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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
 
READ ALSO: 
'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
 
'Adapting'
 
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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COVID-19

Munich sees sharp rise in Covid cases after Oktoberfest

Since the start of Germany’s Oktoberfest, the incidence of Covid infections in Munich has risen sharply. Though a connection with the festival can’t yet be proven, it seems likely.

Munich sees sharp rise in Covid cases after Oktoberfest

Two weeks after the start of Oktoberfest, the Covid numbers in Munich have more than tripled.

On Sunday, the Robert Koch Institute (RKI) reported an incidence of 768.7 for the city of Munich, though updated figures for the end of the festival are not expected until later in the week. Usually, on weekends and public holidays, there is a delay in reports.

In the entire state of Bavaria, the incidence value on Sunday was 692.5.

According to Munich’s public health officer, Beatrix Zurek, bed occupancy in Munich hospitals has also increased. Two weeks ago, 200 beds in Munich were occupied by Covid patients, whereas there are now around 350.

Though a relationship between the sharp rise in infections with Oktoberfest, which ended on Monday, can’t be proven at the moment, it seems very likely, according to experts. A significant increase in Covid incidences has also been shown at other public festivals – about one and a half weeks after the start. 

READ ALSO: Germany’s famed Oktoberfest opens after two-year pandemic hiatus

After a two-year break due to the pandemic, around 5.7 million visitors came to this year’s Wiesn according to the festival management – around 600,000 fewer than at the last Oktoberfest before the pandemic in 2019, when there were 6.3 million.

Federal Health Minister Karl Lauterbach (SPD) took to Twitter to comment on the rise in incidence in Munich during the Oktoberfest. “This would not have been necessary if self-tests had been taken before admission,” he said.

“Compared to the price of a measure of beer, €2-3 (for tests) wouldn’t have mattered,” he said.

Even before the start of the Wiesn, he had spoken out in favour of people taking voluntary self-tests. Lauterbach stressed that now is the time for special measures against Covid.

“The development shows what will happen if the states wait too long with the mask obligation in indoor areas,” he added.

READ ALSO: KEY POINTS: Germany’s new Covid-19 rules from October

In neighbouring counties, where many Oktoberfest visitors came from, the number of Covid cases has also risen noticeably.  Beatrix Zurek said that it is unclear, however, how much of a role Oktoberfest played in these figures, as people are currently much more active socially overall, with concerts and other events also taking place throughout the state.

Christoph Spinner, an infections specialist at Munich’s Klinikum, has urged people not to be alarmed by the rising numbers.

“We had expected rising incidences here. We knew that there could be a doubling, tripling, even quadrupling,” he said.

He said that this is no cause for concern, as many people have been vaccinated or have also recovered from previous Covid infections, so any new infections are therefore usually mild.

The virologist advises people over 60 or with pre-existing conditions to get a second booster vaccination, but otherwise said people shouldn’t be alarmed by the rising incidences.

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