EXPLAINED: What is the Covid situation on German hospital wards?

A Covid patient in intensive care in Dresden.
A Covid patient in intensive care in Dresden. Photo: dpa/dpa-Zentralbild | Robert Michael
Coronavirus infections having been surging in Germany in recent weeks. But what stress is this placing on hospital wards up and down the country?

Since the summer, the government has decided to focus on hospitalisations with severe Covid symptoms as the benchmark for new restrictions on personal contacts and entry to events.

The government decided to move away from looking solely at the incidence of infection due to the fact that vaccines would help prevent serious symptoms in most cases. Now, a 7-day hospitalisation rate is published every morning.

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On the national level, the incidence on Tuesday morning was 5.6, which means that there were 5.6 hospitalizations per 100,000 inhabitants of Germany over the last seven days. In a country with a population of 82 million people that equates to some 5,000 people who were taken to hospital with symptomatic Covid. 

What really matters in terms of new restrictions is the situation at the state level – and this varies considerably through the country.

So, what is the situation like in hospital wards in the individual states?

Current hotspots

The state with the highest rate of hospitalization by far is Thuringia in eastern Germany, where the incidence in the latest report by the Robert Koch Institute (RKI) stands at 18.35 hospitalisations per 100,000 inhabitants.

Saxony-Anhalt has the second highest incidence at 11.74 followed by Bavaria which has an incidence of 9.50 hospitalizations per 100,000 inhabitants.

Hamburg has the lowest hospitalisation rate at 2.48.

Surprisingly, the state of Saxony, where the government has imposed a tough lockdown for the unvaccinated, has a relatively low hospitalisation rate. The eastern state, known for its low vaccine take up, has a hospitalization rate of just 4.36, similar to those of Schleswig-Holstein and Hessen.

The intensive care register, published by the German Intensive Care Association (DIVI), tells a rather different story on Saxony.

It shows that over a third of all ICU beds in the state are currently occupied by Covid patients. No other state has such a high level of occupancy, although Thuringia and Bavaria aren’t far behind.

Percentage of critical care beds taken up by Covid patients. Source: DIVI

It is not immediately clear why Saxony has a low hospitalization rate but a high level of ICU occupancy.

The small city state of Bremen currently has the fewest spare beds on its critical care wards, with just 12 free ICU beds in the whole state, or 1.1 per hospital.


The DIVI register also provides a detailed breakdown of people requiring intensive care treatment according to their age.

The need for critical care is heavily weighted towards older members of the population. Roughly 85 percent of people currently on critical care wards are over the age of 50, with close to 30 percent of the overall number being aged between 60 and 69.

Put another way, there are some 2,500 Covid patients currently receiving critical treatment who have already celebrated their 60th birthdays. At the same time there are a little over 80 patients on ICU wards with severe Covid symptoms who are yet to reach the age of 30.

Vaccinated and still hospitalized?

People who have not been vaccinated against Covid-19 are much more likely to end up in hospital with severe symptoms, data compiled by the RKI shows.

Hospitalisation rates in the 60+ demographic (vaccinated vs. unvaccinated) Source: RKI

This is particularly true of people over the age of 60, where the hospitalization rate among the vaccinated stands at around six per 100,000, while unvaccinated people in this demographic have a hospitalisation rate of close to 30.

At the same time, elderly people who have been fully vaccinated now account for roughly 40 percent of hospitalisations in their age group.

Over the past month, fully vaccinated patients have made up some 30 percent of new patients on ICU wards (474 from 1,592 new Covid patients.)

Link to restrictions

The German states agreed on national rules this month that would connect the hospitalization rate to new restrictions.

A rate higher than 3 would trigger 2G rules – meaning only vaccinated and recovered people would be able to enter restaurants, bars and other venues.

At a rate of 6 the so-called 2G-plus rule would be introduced – meaning the vaccinated and recovered would also need a negative test result to get into a venue.

When hospitalizations in a state top an incidence of nine, then the state can bring in tough lockdown measures such as contact restrictions.

The use of the hospitalization rate as the primary gauge for imposing restrictions has faced criticism from some public health experts.

Markus Scholz, an epidemiologist at the university of Leipzig, told Handelsblatt that the incidences were set “far too high.”

“In Saxony the threshold of 9 has not yet been reached, yet the healthcare system is already on the verge of collapse, which is why a new lockdown is now necessary,” he said.

Others have raised concerns that delays in reporting new patients by hospitals would mean that restrictions could be imposed too late.

SEE ALSO: Key points from Germany’s new Covid restrictions for winter

Member comments

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  1. Different States have different definitions of 2G plus. In our area of RP, it just means fewer unvaccinated people are allowed in to big events like football matches, only vaccinated or recovered at Christmas markets, but no extra test. The plus for the 3G is a PCR test is required rather than an antigen. It’s getting very confusing no doubt.

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