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Doctors assume that the number of Covid-19 intensive care patients will continue to rise until January. Now they are calling for a triage regimen where doctors must decide who to help first..
In Germany’s intensive care units, the situation in the corona pandemic will remain extremely tense in the coming weeks, regardless of the current lockdown. Uwe Janssens, president of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), told a virtual press conference that there will be a “continuing borderline situation in intensive care units” until January. The main problem is not a lack of intensive care beds, but a shortage of staff.
Intensive care doctors expressed concern about how the situation could develop after Christmas. The numbers in intensive care units would continue to rise, “no matter how well the closure works,” said spokesman for the DIVI intensive care registry, Christian Karagiannidis. They estimate around 6000 patients, and therefore around 1000 more than at the moment. Doctors hope that after this increase, the numbers will fall again due to the current lockdown, Karagiannidis said.
Legal regulation is required for triage
Steffen Weber-Carstens from Charité Berlin emphasized that currently there is no so-called triage situation in Germany. This also applies to Saxony, where the number of infections is particularly high today. However, from there, patients would be transferred to other federal states, Weber-Carstens said, for example to Mecklenburg-Western Pomerania.
Triage is understood to mean when physicians have to decide which patients they prefer to treat with limited medical capabilities. In the case of corona patients, doctors would have to decide who should hook up a ventilator first and who shouldn’t.
DIVI President Janssens has called for legal regulation for triage situations in the crown pandemic. The current legal uncertainty “is not easy to bear” for doctors. If it were necessary to prioritize patients, physicians today would have to make decisions based on a multiple-eye principle, but “at worst based on intuition.” Janssens complained that in case of a decision there may be criminal consequences, in extreme cases this leads to the inability to act. That is why DIVI recommended creating legal security here.
“Reduce contacts at Christmas”
Intensive care doctors urged the population to limit contacts during Christmas as much as possible. People should celebrate Christmas as little as possible, Janssens said. It will be a “very hard Christmas” for the nursing staff at the clinics. Janssens was also convinced that all crown patients could be cared for in Germany.
Laying on the cloverleaf principle
According to doctors, the nationwide transfer of intensive care patients according to the clover leaf principle is now activated. Several federal states together each form one of the five cloverleaves as separate planning units. The two most populous states, Bavaria and North Rhine-Westphalia, each form a separate sheet. The concept, developed since April, is intended to help overburdened regions and hospitals by moving groups of patients to other locations.
