What is the Coronavirus pandemic, for German means hospitals

“This is crazy”, “disastrous”, “catastrophic”: Uwe Janssens a dramatic adjectives when he describes the current Situation in Italian hospitals. “Colleagues’ reports, it is like war,” says the Secretary General of the German society for Internal intensive care medicine and emergency medicine. The hospitals are creaking under the load of the many Infected. But also in Germany, the Coronavirus is a stress test for the hospitals, including staff.

Janssens works in a hospital in Eschweiler, a few kilometers away from Gangelt in the most affected district of Heinsberg in North Rhine-Westphalia. “Highly employees as patients,” says Janssens contaminated. “I call it a risk area.” Why the Robert Koch Institute (RKI) used only the term “particularly of the Region concerned”, made it difficult for him not to be.

To the anxious question, whether the German health system could withstand the pressure, repeat the experts, like a mantra, that this is entirely dependent upon the speed of propagation. “We have a disease for which we still need to get a feel for it,” says Uta Merle. The Doctor from the University hospital Heidelberg in charge of the intensive care unit with the current Covid-19-patients. “The patients are not allowed to just come all at once.”

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In Germany could infect, according to the RKI’s assessment, in a period of one to two years of 60 to 70 percent of the population with the new Coronavirus. In this country, there are about 28,000 beds for intensive care patients. “If we were in Italy, we would have been transferred to 11,000 beds to our size. As you can see the reserve potential,” says Reinhard Busse, Professor of health care Management from the Technical University of Berlin.

Germany have one of the largest bed densities in the world, says Jörn Wegner of the German hospital society. According to previous findings, the played a decisive role in the height of the death rate by Covid-19. Intensive are equipped with complex monitoring devices and are maintained by more nurses. The RKI is to develop a tool, with whose help in the case of an Overload of a particular hospital can be seen where in the vicinity that still have free beds are.

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In Italy, also ventilation devices in addition to intensive care beds are scarce. Around five per cent of all registered in China Affected patients, according to the RKI, so far, so hard to the inflammation of the lungs Covid-19 that they had to be connected to the ICU on a ventilator.

A Covid must be ventilated-19-Patient, then in the long, explains Michael Pfeifer, President of the German society for pneumology and respiratory medicine. For a Patient this could take several weeks. “If new signings come in, is the place.”

Federal Minister of health, Jens Spahn (CDU) says that there are 25,000 beds ventilation options – additional devices should be purchased. The medical technology manufacturer dräger factory, for example, has received an order for 10,000 of the ventilation equipment from the Federal government. As a company spokesperson explained, has increased the weekly production of a type of equipment that will be used at the Corona-patients often, significantly the last. These devices would be manufactured in Germany, shortages due to global supply chains and reduced transport capacity but are not completely ruled out.

The Federal government purchased, under the leadership of the procurement office of the German armed forces also medical goods to the value of 163 million euros to cope with the Corona-crisis. “Us, too, the Italian situation does not overload yet,” said the TU Berlin expert coaches. “Always assuming we can protect the personnel and it would not be missing.”

Shortage of personnel

This is precisely what Michael Pfeifer drives. “What makes us more Worried than the equipment, the staff.” The resource person in the ICU is scarce. Staff not trained in intensive care, should early be trained, so that it could be used in crisis situations in addition.

The staff in the hospitals are under a lot of pressure: in Addition to a high work load, many are afraid to get sick themselves, or infecting others unknowingly with the Virus, said the doctors official Janssens had. “What the, is huge.”

The RKI recommends home quarantine for medical personnel, the close unprotected contact to a confirmed case within the framework of the nursing or medical investigation, and had no protective equipment worn. Janssens considers this to be “simply not practicable”, if you do not want to bring the health system to collapse.

In Eschweiler, about a sick sister was ill. If we had followed the recommendation of the RKI, had just gotten 70 employees in quarantine. Janssens: “Then we should have the emergency supply must be switched off.” Anyway, almost all of the employees were in Gangelt space in the clinics is contaminated. In Eschweiler, the affected staff is therefore regularly test.

Here is another eye of a needle was demonstrated, Janssens says. The financing of the regular re-testing is largely unclear. 150 Tests were at the clinic that day, if at all. Already, the laboratories are overloaded. The cooperation with the health authorities operating in individual cases. Nevertheless, there are always differing information, “which differ from the recommendations of the RKI”. The create lots of uncertainties.

Bonus for intensive care beds

Eventually, the point will be reached where the health system, its resources must focus on, said Minister Spahn recently. Additional capacity will arise from the fact that – as far as medically justifiable all planned inpatient treatments and operations will be postponed indefinitely. The fact the Federation and the Länder agreed on Thursday. The resulting economic consequences for the hospitals to be compensated for by the statutory health insurance funds. In addition, there is a Bonus for each intensive care bed, which is in addition maintained.

To get off lightly by the epidemic, must think with the population, says Clemens Wendtner, chief of infectious diseases and tropical medicine in Munich. He has treated the first German Covid-19-patients. The inpatient capacity has to be in principle available in Germany. “We just need to use the resources very sensibly and not block each other.”

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