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Saxony’s statements contradict each other in the debate on triage in German hospitals. The occasion is the Oberlausitzer Bergland Clinic in Zittau, where the “triage” is said to have taken place. The medical director there, Mathias Mengel, had apparently said in an online citizens forum: At his hospital, one had to decide multiple times which Covid 19 patient would still receive ventilators.
The doctor told the t-online news portal: “In recent days we have been in the situation several times where we had to decide who receives oxygen and who does not.”
The Prime Minister of Saxony, Michael Kretschmer (CDU), called this in the newspaper “Bild” as an exaggerated “call for help” from the director of the clinic. “If they don’t listen to you, you sound louder, then you get more drastic,” Kretschmer said. Saxony Health Minister Petra Köpping (SPD) described the selection statement as a “wake-up call” because: “Soon we will no longer know how to care for patients.” The minister could not confirm the case itself.
The Zittau hospital management also stated that there was no triage situation, that it was a “misunderstanding”. Generally, triage is understood as follows: if devices, medications, staff are not enough for everyone, patients are divided into levels of urgency, from “trier” – French to “sort”. Patients whose chances of recovery are better are more likely to receive treatment than those with the worst chances. Simply put, some associate it with “letting die.”
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Doctors who are familiar with what is happening in Saxony emphasize: Zittau was about relocating and postponing the interventions that would have been carried out at the site before the pandemic. This is always common when, for example, after a serious accident, a large number of patients suddenly arrive.
The clinic in Zittau is located in the Görlitz district, the current coronavirus hotspot in Germany. More recently, patients were transferred from there to Leipzig, said Christian Kleber from the Dresden University Clinic, which coordinates intensive care in eastern Saxony. It can be assumed that these cases will be more frequent in the coming days. But there are still free intensive care beds in Saxony.
Intensive care physician: we constantly prioritize in daily life
“In everyday life, we constantly prioritize which patient needs the often scarce intensive care space first,” said Jörg Weimann, one of the leading intensive care physicians in Berlin. “This is achieved in normal times without any disadvantage for the patient, that is, according to impeccable criteria that are understandable to all specialist colleagues. In times of crisis it may be different, so even a sensible sequence could mean that some patients do not can be treated immediately. Only in absolute terms An emergency threatens classification: that would be the rare and extremely stressful decision about which case can be saved with the scarce resources available and for whom, in the worst case scenario, it is not enough ” .
Weimann co-designed the pandemic concept for Berlin, according to which intensive care units are assigned to three “levels.” As Level I, the Charité handles the most serious cases. Level II consists of 16 clinics, including the large Vivantes houses, also state-owned, that treat other patients also serious with Covid-19. Level III clinics treat intensive cases that are not infected with the coronavirus.
Kalayci: there is enough capacity in Berlin
The situation in Berlin is currently better, even if people infected with coronavirus account for 28 percent of patients in Berlin’s intensive care units. Berlin Health Senator Dilek Kalayci (SPD) told the German Press Agency: “In Berlin there is enough capacity to care for Covid-19 patients.” There are still more than 200 intensive care beds available and ventilators are also available. There are also 2000 normal beds.
However, nurses are sought everywhere. As reported, many positions were not filled even before the pandemic. There are also cases of illness and quarantine among the clinic’s employees. Clinics tried to hire workers, several hospitals were said, but the job market was practically empty.
Doctors in Berlin and Saxony emphasize that the acute shortage of local personnel can make transports to other cities time-consuming. This, in turn, could affect the care of displaced patients, but to speak of “triage” is incorrect. The Charité is also studying transferring patients to other clinics because there are many cases of Covid 19. The Berlin university clinic worries about tumor operations being carried out in other cities, for example. A spokesperson for Charité said: There is no triage situation.
Senator Kalayci had ordered that planned treatments be postponed in order to save resources for the fight against the corona virus. However, clinics often only earn net money through regular operations. The president of the Berlin Medical Association, Günther Jonitz, told Tagesspiegel that the staff situation was extremely tense and that he was asking clinics to postpone any postponement of any intervention: “In the meantime, some hospitals are receiving non-specialized treatment, with pediatricians who care for adults there, for example. “
