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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Pandemic in Germany unlikely to end this year, says top virologist

High profile German virologist Christian Drosten believes Germany will see a severe spike in Covid infections after summer, and that the pandemic will not become endemic this year.

Pandemic in Germany unlikely to end this year, says top virologist

Drosten previously said that Germany would probably be able to declare the end of the pandemic this year.

But in an interview with Spiegel, Drosten said he had reevaluated his opinion. 

“When the Alpha variant came, it was very surprising for me. When Delta appeared I was sceptical at first, then with Omicron we had to reorient ourselves again. And since January there have already been new Omicron subtypes.

“So I would actually like to correct myself: I no longer believe that by the end of the year we will have the impression that the pandemic is over.”

READ ALSO: End is in sight for pandemic in Germany, says virologist 

Drosten also said that Germany will not see a largely Covid-free summer, which has been the case in previous years, and a further increase in infections in autumn. 

“We are actually already seeing an exponential increase in case numbers again,” Drosten said.

“The BA.5 variant (of Omicron) is simply very transmissible, and people are losing their transmission protection from the last vaccination at the same time.”

In other countries, he said, when the number of cases become high, hospitalisation and death rates also rise again. “Unfortunately, that will also be the case here,” said Drosten, but added: “Overall, however, far fewer people will become seriously ill and die than in 2021.”

Drosten said he expected many more infections from September.

“I hope that the school holidays will dampen the increase in cases somewhat. But from September, I fear we will have very high case numbers,” the head of the virology department at Berlin’s Charité hospital told Spiegel.

READ ALSO: German Health Minister lays out autumn Covid plan

Virologist Christian Drosten at a Covid press conference in 2021.

Virologist Christian Drosten at a Covid press conference in 2021. Photo: picture alliance/dpa | Kay Nietfeld

If the government does not take any action, he predicted there would be a lot of sick leave across all industries. “That will become a real problem,” he said.

Drosten said he did not expect overcrowded intensive care units in Germany.

But the new BA.5 sub-variant, which is becoming dominant in Germany, may affect people more strongly. 

“The wheel is turning more towards disease again,” said Drosten. It is not true that a virus automatically becomes more and more harmless in the course of evolution. “That makes me even more worried about the autumn,” he said.

Drosten recommends wearing masks indoors during the colder months, saying it is “the least painful” measure.

If, in addition, “up to 40 million people could be immunised or given a booster vaccination” before winter, for example by urgently calling for company vaccinations, that would “really make a difference”, Drosten said.

In the long term, he said it’s inevitable that people will become infected with coronavirus.

He said the population immunity due to vaccinations and infections will at some point be so strong that the virus will become less important. “Then we will be in an endemic state,” said Drosten. In the worst case, however, this could take “several more winters”.

However, Drosten warned against people trying to deliberately infect themselves with Covid, saying getting the infection in summer doesn’t mean people will be protected in winter. 

Drosten himself said he has not yet contracted Covid-19.

“So far, I guess I’ve just been lucky,” he said. “I rarely put myself in risky situations, but I’m not overly cautious either.”

‘Pandemic depends on behaviour’

According to the Robert Koch Institute (RKI)’s latest weekly report, more outbreaks are occurring in care homes, and the number of patients in intensive care units is slightly rising as infections go up. 

The institute said there had been a 23 percent increase in the 7-day incidence compared to the previous week. On Friday the 7-day incidence stood at 618.2 infections per 100,000 people. There were 108,190 infections within the latest 24 hour period and 90 deaths. 

“The further course of the pandemic depends not only on the occurrence of new virus variants and the uptake of vaccinations on offer, it also depends to a large extent on the behaviour of the population,” said the RKI.

According to the DIVI intensive care register, the number of Covid-19 patients in ICUs had increased to 810 on Thursday this week, from about 600 at the beginning of the month.

However, that number is still low compared to previous Covid peaks when thousands of people were in intensive care in Germany.