Clinic chief on Covid-19: people of all ages in the intensive care unit

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Uniklinikum Essen, intensive care unit: 16 patients with the diagnosis of Covid-19 are currently lying in the hospital beds here. The course of their infection is so difficult that they have to be ventilated or specially monitored. Not only old people and people with previous illnesses, but also young and previously healthy people end up there. “Throughout the bank, all retirement funds have to be treated intensively,” says Jochen Werner, medical director of the clinic. “Even young and healthy people can have a difficult course.” On average, the patients are currently in their early 50s. In the summer, the average age was even 44.

Step by step, the number of Covid-19 patients at the Essen University Hospital has climbed again. While in July there were still around three sick people who were treated there daily, in September there were already around 20 patients per day with an infection in the hospital rooms. Since the beginning of October another five to eight sick people have been added every day. There are now 63 inpatients here. Including: the 16 intensive care patients.

Because the infection process is always a bit delayed, this is just the beginning, according to Werner. “We’re going into an infection season,” he says. “That will keep us busy in the coming months.”

The University Hospital in Essen shows a small excerpt from what is currently going on nationwide. At over 7,000, the number of new infections reached a new all-time high in mid-October. This is partly due to the fact that significantly more tests are carried out than at the beginning of the pandemic. Still, the numbers are alarming. According to the RKI, around six percent of all infected come to a hospital. In the past week there were more than 1000 infected nationwide – over 650 of them are in the intensive care unit.

Not every free bed can be used

That may sound comparatively little. Because according to the DIVI intensive care register there are around 30,000 intensive care beds across Germany. Around 8,700 of these are currently unoccupied. “What many people forget is that there aren’t enough nurses to be able to use all of these beds,” says Werner. If medical personnel also become ill, the situation becomes even more precarious.

What do these numbers mean? Are beds kept free in the hospitals again and operations not carried out? “We can no longer leave beds empty as we did in spring,” says Werner. At the beginning of the pandemic, more than 2000 operations were postponed – and they are still far from being caught up.

To deal with the situation, the hospitals have to work together, says Werner. This means that Covid-19 therapy should be more centralized. Most of the patients take over selected locations that have the equipment and the necessary expertise. In the further course of the pandemic, these could then also provide telemedicine support to other hospitals in the treatment of corona patients.

“We centralize in Essen,” says Werner. That is why the number of Covid 19 patients in his house is so high in Germany’s largest metropolitan region. Treatment schemes have now been developed. Infectiologists, lung specialists and intensive care physicians now have sufficient expertise in dealing with the novel virus. In exchange, other clinics in Essen take on patients who do not necessarily have to be treated in a university clinic.

According to Werner, the fact that this system is not yet used everywhere is due to the hospital structure, the attractiveness of the case and the resulting financial reasons. “Everyone can do what they want,” says the clinic director. That is one reason why the hospital system has not worked properly for years.

Now there is a treatment strategy and medication

The good news is that doctors are now much better acquainted with the virus. “You still don’t know various things,” says Werner. “But we are significantly further than at the beginning of the pandemic.” There is now a sensible treatment strategy and certain drugs. Although 63 Covid-19 patients are currently being treated at the Essen University Hospital, it is almost full operation. In the spring, when the hospital postponed numerous operations, there were only two more patients.

At that time, the hospital was divided into two areas – with the result that many beds in the area for Covid 19 patients remained empty. In view of the increasing numbers, however, additional beds will have to be created again: “But not to the same extent as we did in March. We must by no means neglect the concerns of all the other seriously ill people. “

Werner nevertheless assumes that operations will have to be postponed again soon. Together with the treatments from spring that have not yet been made up, there is a jam. Even the head of the hospital cannot say when and how the operations can be caught up again: “We don’t know how long it will take.”

Despite the rapidly increasing numbers, Werner does not assume that the hospitals will be overloaded at some point. “The German health system is so good that we can handle this situation for a long time.” The system can absorb a lot, he says. How much, however, also depends on how well the cooperation works.


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