Markus Salzmann
The massive increase in COVID-19 infections is pushing hospitals throughout Europe to their limits. In Germany, the number of intensive care patients grows daily. Doctors’ representatives and other experts are increasingly warning of the consequences of a shortage of nursing staff and intensive care beds.
The Robert Koch Institute reported 1,700 coronavirus patients in Germany’s intensive care units on Friday morning. By Saturday, the figure had risen to 1,830 and by Monday to 2,243. The number of cases subject to intensive care treatment has almost tripled in the past two weeks.
Despite these figures, the federal and state governments have not imposed a necessary lockdown, but only highly inconsistent restrictions on contact. Schools and daycare centres remain open so that work can continue in the factories and other workplaces.
The German Hospital Federation expects the number of intensive care patients to reach a new peak soon. The head of the organization, Gerald Gass, assumes the previous peak of April will be exceeded in two to three weeks and can no longer be prevented. “Anyone who is admitted to hospital in three weeks is already infected today,” Gass told the Bild newspaper.
Due to the extreme shortage of intensive care specialists, Gass announced that nursing staff from non-intensive medical areas would be deployed in intensive care units, which was “not optimal.” This is highly dangerous for patients. The fact that it is nevertheless being considered shows how desperate the situation is. Due to the complex equipment and procedures in intensive care, the use of untrained personnel poses considerable risks. At the same time, training and instruction can hardly be provided adequately due to the stressful situation in the clinics.
“There is not much leeway left in some federal states. Berlin has only 14 percent free intensive care beds, Bremen 17 percent,” warned Uwe Janssens, president of the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI). This was also since most clinics are still carrying out their “routine programme.” For many clinics, the urgently needed conversion of capacities to coronavirus cases means financial ruin. While in the spring there was a flat-rate payment to hospitals for keeping a certain number of beds free for coronavirus cases, this no longer exists.
At the same time, the care of other acutely ill patients is also at risk. According to a report by broadcaster NDR, a second intensive care unit has now been opened at the University Hospital in Essen. Ninety patients with COVID-19 are being treated there, 27 of whom are receiving intensive medical care.
The director of the Eye Clinic, Nikolaos Bechrakis, reports that he and his team operate on 400 people every year, many with serious tumours, where every day counts to prevent the threat of blindness. “In the first wave, we already had to lose 25 to 30 percent of our capacity. I am afraid that when the second wave comes it will be more severe,” said Bechrakis.
Saarland’s State Premier Tobias Hans (Christian Democratic Union, CDU) admitted the severity of the crisis this week. “The situation is frightening and alarming: soon many of the 1,900 hospitals in Germany may collapse,” he said. Wards and emergency rooms may have to be closed due to missing or sick staff. “Triage and Italian conditions threaten if we don’t take countermeasures now.”
It is becoming more and more obvious that claims that the lessons from the situation in spring had been learned and that care in German hospitals was stable, which Health Minister Jens Spahn (CDU) repeats like a mantra, are nothing more than deliberate misinformation intended to lull the population into a false sense of security.
The federal and state governments have done nothing to prevent the impending collapse in health care. Although experts have been calling for it for a long time, there is not even a proper record of how many nursing staff with intensive care training are available in Germany. Also, as the number of infections increases, a growing number of doctors and nurses are becoming ill. There is no uniform testing strategy to effectively protect employees in hospitals, nursing homes and similar institutions.
Instead, the precarious situation is at the expense of doctors and nursing staff, who are already working at the limits of their ability to cope with stress. Lower Saxony has again increased the maximum working hours for employees in clinics and nursing homes to up to 60 hours per week and up to 12 hours a day. The other federal states will follow suit. The measure had already been decided at the beginning of the pandemic. Now it will remain in place until May next year.
“For months, the country has been asleep rather than preparing medical facilities for the second wave of the coronavirus pandemic,” Nadya Klarmann, president of the Chamber of Nursing Care, noted. “Now it is up to the employees in the systemically important professions to again save the situation at the risk to their own health.”
The situation is alarming throughout Europe. The World Health Organization (WHO) has warned against overloading the health care system. “Many countries in the northern hemisphere are currently seeing a worrying increase in cases and hospital admissions,” WHO chief Tedros Adhanom Ghebreyesus said recently in Geneva.
In Austria, the situation is worsening day by day. The government has stated that with 6,000 new infections per day, there is a risk of overloading intensive care beds in hospitals. In extreme cases, doctors would then also have to decide who would be treated and who would not, Chancellor Sebastian Kurz (Austrian Peoples Party, ÖVP) noted.
On November 4, a record 6,901 new infections were reported in the Alpine republic. The measures in force since Tuesday, such as a curfew from 10 p.m. to 6 a.m., are unlikely to prevent an increase in cases and deaths. Despite the seriousness of the situation, businesses, daycare centres and the majority of schools—all drivers of the pandemic—remain open.
In Belgium, the health care system is already collapsing. A growing number of clinics can no longer deliver intensive care. According to the trade unions, dozens of doctors and nurses are on duty despite being infected with coronavirus. They receive no protection or support from the government or the trade unions.
“We have to choose between a bad or a very bad solution,” said Philippe Devos from the Federation of Medical Unions. The very bad solution was not to treat patients at all, broadcaster Deutsche Welle quoted the union official.
In terms of population, Belgium is the European country with the most new infections. By November 2, 1,074 out of 100,000 inhabitants had been infected with the virus within the previous seven days.
Switzerland also has an extremely high seven-day incidence, with 588 infections per 100,000 inhabitants. On Monday alone, almost 22,000 new infections were registered in the country with almost 9 million inhabitants. According to media reports, the government in Bern estimates that all intensive care units will be occupied by the middle of the month. In some cantons, such as Geneva and Valais, the treatment limit has already been reached. In Valais, 2,530 out of 100,000 inhabitants have been infected in the last 14 days, in Geneva 2,373 out of 100,000.
The government of the richest European country, whose pharmaceutical industry has an annual turnover of €80 billion, quickly lifted the initial protective measures in the spring, took hardly any precautionary measures and is now sacrificing the lives of countless people. More than 2,400 people have now died of COVID-19 in Switzerland, with 80 each day last Friday and Monday alone.
The situation in Eastern Europe has been extremely tense for weeks. COVID patients from the Czech Republic have already had to be brought to Germany for treatment. The Ministry of Health in Prague has ordered the postponement of all elective surgery.
In the Czech Republic, there were 782 infections per 100,000 inhabitants in the last seven days. According to the doctors’ medical association, more than 13,000 employees in the health care sector have become infected with coronavirus. If they did not continue to work when they showed no symptoms, providing treatment would no longer be possible. In the meantime, the government has imposed a night-time curfew. But that will hardly be enough to avert the complete collapse of hospitals.
In Poland, hospitals are completely overwhelmed by the rapidly increasing number of COVID-19 patients. The hospital in the border town of Slubice, which has been reconfigured for coronavirus patients, recently reported four deaths from the disease within 24 hours, according to broadcaster rbb. On HTS local television, managing director Lukasz Kaczmarek spoke about the catastrophic situation. “There is a lack of cleaning agents, body-care products such as cream and shower gel. That is bad. Also, our hospital has an infrastructure from the 1960s. We have to cope with this situation.” There was also a lack of disinfectants, food and garbage bags.
The situation in France and Britain is similar.
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