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Thursday 17 December 2020
Heidelberg: triage possible
Charité reduced to “emergency program”
More and more clinics are reaching their limits due to the increasing number of corona patients. Therefore, the Berlin Charité interrupts all planned interventions. Heidelberg University Hospital no longer rules out triage, that is, prioritizing patients.
For days now, reports of German hospitals at the limit of their possibilities have been increasing. With the Berlin Charité and the Heidelberg University Hospital, two big reputable German hospitals are now reporting that they have reached the border in light of the corona pandemic. Heidelberg University Hospital no longer excludes triage due to the sharp increase in the number of Covid 19 patients and full intensive care units. In Berlin, the Charité health care board of directors, Ulrich Frei, said: “Although we have managed to cope with quite moderate restrictions on clinical care so far, […] we must first reduce our activities to a pure emergency program in the next 14 days. “
“We are still in an unusually severe crisis, like the one we have not yet experienced. We still have difficult weeks ahead,” Frei said. The return of operations to an emergency program at Christmas and the turn of the year means, in Frei’s words, that initially there will be no more predictable interventions and that bed occupancy will be reduced by at least another 300 beds.
According to the clinic, emergencies will continue to be attended and tumor operations will be carried out. There are no restrictions on rescue centers. La Charité, with its three locations in the capital, deals mainly with severe cases of Covid 19, but also cares for those affected in normal rooms. It is the largest university hospital in Europe.
Heidelberg University Hospital also sees its capacity limits reached. The senior medical director of the university clinic, Ingo Autenrieth, told Radio Regenbogen: “We have not had a triage yet, but that can happen to us. We are prepared for it.” He emphasized: “We have never experienced a situation like this in Heidelberg or anywhere else in Germany in the last 50 or 60 years.” The term triage means that healthcare professionals must decide who to help first due to limited resources.
According to the daily report of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) on Thursday, the number of corona patients in intensive care units in Germany continues to rise. Meanwhile, 4,856 people are being treated there for corona infections, 20 more than the day before, as you can see from it. Therefore, 57 percent of them are invasively ventilated. A week ago, the number of Covid-19 cases treated in intensive care units was 4339, on December 1 it was 3921. The number of free intensive care beds for adults is estimated at 3722 in the daily Divi report . Nearly 10,800 adult beds are specified as a 7-day emergency reserve.
On Wednesday, Divi and the group of specialists in Intensive Medicine, Infectious Diseases and Emergency Medicine of the Robert Koch Institute (RKI) declared that they are not currently at the point of having to prioritize patients. Even in the case of a possible regional overload of clinics, it has been regulated for some time that patients can be transferred within Germany.
In Saxony, Zittau’s remarks caused a stir. A doctor from the Oberlausitzer Bergland Clinic had spoken of the fact that triage had to be used several times in the tense situation of the clinics. Then the politicians tried to give the go-ahead. The doctors had talked to people living in the same region but did not accept the situation in hospitals, Prime Minister Mchael Kretschmer said. The argument was “too violent” in the choice of words: “In Zittau, in Saxony, in Germany, clear ethical and medical standards are being used at the moment. There are no special criteria for Covid-19.”
According to Kretschmer, the government has now responded to Zittau’s “wake-up call” and organized aid. Bundeswehr soldiers were to assist in Zittau by the end of the year and Health Minister Petra Köpping managed to organize the capacity for additional beds in hospitals and rehabilitation facilities.
