The number of new infections in Germany continues to grow every day, a lockdown light will apply nationally from Monday. The drastic restrictions of public life are also designed to keep the health system from collapsing and intensive care units from becoming overloaded with Covid-19 patients.
Intensive care physicians and nurses are already warning of impending overload: “If the number of corona patients in intensive care units increases dramatically, not all of them will be able to receive professional care,” the German Association for Specialized Nursing recently warned. Not because there is a shortage of beds in the intensive care unit, but because there is a shortage of qualified nursing staff.
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Uwe Janssens, president of the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI), also told the German news agency that the problem was not so much the number of intensive care beds. “We have more beds and more fans than at the start of the pandemic. But we don’t have a tired mouse with the staff anymore. “
The shift system can quickly get out of hand if it can be shown that employees are infected with the virus. He estimates that there is a national shortage of about 3,500 to 4,000 specialists in intensive care. Bed occupancy currently differs from region to region, Janssens explains. In Schleswig-Holstein, 40.7 percent of intensive care beds are free, 18.7 percent in Hesse, but only 13.7 percent in Berlin.
Number of intensive care patients quadrupled
The trend points in a clear direction: Since the end of September, the number of reported cases of Covid-19 treated in intensive care has been increasing rapidly. On October 1, there were still 362 people being treated in an intensive care unit for coronavirus disease; currently, as of October 30, 1,839 people. This is stated in the intensive care register that the Robert Koch Institute maintains together with the German Interdisciplinary Association for Intensive Care and Emergency Medicine.
De Tagesspiegel asked various clinics about the on-site care situation in the intensive care units – whether there is already a shortage of nursing staff and how they are preparing for the coming weeks.
The conclusion: Many clinics see themselves as well prepared, but also admit that if the number of infections rises sharply, additional measures – helpers from other areas, fewer treatments in other departments – are needed. Nursing students, retired doctors, nurses from other departments or doctors in the Bundeswehr could help.
However, in order for enough intensive care nurses to work in the wards, they should continue to protect themselves well against coronavirus contamination. If the nursing staff also fall ill, they will not be able to go to the demanding intensive care unit – which could worsen the situation in intensive care units.
According to clinic spokesperson Timo Müggel, the University Hospital of Cologne could no longer organize patient care “within the old framework” when extra intensive care beds were needed during the corona pandemic. In that case, more nurses are needed, who then have to be deployed from other areas in intensive care. “However, we believe that the experiences in the spring will prepare us for the challenges of the coming weeks.”
The number of current Covid-19 patients at Cologne University Hospital is easy for carers to manage. For the coming weeks, however, the clinic expects more serious illnesses and greater physical and psychological stress for the intensive care staff.
The situation at the University Hospital of Dresden in Saxony is assessed in a similar way: “At the moment we have enough nursing staff in the intensive care units,” says the hospital. However, it is to be expected that the university hospital will also reach its limits if more and more people become infected.
“In these cases we will redistribute staff,” said a spokeswoman – this would require postponing non-urgent operations and deploy nursing-trained students.
Volunteers and staff from other areas
The University Medical Center Schleswig-Holstein also relies on volunteers and staff from other areas as the number of Covid 19 patients increases. Clinic spokeswoman Anna Dammrich-Warth explained that the current intensive care beds are “adequately staffed”.
“We were able to book a large number of volunteer helpers in the first corona wave, including many medical students and nurses who are currently not working.” In an emergency, nurses and doctors from other hospitals or the armed forces could also help.
Konrad Schwarzkopf, chief physician of the Clinic of Anaesthesiology and Intensive Care Medicine at the Saarbrücken Clinic, explained that the quarantine measures in the context of the Corona crisis have exacerbated the absence of staff. “We currently have very few employees who are sick, but we can expect a greater number,” he said.
The doubling of the intensive care ventilation beds, which is needed in an emergency, will only succeed if the measures taken to ensure the safety of the employees are effective. He appealed to the responsibility of all employees in the health sector.
A nurse goes to the Corona intensive care unit at the University Hospital of Dresden behind a glass door with a ventilator … Photo: dpa / Sebastian Kahnert
Due to the increasing numbers, the Saarbrücken Clinic has re-launched a call for counselors – the program asking for support from volunteers in the medical field was launched in the spring.
Situation “absolutely worrying”
Stefan Kluge, the head of intensive care medicine at the University Medical Center Hamburg-Eppendorf (UKE), warned at a press conference in Berlin on Thursday that hospitals and intensive care units would be overloaded. The situation with new corona infections is “downright worrying”.
About 7,000 more free intensive care beds would be reported. But these free capacities recorded in the hospital registry could not be fully exploited, Kluge said. He calls on hospitals to report only those beds for which personnel are available in addition to technical equipment.
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According to spokesman Markus Bien, the University Hospital Leipzig considers itself “very well positioned” in terms of staff. The hospital can continue to perform non-emergency operations.
“However, if the situation worsens, compromises would have to be made here to relocate staff to treat Covid 19 patients,” the management estimates. If the infection rate continued to rise as it does today, the clinic would not be able to maintain its “services beyond the care of Covid 19 patients”.
Many intensive care beds in the Brandenburg clinics are still available
Brandenburger Kliniken also sees itself well equipped for more and more infections. The situation in the hospitals is still good, said the director of the Brandenburg State Hospital Association, Michael Jacob, of the dpa. Not all intensive care beds are occupied. The tense workforce could become the bottleneck when the second corona wave arrives in hospitals.
Even at normal times, getting intensive care staff is difficult, Jacob said. At the beginning of the year, hospitals doubled the number of intensive care beds, but not the staff.
The Ernst von Bergmann clinic in Potsdam is also well positioned for nurses and doctors Photo: Ottmar Winter PNN
The current minimum nursing staff for intensive care, which requires a nurse to care for a maximum of 2.5 patients per day and 3.5 patients at night, will soon be difficult to comply with.
Potsdam Clinic: enough nurses and doctors
At the Carl-Thiem-Klinikum in Cottbus, the situation is currently “in the green”, according to spokeswoman Anja Kabisch. For several weeks, the crisis team has been meeting every day to be able to respond quickly to changes. All services are covered.
“So far, it doesn’t look like we are heading for a situation where we can no longer control patient service,” said Kabisch. But she cannot see into the future either.
There is currently no shortage of staff at the Ernst von Bergmann clinic in Potsdam – neither nursing nor doctors, said spokeswoman Damaris Hunsmann.
But beds are not endlessly available. There is a need to consider which surgeries can be postponed as the number of Covid patients requiring intensive medical care increases.
“In 20 days we will be somewhere completely different”
In an interview with Tagesspiegel, Uwe Janssens, President of the German Interdisciplinary Association for Intensive Care and Emergency Medicine, said that it was fundamentally correct that all clinics in Germany were well prepared: “All clinics are in a different strategy mode than in March, you learned a lot. “
Uwe Janssens, Chairman of DIVI, German Interdisciplinary Association for Intensive Care and Emergency Medicine Photo: Reiner Zensen / image images
Nevertheless, it cannot be ignored that the number of infections is currently doubling by ten days. “In 20 days we will be somewhere completely different.” In addition, it would take about two weeks to see how many of the approximately 16,000 newly infected people would have to go to intensive care units. ‘If about five percent of the newly infected end up in intensive care today, you can calculate how many there are.’
It becomes especially problematic when more elderly people become infected again. “We in intensive care medicine would like a clear signal from politics that we are now going into the same mode as we had before.” The most important thing is that the financing is complete.
He is not surprised that many clinics are optimistic despite the rising numbers of coronavirus. It always matters whether you talk to the management of the facilities or the doctors and nurses. In intensive care, everyone agrees that action should be taken now.
In Berlin, the number of free intensive care beds quickly approached the critical 10 percent limit on Monday. Many hospitals in the capital have already begun to postpone planned operations. (with dpa)