The corona numbers are increasing – this is slowly becoming noticeable in the clinics. What is the situation in the intensive care units? Divi President Gernot Marx is confident and well prepared. The only concern is the possible loss of staff, especially due to corona.
The Corona autumn wave is rolling on. Health Minister Karl Lauterbach (SPD) confirmed this on Thursday. The corona numbers are increasing. More corona-positive people are also being treated in the clinics again. What is the current situation in the intensive care units? In an interview, Divi President Gernot Marx talks about the current situation and what to expect in the coming weeks.
Prof. Marx, how is the current corona situation emerging from the point of view of intensive care physicians?
Gernot Marx: “First and foremost, I would like to reassure you here: We intensive care physicians are currently seeing far fewer seriously ill people among the Covid 19 sufferers than a year ago. We also have medicines, like Paxlovid, that we can use early on in patients who are at risk for a severe course. And we know that we can treat severe cases with cortisone. In addition, many people are protected from severe courses by three or four vaccinations. In addition, many patients have already had an infection with Sars-Cov-2 in addition to the vaccinations and have survived it well. So the situation today is different than it was a year or even two years ago. more stable. More manageable.”
Who is currently in the intensive care units because of Corona?
Marx: “Especially the people who are not fully vaccinated and are over 60 years old and have relevant previous illnesses. These people belong to the vulnerable group, so they have a high risk of a severe course – as do immunosuppressed people of all ages or pregnant women.
As of today, we are treating 1,366 patients with Covid-19 in the intensive care units. The numbers have increased significantly in the past few days* and are at exactly the same level as last year.
However, the picture on the wards has changed significantly compared to 2021: last autumn there were much younger patients in the intensive care units, most of them between 50 and 59 years old. Only 38 percent of the patients were older than 60 years. Today, 81 percent of our patients are older than 60 years. Most are in their seventies, around 20 years older than the patients last year.”
At the moment, as the RKI reported last week, it is primarily the medium-sized population groups that are infected with Sars-Cov-2…
Marx: “It was like this at the start of each wave: the younger ones get sick first and only a few patients have to be treated in the intensive care units. But then the older and vulnerable population groups became infected, which we then increasingly have to treat in intensive care units. In addition, severe courses only develop some time after infection. This also means that we will only see more severe courses again in a few weeks. However, we have been observing for two weeks now that the number of Covid-19 patients requiring intensive care in the intensive care units is increasing again.”
They emphasize that the Covid-19 patients in the intensive care unit are still seriously ill.
Marx: “Right. Covid-19 remains a serious disease. That is why the Divi also unreservedly follows the Stiko recommendations: three Covid vaccinations under the age of 60. Four Covid vaccinations over 60 years. Then there is significant protection against a severe course.”
So what do you expect in the next few weeks?
Marx: “Incidences will continue to rise – as in the past few winters. We will see more and more patients in the hospital again in the next few weeks, but most of the Covid 19 patients will very likely be in the normal wards. We therefore expect proportionately far fewer seriously ill patients. Of course, how many we have to treat depends on the number of infected people in the population.”
So when a new wave rolls in, are critical care physicians prepared?
Marx: “The greatest concern for us intensive care physicians, as was the case this summer, is the many absences from employees due to Covid-19 who cannot work with symptoms, but of course have to isolate themselves without symptoms. Without these employees, regular operations in the intensive care units and also in the emergency rooms and normal wards cannot be maintained. We will then have fewer beds that can be operated again, and we will have to postpone operations again.”
How do you assess the situation for the employees?
Marx: “The teams in the intensive care units, as well as all employees in the healthcare system, are under a lot of stress even in the third Corona winter. We are trying to treat more and more patients with fewer and fewer staff.”
Can you recommend measures to get through the winter better?
Marx: “In our opinion, the vaccination against influenza will take on a special, really important meaning this winter. Each virus on its own can trigger a wave with many sick or even seriously ill people. The combination of corona viruses and flu viruses can promote severe courses overall. Accordingly, the flu vaccination is highly recommended for everyone over the age of 60. The following applies to corona and influenza: the higher the vaccination rate in the population, the more likely it is that we will prevent a wave of infected patients in the coming months. All healthcare workers should also be vaccinated against the flu and, of course, be fully vaccinated against Covid-19 with four vaccinations so that they do not have to fear additional illnesses and further absences.”
As many employees as possible and as few patients as necessary.
Marx: Absolutely! The care of emergency patients and people with life-threatening illnesses, the resilience of our healthcare system, of course depends crucially on how many employees in the clinics and practices are available for treatment.
Looking at the numbers, I can say for intensive care and emergency medicine: Yes, we have the same number of Covid-19 patients to be treated in the intensive care units today as we did at the same time last year, and we also have good medication available for this Disposal. At the same time, however, I see in the Divi intensive care register that there are 1,850 fewer intensive care beds available today compared to the same day in 2021.
The operating situation is therefore very vulnerable and reacts immediately to the additional burden of new Covid 19 patients or numerous admissions due to a flu wave. So it is imperative that we take care of the patients, but also of those who care for them!”
*The Divi points out that in the Divi intensive care register operated jointly with the RKI, a significant increase in the number of cases of Covid 19 patients in the intensive care units can be seen, but cases are also listed here that are being treated in intensive care due to another illness and where the Sars-Cov-2 diagnosis is not the focus of the disease or treatment.
However, 50 percent of the Covid 19 patients currently being treated are ventilated, which is an indication of a very severe course. Half of the ventilated patients are currently dying.
