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German coronavirus: Nation risks running out of intensive care units in Covid crisis

The number of Coronavirus infections hit a record high on Friday with nearly 24,000 new daily cases recorded – and so did the number of patients in the country’s intensive care units. Official data from the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) show that the number of Covid-19 patients in German intensive care units (ICU) has increased from 267 on 21 September to 3,615 per year. November 20 – a more than 13-fold increase in just two months.
Europe’s largest economy has come through the pandemic well so far compared to neighboring countries. This is partly due to its high intensive care capacity with 33.9 beds per. 100,000 inhabitants; in contrast, Italy has only 8.6. But with Covid cases across the region shooting into the air, even Germany̵
7;s healthcare system is under strain, and hospitals in some areas are coming increasingly close to their borders.

Germany’s leadership warned on Friday that the system could collapse in weeks if the current trajectory continues. “The number of serious cases in intensive care is still rising. The number of deaths is something that is not really talked about and it remains very high,” said Steffen Seibert, spokeswoman for Chancellor Angela Merkel.

“We have not yet managed to bring the numbers back to a low level. We have largely only managed to get past the first step so far, ie stop the strong, steep, exponential rise in infections, and we are now stable, but our numbers are still very, very high. “

‘Patients get worse very quickly’

Michael Oppert, head of intensive care at Ernst von Bergmann Hospital in Potsdam, just outside Berlin, is equally concerned about the dramatic increase in recent weeks – and expects things to get worse.

“We are not at the forefront of the wave now, at least as far as I can see,” he told a visiting CNN team this week. “And we have capacity for a few more patients, but if this continues at the rate we are experiencing right now, I can imagine that even our hospital with over 1,000 beds will get to a point where we have to send patients home or to other hospitals for treatment. ”

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Bettina Schade, a nurse in the Covid ward at the same hospital, described how the ward has changed in the last few weeks. “The number of patients has increased. We are getting a lot more patients with different degrees of disease. Both to the normal Covid ward, but many also come to the emergency unit and have to enter the ICU very quickly,” she said. . “We are currently experiencing having to place many patients from the normal Covid ward very quickly at the ICU because patients are deteriorating very quickly.”

This is true even for many younger patients with severe symptoms, said Tillman Schumacher, a senior infectious disease physician. “We have patients aged 30 or 40 here who are in a ventilator and I’m not sure if they will survive.”

Only two of the 16 ICU beds were available, and hospital staff canceled already non-urgent operations to free up capacity – as well as planning to convert several of its general intensive care facilities into Covid units.

Dr. Uwe Janssens, head of DIVI, explained what measures would be taken if the current increase continues. “The regular program for hospitals needs to be shut down, a partial closure of the regular surgery and hospitalization of patients that you can delay for several weeks without any strain, they can be delayed. There are people who do not need an emergency surgery. or an emergency catheter or something like that. They can be delayed. And by doing this you get capacity and get the nurses and doctors to help the ICU doctors and the ICU nurses in their wards. ”

After taking into account non-covid patients, 22,066 intensive care beds in the country were occupied per. November 20, while 6,107 remained unemployed. Germany has a reserve of approx. 12,000 ICU beds including field hospital beds in the Berlin Congress Center.

Despite the large capacity, Health Minister Jens Spahn warned earlier this month that ICUs could be overwhelmed if daily infection rates continue to rise at current levels. “We are now seeing an increasing burden and the threat of being overwhelmed in intensive care, in hospitals and by GPs,” he said in an interview with Germany’s state television station ARD.

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And that could be bad news for the whole of Europe. Until now, Germany has taken Covid patients from neighboring countries whose health systems are overwhelmed.

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The German Foreign Ministry confirmed to CNN that during the first wave of the pandemic between March 21 and April 12, 232 patients were transferred to Germany for treatment – 44 of them from Italy, 58 from the Netherlands and 130 from France. Also in the fall, the federal states of North Rhine-Westphalia and Saarland offered space to 36 patients – three of them from the Netherlands, 25 from Belgium and eight from France, a foreign ministry spokesman said.

” These patients need intensive medical attention, ” said Anja Wengenroth, a spokeswoman for the University Hospital Münster in Münster, North Rhine-Westphalia. Her hospital established a system in the spring where Benelux countries – Belgium, the Netherlands and Luxembourg – could submit a request for ICU beds, a scheme that is under way. The North Rhine-Westphalia Ministry of Labor, Health and Social Affairs confirmed to CNN that 46 hospitals have currently agreed to accept foreign Covid-19 patients. 76 beds are currently available. ”

Anne Funk, head of the cross-border cooperation division in Germany’s smallest state of Saarland, which borders France, told CNN that in the first wave of the pandemic, hospitals took in 32 French patients. At the end of October, Saarland France offered eight beds; three patients have been transferred to date.

“We want to help where we can,” Funk said. “We do not want to differentiate between nationalities. At the moment we still have capacity. We coordinate with medical and local authorities in France on the basis of individual needs. We are here to help.”

For now, they can continue to do so, but as Germany’s ICUs fill up quickly, it’s not clear how much longer.

Nurses tend to patients in the coronavirus intensive care unit at Dresden University Hospital, 13 November 2020.

Anti-pandemic protests

Germany has recently seen a series of demonstrations against the country’s anti-pandemic measures, with many protesters denying the severity of the virus.

The country is in a nationwide partial shutdown, which requires restaurants and bars to remain closed, people avoid travel, keep their contacts to an absolute minimum and limit public meetings to members of two different households. Schools and shops have been open. German federal and state leaders will meet next week to decide to introduce further measures.

Protesters raised their hands in front of police officers during a protest against the government's coronavirus restrictions in Berlin, on November 18, 2020.

On Wednesday, thousands of people gathered near parliament in Berlin while lawmakers debated plans for greater legal powers to enforce restrictions. The police used water cannons and tear gas to disperse protesters, many of whom were not wearing face masks.

This is considered a slap in the face by medical staff at the front line who work hard to keep people alive, like Schade. “I also hear some people I know say things like: it’s like a flu or can be compared to a regular flu,” the nurse said. “We just can not understand people saying that! Of course we all fear that at some point we may not get any further and could have a situation like they had in Italy where patients are outside in cars and being treated with oxygen because there is no more capacity. ”

Germany is still far away from such scenarios, but while there are still thousands of ICU beds available in the country, Oppert had a message to warn about the second wave of the pandemic and its dynamics.

“It’s different, it’s harder,” he said. “We tend to see more patients now. Not only here in the Berlin / Potsdam region, where we have a heavy burden of intensive care patients, but nationwide the number is increasing and they are still climbing, they are not coming down at the moment.”

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