'Masks are in short supply': How coronavirus has hit Germany's frontline health workers
The coronavirus crisis in Germany may appear to have calmed in recent weeks – but healthcare workers say they still have a lack of equipment and are concerned about risks.
Since the start of the pandemic, Germany’s Robert Koch Institute (RKI) for disease control, says 20,400 workers from hospitals, doctors' practices, emergency services and nursing homes are confirmed to have contracted coronavirus, making up around eleven percent of all those infected.
However, this could be the tip of the iceberg as there are thought to be many more undetected cases.
A total of 894 people who work in the health sector have had to be treated in hospital, while at least 60 have died after becoming infected by Covid-19, reported the Süddeutsche Zeitung on Tuesday May 19th. An estimated 19,100 people have recovered.
The RKI has recorded more than 11,800 cases of coronavirus in hospitals, medical practices, dialysis facilities and emergency services alone (as of May 6th). In nursing and other residential facilities there have been more than 8,500 infections.
As of Tuesday May 19th there had been a total of 177,289 confirmed coronavirus infections in Germany.
Of those around 155,357 people have recovered and 8,041 people have died, according to Johns Hopkins University figures, which reports slightly higher figures than the RKI due to calculating data in real time throughout the day.
READ ALSO: More than 2,000 medical staff infected with coronavirus in Germany
Germany easing lockdown – but concerns on health frontline
Germany has managed to get the crisis under control through shutting down much of public life and enforcing social distancing measures.
The number of new infections has remained below 1,000 in recent days.
Meanwhile, the reproduction number, which shows how many people a person with coronavirus goes on to infect, was on Monday May 18th estimated by the RKI to be 0.82. Experts want to keep the number under 1.
As businesses reopen and Germany emerges from lockdown, the situation on the whole appears to be positive.
But for employees in hospitals, old people's homes and nursing services, fears over the spread of coronavirus remain high and the situation is volatile.
Every day since mid-April, an average of more than 230 doctors and nurses have been infected with coronavirus, the SZ reported.
On some days, employees from the health sector report more than one in five coronavirus cases.
'I only get one face mask a day'
Healthcare workers have also been raising concerns about a lack of protective equipment.
In a survey conducted recently by Marburger Bund, the association responsible for representing doctors, 38 percent of those questioned said they lacked protective equipment.
They said respiratory masks with fine particle filters (FFP2 and FFP3) are missing, as are gowns, protective goggles, visors, gloves and even simple surgical masks.
The German Nurses Association shares similar experiences. "As before, many institutions report that FFP2 and FFP3 masks are in short supply," said its spokeswoman Johanna Knüppel.
In view of this outlook, many health workers are concerned about their health.
"I only get one face mask a day," an anaesthetist working in a hospital, who wanted to remain anonymous, told the SZ.
READ ALSO: What's the latest on coronavirus and what do I need to know?
The same applies when it comes to the FFP2 mask, which is needed to ventilate patients in the intensive care unit or for anaesthesia.
Laying the ventilation tube is considered to pose a particular risk of infection because corona viruses are found in large numbers in the throat.
"I am required to wear this one mask all day long," said the anesthesiologist, "I don't feel comfortable wearing it."
A change of mask is only planned at the hospital if a doctor has treated a patient who is demonstrably infected with Sars-CoV-2.
"Until we know if the patient is infected, we pretend he isn't," the hospital worker said.
However, the reason for the many infections in clinics and homes is not only down to the lack of equipment.
A nurse holding a swab in a test tube in a treatment room of the Corona Outpatient Clinic at the Paracelsus Clinic in Zwickau, Saxony. Photo: DPA
"In some institutions, the virus has also spread because they were unable to separate areas well from each other structurally," said Knüppel.
In addition, the staffing levels often do not allow for a strict separation of infected and non-infected areas, even in terms of personnel. "Three shifts always have to be covered," Knüppel said.
However, not all hospital employees infected with Sars-CoV-2 were infected during their work, Oliver Keppler from the Max von Pettenkofer Institute of the University of Munich discovered.
He investigated transmission chains in hospitals by analysing the genetic relationship of the viruses.
This suggests that many hospital staff became infected in their private environment, at least as late as March, and that they subsequently infected each other rather than from Covid-19 patients in the hospital.
"Fortunately, these transmissions have drastically decreased over the last few weeks," said Keppler. He is calling for further studies to be carried out to investigate the transmission pathways in the general population.
Call for more tests
There are also concerns over testing in healthcare settings.
Although Germany has won plaudits worldwide for swift action and testing, according to the SZ, the RKI said it has no data on the extent to which testing is carried out in hospitals and nursing homes.
The Marburger Bund is therefore calling for more frequent testing and recording of infections in staff in health facilities.
"We need to test much more frequently so that we can protect infected employees and patients alike," said chairwoman Susanne Johna.
This could be about to change. Last week Germany approved a new law which means testing, particularly in nursing homes and hospitals, will be expanded.
The government also plans to provide a €50 million cash injection to Germany's 375 health care authorities so they can upgrade technology and equipment.
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Since the start of the pandemic, Germany’s Robert Koch Institute (RKI) for disease control, says 20,400 workers from hospitals, doctors' practices, emergency services and nursing homes are confirmed to have contracted coronavirus, making up around eleven percent of all those infected.
However, this could be the tip of the iceberg as there are thought to be many more undetected cases.
A total of 894 people who work in the health sector have had to be treated in hospital, while at least 60 have died after becoming infected by Covid-19, reported the Süddeutsche Zeitung on Tuesday May 19th. An estimated 19,100 people have recovered.
The RKI has recorded more than 11,800 cases of coronavirus in hospitals, medical practices, dialysis facilities and emergency services alone (as of May 6th). In nursing and other residential facilities there have been more than 8,500 infections.
As of Tuesday May 19th there had been a total of 177,289 confirmed coronavirus infections in Germany.
Of those around 155,357 people have recovered and 8,041 people have died, according to Johns Hopkins University figures, which reports slightly higher figures than the RKI due to calculating data in real time throughout the day.
READ ALSO: More than 2,000 medical staff infected with coronavirus in Germany
Germany easing lockdown – but concerns on health frontline
Germany has managed to get the crisis under control through shutting down much of public life and enforcing social distancing measures.
The number of new infections has remained below 1,000 in recent days.
Meanwhile, the reproduction number, which shows how many people a person with coronavirus goes on to infect, was on Monday May 18th estimated by the RKI to be 0.82. Experts want to keep the number under 1.
As businesses reopen and Germany emerges from lockdown, the situation on the whole appears to be positive.
But for employees in hospitals, old people's homes and nursing services, fears over the spread of coronavirus remain high and the situation is volatile.
Every day since mid-April, an average of more than 230 doctors and nurses have been infected with coronavirus, the SZ reported.
On some days, employees from the health sector report more than one in five coronavirus cases.
'I only get one face mask a day'
Healthcare workers have also been raising concerns about a lack of protective equipment.
In a survey conducted recently by Marburger Bund, the association responsible for representing doctors, 38 percent of those questioned said they lacked protective equipment.
They said respiratory masks with fine particle filters (FFP2 and FFP3) are missing, as are gowns, protective goggles, visors, gloves and even simple surgical masks.
The German Nurses Association shares similar experiences. "As before, many institutions report that FFP2 and FFP3 masks are in short supply," said its spokeswoman Johanna Knüppel.
In view of this outlook, many health workers are concerned about their health.
"I only get one face mask a day," an anaesthetist working in a hospital, who wanted to remain anonymous, told the SZ.
READ ALSO: What's the latest on coronavirus and what do I need to know?
The same applies when it comes to the FFP2 mask, which is needed to ventilate patients in the intensive care unit or for anaesthesia.
Laying the ventilation tube is considered to pose a particular risk of infection because corona viruses are found in large numbers in the throat.
"I am required to wear this one mask all day long," said the anesthesiologist, "I don't feel comfortable wearing it."
A change of mask is only planned at the hospital if a doctor has treated a patient who is demonstrably infected with Sars-CoV-2.
"Until we know if the patient is infected, we pretend he isn't," the hospital worker said.
However, the reason for the many infections in clinics and homes is not only down to the lack of equipment.
A nurse holding a swab in a test tube in a treatment room of the Corona Outpatient Clinic at the Paracelsus Clinic in Zwickau, Saxony. Photo: DPA
"In some institutions, the virus has also spread because they were unable to separate areas well from each other structurally," said Knüppel.
In addition, the staffing levels often do not allow for a strict separation of infected and non-infected areas, even in terms of personnel. "Three shifts always have to be covered," Knüppel said.
However, not all hospital employees infected with Sars-CoV-2 were infected during their work, Oliver Keppler from the Max von Pettenkofer Institute of the University of Munich discovered.
He investigated transmission chains in hospitals by analysing the genetic relationship of the viruses.
This suggests that many hospital staff became infected in their private environment, at least as late as March, and that they subsequently infected each other rather than from Covid-19 patients in the hospital.
"Fortunately, these transmissions have drastically decreased over the last few weeks," said Keppler. He is calling for further studies to be carried out to investigate the transmission pathways in the general population.
Call for more tests
There are also concerns over testing in healthcare settings.
Although Germany has won plaudits worldwide for swift action and testing, according to the SZ, the RKI said it has no data on the extent to which testing is carried out in hospitals and nursing homes.
The Marburger Bund is therefore calling for more frequent testing and recording of infections in staff in health facilities.
"We need to test much more frequently so that we can protect infected employees and patients alike," said chairwoman Susanne Johna.
This could be about to change. Last week Germany approved a new law which means testing, particularly in nursing homes and hospitals, will be expanded.
The government also plans to provide a €50 million cash injection to Germany's 375 health care authorities so they can upgrade technology and equipment.
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