humanitas hospital in Milan, says medical staff need to be more flexible in the work they do, and more mobile.
A nurse is seen in the coronavirus disease (COVID-19) unit at the CHR Centre Hospitalier Regional de la Citadelle Hospital in Liege, Belgium, June 16, 2020. (File Photo: Agencies)
"If there is another big wave, we should be prepared to deploy doctors and nurses from nearby regions within Italy. This did not happen a lot in the first wave," he told Reuters.
Many countries were caught unprepared by the COVID-19 pandemic in March and April, and hastily retrained medics to work with patients with severe cases of the disease, to ramp up numbers and replace those who fell sick.
Some sent medical students and retired doctors to help out in intensive care wards as hospital staff were overwhelmed. Those worst-hit by the pandemic had to provide more beds and essential equipment for acute care units, and some built new hospitals.
But problems and shortages persist. Italy, for example, may need to boost by 50 the number of anaesthetists, resuscitation experts and other medics it has working in intensive care, according to the Italian society of intensive care SIAARTI.
Across Europe, hospitals have been re-training surgeons, cardiologists, internal medicine physicians and nurses from other departments, and have moved them to intensive care units when needed.
Many have attended crash courses on how to handle COVID-19 patients, said Jozef Kesecioglu, president of ESICM and head of intensive care at the University Medical Center of Utrecht, in the Netherlands.
"We gave them jobs with less responsibility, such as washing patients, turning patients around, checking the lungs or looking at scans," he told Reuters.
Intensive care specialists had continued to do the most delicate work, such as handling tubes in patients' throats or adjusting mechanical ventilation, Kesecioglu said.
He plans to call back the same people to offer them more training. Under normal circumstances, intensive care workers undergo years of training but he said: "We should not wait until the new wave comes, we should give them regular training."
The Netherlands is trying to recruit more skilled workers and hopes to narrow structural gaps in the intensive care workforce, said Rotterdam's Erasmus Medical Centre, one of the largest university hospitals in Europe.
SIAARTI says medical students who specialise in intensive care medicine should be fully integrated into wards for the last two years of their five-year training, and has recommended financial incentives be offered to attract more students.
The European Commission, the European Union's executive, funded cross-border transfers of medical staff to the most affected countries at the height of the coronavirus crisis.
In April, teams of "flying doctors" were sent from Norway and Romania to Italy.
But the experiment has failed to gather much support, and Cecconi said moving doctors from one country to another "should be an option but not the first option," as language barriers may make them less effective.
Some patients were also moved around to receive treatment. France transferred some to less-affected regions of the country and sent others to Germany, which also took in COVID-19 patients from Italy.
But Cecconi warned of transportation risks and logistical complications.
"Often our patients are very sick," he said. "I'd rather have skilled people who know how to work in my environment."