Europe Puts Its Hospitals on Rails

This month, Italy introduced a new tool in its fight against coronavirus and other health crises: a hospital train. Capable of treating and transporting as many as 21 critically ill patients, the newly equipped train is currently located at Milan’s Greco Pirelli railway station, in Italy’s worst hit region, Lombardy. With pressure on regular hospitals reduced since Italian cases of Covid-19 peaked between late March and early April, the train is not due to be deployed immediately. It could, however, be used to relieve any regions hit hard in a second wave. It is one of several converted trains in western Europe since the beginning of the pandemic – with one mobile clinic already being credited for saving lives.

In April, Spain’s national carrier Renfe retrofitted three high-speed 730 Series trains for medical use. Capable of speeds of up to 160 miles per hour, the trains were nonetheless chosen for reasons other than their speed. The model’s doors open at the same level as the platform, making them easier to access with trolleys and stretchers, while their hybrid electric and diesel fuel system means they can be used on any part of Spain’s rail network. Kept on standby to transfer patients to an emergency hospital in Madrid from hard-hit regions with limited beds, the trains have not yet been needed in a country whose health system has struggled during the pandemic, but not failed. The video below shows a simulation of one of the trains in use.

It is France, however, that has done most to use railways to help manage its pandemic response. In March, CityLab reported on its plan to use a high-speed TGV train to transfer Covid-19 patients from the particularly stricken Grand Est region flanking the German border to hospitals in western France. Since then, carrier SNCF has conducted patient transfers: four from the Grand Est region, and five from Paris to hospitals in Brittany and Aquitaine. The transfers seem to have had an effect.

Health authorities in Brittany announced this month that of 84 patients transferred by hospital train to the region, 57 had already improved enough to return to their home regions, and 17 released from hospital. Six patients transferred have since died, nine remain in intensive care, and a further 12 have left emergency care but remain in the hospital. It’s unclear whether or not these outcomes are better than if the patients had all remained in the regions where they were first admitted to the hospital, but it seems likely that the transfers gave a better chance of recovery to both the patients on the trains and the patients left behind in hospitals.

But what happens to trains like these when there are no health emergencies? Some critical voices in Italy have suggested that the new train risks being a gimmick, a waste of resources in a country where all sorts of medical needs are still pressing. Its creators point out that its only fixtures are the bed structures for patients. Equipment such as ventilators and medicine can easily be removed, and will be if they are needed elsewhere. In the meantime, many countries have been so shaken by the pandemic that they may feel such emergency facilities are well worth keeping at hand for whatever lies around the corner.

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