What Germany can learn from the emergency

Belgium was already one of the countries most affected by Corona in spring. Now, the numbers in the neighboring country are increasing again dramatically. What could that mean for Germany?

Over 18,200 new infections in one day with just 11.5 million inhabitants: Belgium is currently being hit by a second corona wave. Scientists suspect that the development could also be transferred to Germany. What would that mean for our healthcare system?

What is the current situation in Belgium?

So far (as of October 26, 2020), according to Johns Hopkins University, there have been a total of more than 321,000 confirmed coronavirus infections in Belgium, most of them in the provinces of Liege (Liège), Brussels and Hainaut (Hainaut ). More than 10,800 people died from Covid-19 in our neighboring country. The death rate is one of the highest in the world, according to Johns Hopkins.

A new record for new infections was calculated for October 20, and 18,217 people in Belgium were demonstrably infected with SARS-CoV-2 that day. The Sciensano state health institute recently reported a 44 percent increase compared to the previous week.

As “tagesschau.de” reports, 585 new corona patients had to be admitted to Belgian clinics on October 24 alone. Some of them need to be treated in the intensive care unit. In addition to crownless patients, this would create an “extreme burden” on hospital staff, and conditions such as spring are feared in Italy. According to Sciensano, there are currently 4,827 Covid patients in the Belgian hospital, 757 of them in intensive care.

These numbers are still slightly below the spring level, but the curve is rising sharply here as well. However, as “spiegel.de” reported, many of the doctors and nurses are now infected or in quarantine. The magazine quotes the president of the Belgian medical union federation as saying that health professionals who test positive are asked to work anyway, as long as they do not show symptoms. 87 percent of hospital capacity in Belgium was already full last week.

In the fight against the pandemic, a further tightening of rules in the Brussels region went into effect on October 26. There is now a mask requirement everywhere, the nightly curfew starts at 10pm instead of midnight.

How have the numbers developed in Belgium?

While the number of infections in Belgium was not extremely high in spring, the neighboring country was particularly notable in March / April with particularly high mortality rates. On the worst days in Belgium in early to mid-April, more than 250 people died from the coronavirus every day. However, the number of infections only ranged from 1,500 to 3,000 new infections each day.

Mask requirement in Brussels: Belgium is severely affected by the corona pandemic for the second time. (Source: Xinhua / imago images)

The number of infections has risen sharply since the beginning of October, while the number of deaths remains below the spring level. With more than 18,000 new infections each day, the death rate is currently less than 50 per day. At the same time, however, the number of patients to be treated in the hospital has increased at the same rate as in the spring.

How does the situation in Germany compare?

Basically you have to consider that Germany has more than seven times more inhabitants than Belgium. Compared to Belgium’s highest daily rate of new infections of more than 18,000, the Robert Koch Institute reported the highest daily value to date on October 24 with comparatively “only” 14,714 new infections. Looking at the total number of infections, it is also clear that Belgium has almost caught up with Germany despite a significantly smaller population: there have been more than 321,000 confirmed SARS-CoV-2 infections in Belgium, while there are slightly more in Germany. according to Johns Hopkins University. than 443,000.

Reinhard Busse is director of the Department of Health Management at TU Berlin and co-director of the European Observatory for Health Systems and Policies. In mid-October, the scientist made comparisons with the development of the crown in Germany and other European countries. Belgium also served as an example. Initially, it looks at the beginning of the pandemic, when there were a particularly large number of Covid 19 patients in many countries who had to be treated in hospitals. In Germany there was a hospitalization rate of about 20 percent at the time, and one in five of these patients required ventilation, Busse said.

Mask requirement in the city center of Liège: The city of Belgium was particularly affected by the corona pandemic. (Source: ANP / imago images)

In order to be able to make a comparison with Belgium, Busse focused mainly on the seven-day incidence. In the last nine weeks, Belgium has risen from 27 new infections (per 100,000 inhabitants in one week) to 209 in the first and finally to 412 in the second week of October. The 14-day incidence is now 1,288 and has therefore increased by 220%. The numbers would have multiplied by thirteen in seven weeks, Busse explains.

However, as of mid-October, the seven-day incidence in Germany was still in the early 30’s. Belgium is particularly interesting for a comparison with Germany because in early September there were similar values ​​to Germany in mid-October. On September 8, Belgium had an incidence of 32.

For a better comparison, the scientist also looked at how many of the new patients in other European countries such as Belgium should be treated as inpatients. You can see “that currently in all countries the percentage of newly infected people who are hospitalized is only about three to six percent.” One reason for this is, of course, the age structure, which does not explain “most of it is just very different.”

In addition to the new infections, Belgium also treated a similar number of Covid patients in intensive care units in early September, as did Germany in mid-October. “In this sense, I would say that if we want to anticipate what awaits us, we can compare ourselves with Belgium,” concluded Busse. “And then you can see that in the following weeks, that is, in the five weeks after Belgium and the Netherlands had numbers as high as we have today (mid-October), hospital cases have multiplied by six and eight respectively. cases of intensive care by a factor of five or six. “

Would our healthcare system be overwhelmed by an increase in the number of infections like in Belgium?

If the Belgian figures for mid-October are transferred to Germany, there would be around 16,000 Covid patients in this country’s hospitals. “We have almost 500,000 beds, that is, three percent of our hospital beds. And there would be 2,700 intensive care patients, that is, less than ten percent of our intensive care beds and still a few fewer than we saw in April. Now we have a completely different number dynamic, “explains Busse. But he also warns: “But of course, if it increases indefinitely, the beds will fill up more and more.”

For the moment, Germany would not be directly overwhelmed with numbers as in Belgium. However, it should also be noted that it is not only the number of sick and intensive care beds that is decisive, but also the workload of the staff. This is also criticized, for example, by the well-known nurse and doctor Alexander Jorde on the news portal Twitter:

And the current daily report (as of October 26, 2020) from the register of the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) shows: nearly 1,400 Covid-19 patients are currently in intensive care, 622 of whom are ventilated. That’s 191 new patients compared to the day before. A total of some 30,000 intensive care beds remain 8,400 free, in addition to an “emergency reserve” of about 12,000 beds that may be available in a week. At the moment, it does not seem problematic in Germany, at least when it comes to the capacities of the hospitals. However, if the numbers continue to rise as strongly as in recent weeks, the German healthcare system could also reach its limits.