Coronavirus: Rise in COVID Cases Pushes German Hospitals to Limit | Germany | In-depth news and reporting from Berlin and beyond | DW

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Steinmeier speaks with relatives of coronavirus victims in Germany via Zoom conference


Could Germany soon see COVID-19 and other priority patients based on their chances of survival, like the scenes seen in Spain, Italy and France during the first wave of the pandemic in last spring?

This is highly unlikely, according to the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) – despite rising numbers of coronavirus infections in the country and increasing pressure on intensive care units.

“To date, since the start of the pandemic, we have not needed to prioritize patient care, despite the increasing occupancy of intensive care beds,” said the spokesperson for DIVI Press, Jochen Albrecht, in a statement.

And yet, many German hospitals are overloaded. According to the intensive care DIVI registry, the number of available beds rose from more than 30,000 in June 2020 to some 23,900 earlier this week.

Fewer healthcare workers, vacant beds

Intensive care units are increasingly overcrowded. As of April 17, 22,539 intensive care beds were occupied across the country, leaving about 12% still vacant. By comparison, at the peak of the second wave on December 16, the proportion of vacant beds was just under 17%.

The main reason for the current lack of capacity is a shortage of qualified health personnel. Since the start of the pandemic in early 2020, approximately 9,000 nurses have left the profession. This loss is now being acutely felt, even as vaccinations for nurses and doctors have increased in recent months.

Despite the tense situation, Germany is still in a relatively good position compared to neighboring countries, at least in terms of the total number of intensive care beds. In March 2020, Germany ranked first among 15 EU countries with more than 30 intensive care beds per 100,000 inhabitants, above the average of 13.1 beds, according to a study by the insurer private PKV. In contrast, Portugal has only 4.2 beds per 100,000 inhabitants.

Hospitals develop emergency plans

“The good news is that we will be able to take care of all patients, and we will not have a situation in Germany where we have to prioritize one patient over the other,” said Christian Karagiannidis, Scientific Director of DIVI Intensive Care Greffe, in an interview with the Berlin newspaper Daily Mirror April 15. “Before that happened, we would go into absolute emergency mode. “

To avoid having to make these difficult triage decisions, hospitals have developed contingency plans. This means that all non-essential treatments are put on hold and patients can be transferred when the hospital’s capacity reaches the breaking point.

The plan was organized according to the so-called clover principle, according to which the 16 German states are divided into five regions. The concept aims to support overcrowded regions and hospitals by allowing groups of patients to be transferred to places with free capacity.

According to the Robert Koch Institute’s Center for Disease Control, this is done “to provide adequate care for each patient, and NEVER have to prioritize patients, even if there are local bottlenecks.” The medical profession, however, has played it safe. A year ago, the Association of Medical Scientific Societies of Germany (AWMF) developed a guideline outlining how healthcare professionals could allocate critical care resources during the pandemic. Earlier this month, the guideline’s validity was extended until October 31.

Legal guidelines and financial incentives

The guideline states that the likelihood of treatment success should be taken into account for each patient. Underlying illnesses, age, social aspects and disabilities are not legitimate criteria for a decision to prioritize patients, according to DIVI.

Nonetheless, the directive was seen as controversial. “If doctors were to follow the recommendations of expert associations, many people with disabilities would have virtually no chance of receiving life-saving treatment,” said Corinna Rüffer, German parliamentarian and member of the Green Party who called for the matter to be regulated legally.

Erich Irlstorfer, member of the Conservative Christian Social Union, supports a pragmatic solution to address the bottlenecks. He wants to introduce a law that would better reward overtime work for nurses and also provide financial incentives for retired health workers to return to work.

This is an approach supported by pulmonologist Christian Karagiannidis. “Nurses and doctors are tired. This is the basic problem, ”he said. The daily mirror. “It really worries me. “

This article was translated from German

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