Chief physician on mortality among the elderly: "Convinced that there have been deviations"

Maciej Zaremba describes in his article how the elderly in Stockholm are schematically sorted into different categories based on a so-called "clinical fragility scale".

The scale was originally called the "Clinical frailty scale", "CFS", and was developed in 2007 by Canadian researchers with the aim of investigating the connection between the elderly's health and ability to recover from illness.

The use of CFS in coronary care was noticed by the Eskilstuna Courier as early as May.

A document entitled "Guidance on medical prioritization" in the "Governing regulations" from the Stockholm region states, for example, that the elderly who are on the higher part of the CFS scale should only in certain cases be taken to hospital, according to Zaremba's description.

The fact that the elderly have not received good enough medical assessments during the pandemic is also something that Ivo came to when they examined care for the elderly.

In Tuesday's Aktuellt, the region's Stockholm chief physician Johan Bratt responded to the criticism in a debate with Maciej Zaremba.

According to Bratt, the guidelines were not quite as strict as Zaremba believes.

"Is a tool for communication"

- The scale described is a tool for being able to communicate between staff in healthcare to give a picture of the general condition of the patient.

We were always clear in all the different versions of the guidelines that it is individual assessment that applies based on medical position, says Bratt.

So individual assessments were made of patients?

- It is individual assessment that must always apply, answer yes.

However, Maciej Zaremba does not believe that all older people received the individual assessment they should have received.

- I do not think it was that way.

In the first version (of the guidelines, editor's note) it does say that an individual assessment must be made, but not that it must be done by a doctor.

It is added two months later.

Johan Bratt admits that there have most likely been shortcomings in care, but does not want to answer whether this is the direct cause of the high mortality rate among the elderly in covid-19.

- I think that of course there have been deviations.

I'm convinced of that.

That a proper individual assessment has not been made.

We must look at what this has led to.