Markus Salzmann
Amid a rapid increase in coronavirus infections throughout Germany, two people have died in connection from the disease Covid-19. On Monday, an 89-year-old woman died at the university hospital in Essen. She had last been treated in the intensive care unit, where she died of pneumonia. A man who died in Heinsberg district was 78 years old and “had a variety of previous illnesses, including diabetes and a heart condition. Since Friday, he had been treated in the hospital in Geilenkirchen.
On Sunday, for the first time a German citizen was proven to have succumbed to Covid-19. This was a 60-year-old man who had travelled to Egypt a week ago as a tourist.
According to official figures, as of Monday evening 1,194 people in Germany had been infected with the Sars-CoV-2 pathogen. From Friday to Saturday alone, the number rose by 155 cases. At the beginning of the week, it had been 150, with North Rhine-Westphalia being the main focus of the disease. The Ministry of Health in Düsseldorf reported 484 confirmed infections on Sunday afternoon—107 more than on Saturday. Federal Health Minister Jens Spahn (Christian Democratic Union, CDU) called on people to refrain from travelling to this state.
An employee wearing a face mask and gloves is waiting for the next patient behind the door of the corona diagnostic centre in Düsseldorf. (AP Photo/Martin Meissner)
In the meantime, with the exception of Saxony-Anhalt, infections have been officially confirmed in every German state. But even in Saxony-Anhalt, facilities have already been closed and people quarantined. In Zerbst, a hospital was closed to new patients and visitors at the weekend because a doctor from Saxony, who tested positive for the coronavirus, works in the facility.
On Friday, several groups of school children from the risk area of South Tyrol had returned to Saxony-Anhalt. The students and their carers must remain in quarantine for two weeks for the time being. School closures are taking place in numerous states, and in Berlin alone, three schools are currently affected. Hundreds of suspected cases are in quarantine, and no decrease in the rate of infections is expected.
The pathogen has now spread throughout Europe. In neighbouring France, the number of cases is increasing at a similar rate as in Germany. Some 1,126 people have become infected, the French health authorities announced on Sunday evening. The number of fatalities was given as 19. The first death was also reported in the Netherlands. In Austria, more than 140 cases are now known and in Switzerland there are already more than 300 cases (with two deaths).
On Monday evening, the Italian government announced that an emergency lockdown would be extended from the northern region to the entire country.
It is expected that the situation will worsen in the coming days in Germany. Lothar Wieler, president of the Robert Koch Institute (RKI), a German federal government agency and research institute responsible for disease control and prevention, said it could not be foreseen when the peak of the emerging epidemic would be reached in Germany. It was equally unclear how the virus would behave in the future.
The massive spread of the coronavirus in Germany shows both the government’s indifference to the dangers faced by the population and the precarious state of the country’s health care system, which has been systematically run down in recent years.
When Health Minister Jens Spahn remarked two weeks ago that Germany was facing a coronavirus epidemic, he claimed the country was prepared for it. Practical measures, however, were not taken.
Spahn’s latest government statement on the subject was also hard to beat in terms of ignorance. He called for “level-headedness” in dealing with the virus asserting there was “much experience in dealing with all possible dangers,” although little is known about the disease.
The only measure Spahn specifically presented was export restrictions on protective suits and masks from Germany. At a meeting of European Union health ministers in Brussels, several countries protested against the action. This kind of unilateral action bore the risk of undermining a “collective approach,” warned EU Civil Protection Commissioner Janez Lenarcic.
Numerous experts have warned of the dangers of spread of the disease and have outlined possible measures against it. For example, the virologist and director of the Institute for Medical Microbiology at Halle University Hospital, Professor Alexander Kekulé, suggested closing schools and day-care centres and cancelling major events. In this way, the spread of the virus could be curbed and the number of people who fell ill, as well as the number of dead, could be “considerably reduced,” said Kekulé. He commented on the inaction of the German government, saying, “Does Minister Spahn think that the Germans are immune to coronavirus?”
In fact, federal and state governments seem willing to accept any risk. North Rhine-Westphalian Health Minister Karl-Josef Laumann (CDU) announced on Wednesday that the Mönchengladbach Health Office saw no reason to cancel the Bundesliga match between Borussia Mönchengladbach and Borussia Dortmund on Saturday.
In the end, the game took place in front of 50,000 spectators only a few kilometres away from Heinsberg, the hot spot of the virus’s spread in Germany. The city administrators of Mönchengladbach justified the irresponsible decision by saying it did not expect “a situation where people would be infected excessively during this game,” city spokesman Wolfgang Speen explained on Friday. It was assumed that infected people were in quarantine and that “no positive case is heading for the stadium.”
Even now, when it can be assumed that the peak of the spread is far from being reached, the dilapidated state of the health system in one of the richest countries in Europe is already becoming apparent. Bernd Mühlbauer, Professor of Health Economics at the Westphalian University of Applied Sciences Gelsenkirchen, drew attention to staff shortages in connection with the spread of the virus.
In an interview with the TV news broadcast Tagesschau, Mühlbauer remarked that “17,000 nursing staff are already lacking in inpatient hospital care alone.” If the particularly endangered professional groups such as doctors and nursing staff became infected themselves, they must be quarantined, and patients transferred to the surrounding hospitals. “We should actually be prepared for this situation right now,” Mühlbauer said.
In fact, the extreme staff shortage means that guidelines for containing the infection are not being observed. If a clinic employee had contact with an infected person or was infected himself, he or she would have to be quarantined for 14 days, according to the recommendation of the RKI. Now, more and more clinics are declaring that they cannot follow this recommendation, as otherwise the entire health system would collapse.
“If we send all medical personnel who have had contact with infected persons into quarantine, medical care for the population will collapse,” Christian Drosten, head of virology at the Berlin Charité, told the Neue Osnabrücker Zeitung. Drosten announced that the Charité would no longer implement the RKI recommendations one-to-one.
At the University Hospital in Aachen, a region with a particularly high number of cases, a nurse in the premature infants ward had tested positive for coronavirus. Because the woman in the intensive care unit was in contact with 45 hospital employees, they should all have been quarantined for 14 days according to RKI recommendations. This would have brought the work in the intensive care unit to a standstill, the clinic emphasised, thus justifying its disregard for the recommendation.
Doctors outside the clinics, for example family doctors, also work under catastrophic conditions and are not supported by the authorities. In the Frankfurter Rundschau newspaper, family doctor Martina Schaffner reported that she could not order protective masks, gloves or disinfectants for her practice and patients. Out of necessity, she had to buy dust masks at the hardware store.
“I have now found another paint and varnish dealer who can deliver 50 masks to me at the beginning of the week. Otherwise there are none. Or they are so expensive that it becomes unaffordable. When I asked the Association of Statutory Health Insurance Physicians they told me that the health insurance companies are currently refusing to cover the costs. The costs will therefore remain with me,” the doctor said.
According to World Health Organisation (WHO) estimates, 89 million respiratory masks and 76 million examination gloves are already needed every month worldwide. If the exponential increase in infections continues, this demand will rise massively. Although there have been repeated outbreaks of infections in recent years, the premise has always been to purchase protective materials as cheaply as possible and keep them in the smallest possible quantities.
At the same time, Schaffner complained that there were no contacts for physicians in private practice who would be able to provide assistance in the numerous, complex questions surrounding the handling of the pathogen. This meant that small practices cannot keep isolation rooms available. Even larger hospitals are now reaching the limits of their capacities. In many regions, general practitioners are also unable to test suspected cases comprehensively due to a lack of protective equipment and test kits.
The official medical services are also already hopelessly overtaxed due to a lack of personnel. Martina Hänel, chief medical officer at the Marzahn-Hellersdorf Health Office (Berlin), told the Berliner Morgenpost as early as February, “Half of the 22 medical posts are currently unfilled.” For example, public health officers were responsible for the imposition and monitoring of quarantine measures. The authorities were not equipped for such a drastic increase in cases.
The situation is the result of the radical austerity policies of recent years and the subordination of social needs to the drive for profits. The RWI’s Hospital Rating Report 2019 confirms that the situation in German hospitals is deteriorating further. The proportion of hospitals with a negative annual result at group level has increased significantly, to 28 percent compared to 16 percent in the previous year. Around 12 percent of hospitals are thus exposed to an increased risk of insolvency.
Even now, entire units in clinics are increasingly being closed due to staff shortages. Many clinics can no longer maintain emergency care, and this is under supposedly “normal” conditions. During a crisis—as is currently the case with the highly contagious coronavirus pathogen—the demands on clinics increase. Nevertheless, there are already more far-reaching plans for cutbacks.
A study conducted by the Bertelsmann Foundation last year advocated closing more than half of all clinics in Germany. Less than 600 of the current 1,400 hospitals are to be retained, according to the study, which was commissioned by the foundation and conducted by the Berlin Institute for Health and Social Research. With the grotesque argument that only by closing clinics could more staff, better equipment and higher quality be achieved, the report also calls for a further reduction in hospital stays and an even stronger focus on generating profits.
In the expanding pandemic, the capitalist elites in Germany, Europe and worldwide are proving unwilling and unable to take effective action against the spread of the deadly virus. Decades of austerity have ruined health care systems. Massive investment is now needed to ensure that the virus is prevented from spreading further and treated on an international scale. This demands a socialist transformation of society.
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