From fear to routine: One German hospital’s Covid-19 marathon

No matter if a viable vaccine is coming on the market soon or not, Germany's Aachen hospital already knows there will still be a marathon to run when it comes to treating patients worst hit by the coronavirus.

From fear to routine: One German hospital's Covid-19 marathon
The exterior of the University Hospital in Aachen. Photo. Ina Fassbender/AFP
No matter if a viable vaccine is coming on the market soon or not, Germany's Aachen hospital already knows there will still be a marathon to run when it comes to treating patients worst hit by the coronavirus.
“We've learnt that it's an illness with very long legs, and we must not give up after 10 or 15 days but keep at it,” Gernot Marx, who heads the intensive care unit at the university hospital, told AFP.
“The patients who have received the longest treatment were with us in intensive care for 60 days and they really came back from the brink. That is certainly a very important lesson we have learnt.”
Marx and his team were on the frontlines when the pandemic first hit Germany in the spring.
During that first wave, half of the Covid-19 patients in Germany who were put on ventilators succumbed to the disease.
This time round, Marx, 54, hopes more lives can be saved as healthcare practitioners have a better understanding of how best to treat the most severe cases.
Recalling a patient in his fifties who ended up in intensive care even though he had no pre-conditions, the doctor said: “We fought for weeks. He was put on all sorts of machines that we had available and today, he's back home and in pretty good shape. That shows that every effort is worth it.”
A nurse takes care of a Covid-19 patient in the intensive care ward at Aachen hospital. Photo: Ina Fassbender/AFP
'Fear gives way to routine'
Behind the glass door of one of the hospital's critical care units, four patients are kept alive thanks to respiratory machines and infusions. Wearing masks, surgical gowns, glasses and two pairs of gloves each, Marx and his team are on their ward rounds.
Today, it's the patient in bed 9 who needs the most attention.
An ultrasound examination is followed by a discussion. Her treatment is adjusted, as doctors hope to save one more life.
More than 12,000 people in Germany have died after catching the virus, the grim toll dwarfed by devastating numbers recorded in other European countries, including Britain where over 50,000 have succumbed.
At the next bed, Marx checks on a patient who has a respirator with its multiple tubes as well as drips inserted into his upper body, feeding him drugs that help with blood circulation, send him to sleep among others.
“If he doesn't receive this medication, he will die in a few minutes,” said Marx.
Just across the aisle at bed 12, there's encouraging news. Preparations are underway to move the patient whose condition has stabilised.
The next step for him would be to learn to breathe on his own again, before a physical rehabilitation that would run for a further few weeks.
“The first time round, everything was new. There was a lot of fear and uncertainties,” recalled Marx of the emergency in March and April as the world was just waking up to the pandemic. With experience, all that has given way to routine.”
A doctor take care of a Covid-19 patient in the intensive care ward at Aachen hospital. Photo: Ina Fassbender/AFP
Germany has so far coped with growing hospitalisations, with 6,000 intensive care beds still available.
But health officials have repeatedly warned that infection numbers must urgently come down if hospitals are to be able to handle new admissions in coming weeks.
Official data show those admitted to intensive care stay on average nine days while those requiring ventilation stay 18.
On Monday, the number of coronavirus patients in intensive care exceeded the record reached in the first wave.
With thousands of new daily infections, “the number can only rise in the next weeks,” said Marx.
Around two percent of those afflicted with Covid-19 end up taking a bad turn, usually after 10 or 12 days of illness.
Aachen hospital is now treating around 40 patients with coronavirus, more than half of them in intensive care.
Marx says the hospital can cope, but warned that a chronic deficit of healthcare personnel countrywide is worsening because some staff are put on quarantine over infection fears while others are downed by the winter seasonal flu.
Some non-urgent operations are already being postponed. Unlike in spring, however, there has not been a total halt to such surgeries yet.
“We are adapting,” said Marx. “We can take in new patients at any time but are taking on fewer (non-urgent) operations.”
In Berlin, a makeshift medical centre with 90 beds that was set up in the capital's huge exhibition halls is likely to remain in place until May 2021.
Over in Aachen, bed number 12 will likely be ready for a new patient.

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Is the pandemic over in Germany?

As much of Germany lifts - or prepares to lift - the last remaining Covid-19 measures, intensive care units say Covid-19 admissions are no longer straining the system.

Is the pandemic over in Germany?

Despite a difficult winter of respiratory illnesses, intensive care units in Germany say Covid-19 admissions have almost halved. The number of cases having to be treated in the ICU has gone down to 800 from 1,500 at the beginning of this month.

“Corona is no longer a problem in intensive care units,” Gernot Marx, Vice President of the German Interdisciplinary Association for Intensive Care and Emergency Medicine, told the German Editorial Network. “A the moment, we don’t have to think every day about how to still ensure the care of patients, but how to actually run a service that can help.”

Marx said the drop has allowed them to catch up on many postponed surgeries.

The number of sick employees in hospitals is also falling, helping to relieve the pressure on personnel.

The easing pressure on hospitals correlates with the assessment of prominent virologist and head of the Virology department at Berlin’s Charite – Christian Drosten – who said in December that the pandemic was close to ending, with the winter wave being an endemic one.

German federal and state governments are now in the midst of lifting the last of the country’s pandemic-related restrictions. Free Covid-19 antigen tests for most people, with exceptions for medical personnel, recently ended.

READ ALSO: Free Covid-19 tests end in Germany

Six federal states – Bavaria, Baden-Württemberg, Hessen, Thuringia, Lower Saxony, and Schleswig-Holstein – have ended mandatory isolation periods for people who test positive for Covid-19.

Bavaria, Saxony-Anhalt, and Schleswig-Holstein have ended the requirement to wear FFP2 masks on public transport, while Berlin, Brandenburg, Saxony, Thuringia, and Mecklenburg-West Pomerania will follow suit on February 2nd.

At that time, the federal government will also drop its requirement for masks to be worn on long-distance trains. Labour Minister Hubertus Heil says that’s when he also intends to exempt workplaces – apart from medical locations – from a mask requirement.

READ ALSO: Germany to drop mask mandate in trains and buses from February 2nd

Bavaria and Baden-Württemberg will also end the requirement for patients to wear a mask in doctor’s offices. That’s a requirement that, so far, will stay in place everywhere else. Federal Health Minister Karl Lauterbach has also said that he thinks this requirement should remain. 

But some public health insurers and general practitioners are calling for a nationwide end to the obligation for wearing masks in doctor’s offices.

“The pandemic situation is over,” National Association of Statutory Health Physicians (KBV) Chair Andreas Gassen told the RND network. “High-risk patients aren’t treated in all practices. It should generally be left up to medical colleagues to decide whether they want to require masks in their practices.”