Coronavirus infections threaten Germany’s hospitals with overload

By Markus Salzmann
13 October 2020

Experts warn that hospitals in Germany are reaching their limits of capacity due to the dramatic increase in coronavirus infections. While protective measures against the virus have been almost completely dismantled in recent months, the government has done nothing to prepare hospitals for the foreseeable increase in severe cases.

It was necessary to prepare for a wave of seriously ill patients, explained Susanne Herold, head of the Infectiology Department at Giessen University Hospital, at a joint press conference with Federal Health Minister Jens Spahn (Christian Democratic Union, CDU). This would push hospitals to the limits of their capacity, especially in big cities, she added.

Patient in intensive care unit (Photo: Frank C. Müller, Baden-Baden / CC-BY-SA 4.0)

On October 8, 487 COVID-19 patients were in intensive care in Germany, 237 of them requiring ventilation. One month earlier, on September 8, there were 230 cases, of which 130 were ventilated—an increase of 112 percent.

According to Herold, a further significant increase and associated bottlenecks can be expected in the coming weeks. On Saturday alone, the number of new infections rose by 4,721, exceeding 4,000 for the third day in a row. Chancellor Angela Merkel (CDU) had announced at the end of September that she expected 19,200 new infections per day by Christmas.

The rising number of infections inevitably leads to an increasing number of hospital admissions. Social Democratic Party (SPD) health expert Karl Lauterbach expects a death rate of at least 1 percent in the future—i.e., hundreds of deaths per day.

Speaking to the Rheinische Post, Christian Karagiannidis of the German Society for Internal Intensive Care and Emergency Medicine (DIIN) warned about too few intensive care beds, especially in large cities. “Significant capacity limitations” were already apparent, especially in Berlin. In the capital, 84 percent of intensive care beds were already occupied. Every day, the number of admissions to intensive care units is increasing, and it is likely that soon, not all patients will be able to get treatment in the area where they live, according to the physician.

The biggest problem is the lack of staff and completely overworked personnel. This had already become clear in the spring. In this context, the president of the Professional Association of German Anaesthetists, Götz Geldner, has warned of a lack of personnel in hospitals. “If there is a sharp increase in severe coronavirus cases, there will be bottlenecks in intensive care personnel,” he said.

Last year, 37 percent of intensive care beds in German hospitals had to be closed due to lack of staff. The German Hospital Federation had reported three years ago that 53 percent of hospitals were having problems filling intensive care positions. The reasons for this are catastrophic working conditions and poor wages.

Between 1991 and 2017, the number of hospital cases rose by almost 30 percent and the length of stay was halved, which means a greatly increased workload. The number of jobs in the nursing sector has remained almost unchanged over the same period.

Health expert Hartmut Reiners also commented in the Frankfurter Rundschau, “Capacities cannot be fully utilised because there is a lack of qualified nursing staff. Over the last 25 years, the federal states have halved their subsidies for inpatient care”.

Health Minister Spahn reacted to the warnings of the medical profession with his characteristic mixture of ignorance and downright lies. He repeated that hospitals in Germany were well prepared for higher case numbers because they had learned from the situation in the spring. At the same time, he made it clear once again that there would be no further lockdowns. Although the rising case numbers are due to the reopening of schools and businesses, Spahn blamed celebrations exclusively for this.

Hospitals in Germany are anything but well-equipped for the case numbers they are likely to see soon. Although the number of new infections has been rising for weeks, hospitals are keeping significantly fewer beds free for coronavirus patients than at the beginning of the pandemic.

The state government in Baden-Württemberg has decided that in future, only 10 percent of hospital beds will be reserved for COVID patients, instead of 35 percent. Even in Berlin, where the numbers are rising most rapidly, the figure is now only 10 percent, as in Lower Saxony. In other federal states, such as Bavaria or Hamburg, no intensive care beds need to be kept free for coronavirus patients, according to the authorities. Even following the latest figures, the Federal Ministry of Health sees no reason for the states to change these regulations.

Many hospitals are deliberately keeping the admission of COVID patients low, as this means high personnel and material costs with comparatively low revenues. Many hospitals have slipped deep into the red in recent months. According to the Hospital Report 2020 by management consultants Roland Berger, 57 percent of German hospitals expect a deficit for the current year. Despite the ongoing pandemic, several clinics have recently had to close, which further aggravates the supply situation.

As far as representatives of government and business are concerned, this situation is an opportunity to impose long-planned cuts. Last year, a study by the Bertelsmann Foundation demanded that the number of hospitals in Germany be halved.

Amid the pandemic, economic research institute RWI economist Boris Augurzky called for the nationwide closure of hospitals. He recently announced once again that numerous hospitals would run into massive financial difficulties from 2022 onwards. As the Ärztezeitung reports, he demanded the federal government reduce hospital costs. Augurzky predicted that a “phase of thriftiness” was approaching.

Under these miserable conditions, it is not surprising that hospitals and nursing homes will again become hotspots of the pandemic.

In Bad Saarow, Brandenburg, 46 people tested positive. In the clinic of the Helios Group, 25 employees and 21 patients were infected. At present, no admissions can be made at the clinic. Other patients could also be infected, and the infection chains can hardly be traced.

Cases also occurred again at the Ernst-von-Bergmann-Klinikum in Potsdam. Four employees from the clinical area and five employees from the service area have become infected. In March, more than 50 people in the clinic were infected with the coronavirus. The public prosecutor’s office in Potsdam has opened investigations on suspicion of negligent homicide and negligent bodily harm.

In a nursing home in Nuremberg, 28 people were infected this week. Of the 18 residents and 10 staff, at least one person has required intensive medical care. In a facility in Freudental, 24 of 29 residents and seven employees were infected. Further cases are reported almost daily from all over Germany.

According to the Robert Koch Institute, just over 10 percent (as of September) of all infected persons reported to date work in the fields of medicine and nursing; according to official figures, 64 of them have died so far. Further serious illnesses and the deaths of employees and patients are to be expected as a result of the policies of the federal and state governments.

 

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