Germany was seen as a beacon for other European countries when the first coronavirus vague and hailed for one of the best healthcare systems in the world. But now it is starting to fight more serious infections than at any time during the pandemic.
The number of coronavirus infections hit an all-time high on Friday, with nearly 24,000 new daily cases recorded – just like the number of patients in intensive care units nationwide. Official data from the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) shows that the number of Covid-19 patients in German intensive care units (ICUs) rose from 267 on September 21 to 3,615 on November 20 – an increase of more than 13 times in the space of just two months.
Europe’s largest economy has weathered the pandemic fairly well so far compared to its 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 the surge in Covid cases in the region, even the German healthcare system is under strain, and hospitals in some regions are coming ever closer to their limits.
German leaders warned on Friday that the system could collapse within weeks if the current trajectory continues. “The number of severe cases in intensive patients is still on the rise. The number of deaths is something that is not really talked about and it remains very high,” said Steffen Seibert, spokesman for Chancellor Angela Merkel.
“We haven’t yet managed to bring the numbers down to a low level. Basically we’ve only been able to take the first step so far of stopping the exponentially high rise in infections and now we’re stable, but our numbers are still very, very high. “
“ Patients deteriorate very quickly ”
Michael Oppert, head of intensive care at Ernst von Bergmann Hospital in Potsdam, just outside Berlin, is also concerned about the dramatic increase in recent weeks – and expects things to get worse.
“We’re not right on the wave now, at least as far as I know,” 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 currently experiencing, I imagine even our hospital, with over 1,000 beds, will come to a point where we have to send patients home or in other hospitals for treatment. “
Bettina Schade, chief nurse of the Covid department at the same hospital, described how the department has changed in recent weeks. “The number of patients has increased. We are receiving many more patients with varying degrees of illness. Both for the normal Covid service, but many also come to the emergency room and must be placed in the ICU very quickly,” she said. . . “We are currently faced with the need to transfer many patients very quickly from the normal Covid department to the intensive care unit, as patients deteriorate very quickly.
This applies even to many younger patients with severe symptoms, said Tillman Schumacher, an infectious disease physician. “We have patients here who are 30 or 40 years old who are on ventilators and I don’t know if they will survive.”
Only two of the 16 beds in the intensive care unit were vacant, and hospital staff were already canceling non-emergency operations to free up capacity – and planning to convert more of their general intensive care facilities into Covid units.
Dr Uwe Janssens, head of DIVI, explained what action would be taken if the current surge continued. “The regular hospitals program must be closed, a partial closure of regular operations and patient admissions that you can delay for several weeks without any constraints, they can be delayed. There are people who don’t need an emergency surgery or an emergency catheter or something like that. They can be delayed. And in doing so, you get the capacity and nurses and doctors can help doctors and critical care nurses in their wards. ”
After factoring in non-Covid patients, 22,066 intensive care beds in the country were occupied as of November 20, while 6,107 remained vacant. Germany has a reserve of around 12,000 intensive care beds, including field hospital beds at the Berlin Congress Center.
Despite the large capacity, Health Minister Jens Spahn warned earlier this month that intensive care units could be overwhelmed if daily infection rates continue to rise to current levels. “We are now increasingly seeing an increasing burden and threat of being overwhelmed in intensive care, hospitals and general practitioners,” he said in an interview with German public broadcaster ARD.
Germany offers help to other European countries
And that could be bad news for all of Europe. Until now, Germany has been hosting Covid patients from neighboring countries with overwhelmed health systems.
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 Saar offered places for 36 patients – three of them from the Netherlands, 25 from Belgium and eight from France, a spokesperson said. of the Ministry of Foreign Affairs.
“These patients need intensive medical care,” said Anja Wengenroth, a spokesperson for the Münster University Hospital in Münster, North Rhine-Westphalia. His hospital set up in the spring a system allowing the Benelux countries – Belgium, the Netherlands and Luxembourg – to submit a request for ICU beds, an ongoing program. The North Rhine-Westphalia Ministry of Labor, Health and Social Affairs confirmed to CNN that currently “46 hospitals have agreed to accept Covid-19 the patients. There are currently 76 beds on offer. “
Anne Funk, head of the cross-border cooperation division in the smaller German federal state of Saarland, which borders France, told CNN that during the first wave of the pandemic, her hospitals received 32 French patients. At the end of October, the Saar offered France eight beds; three patients have been transferred to date.
“We would love to help wherever we can,” Funk said. “We do not want to differentiate between nationalities. For the moment, we still have capacities. We are working in coordination with the 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 with the rapid filling of German intensive care units, it’s not clear for how long.
Germany recently witnessed a series of protests against the country’s anti-pandemic measures, with many protesters denying the severity of the virus.
The country is in a nationwide partial lockdown that forces restaurants and bars to stay closed, people to avoid travel, keep contact to an absolute minimum, and limit public meetings to members of two different households. Schools and stores remained open. German federal and state leaders will meet next week to decide whether to introduce new measures.
Thousands of people gathered near parliament in Berlin on Wednesday as lawmakers inside debated plans to strengthen legal powers to enforce the restrictions. Police used water cannons and tear gas to disperse the protesters, many of whom were not wearing face masks.
This is seen as a slap in the face by frontline medical staff who work hard to keep people alive, like Schade. “I also hear people I know saying things like: it’s like the flu or can be compared to regular flu,” said the head nurse. “We just can’t understand the people who say that! Of course we are all afraid that at some point we will not be successful anymore and could have a situation like the one they had in Italy where patients are at. outdoors in cars and are treated with oxygen because there is no more capacity. “
Germany is still a long way from such scenarios but, while there are still thousands of intensive care beds available in the country, Oppert had a warning message about the second wave of the pandemic and its dynamics.
“It’s different, it’s more difficult,” he said. “We tend to see more patients now. Not only here in the Berlin / Potsdam area, where we have a heavy burden of intensive care patients, but across the country the numbers are increasing and they are continuing to climb, they are not decreasing. at the moment.”