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Entertainment Clinic chief on the situation in the intensive care unit - and why he thinks that corona easing on New Year's Eve is wrong

21:25  30 november  2020
21:25  30 november  2020 Source:   businessinsider.de

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More and more Covid-19 patients with a difficult course end up in the hospital - and also in the intensive care units. That is why the German Society for Anesthesiology and Intensive Care Medicine (DGAI) recently warned that it would soon reach its limits. On average, only three beds per hospital are free nationwide.

Jochen Werner is Medical Director of the University Hospital Essen . He says his hospital is quite busy, but the situation is still under control. In an interview, he explains to Business Insider what happens when all intensive care beds are occupied and why he believes it would be wrong to relax the measures to celebrate New Year's Eve.

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Business Insider: Prof. Dr. Werner, what is the current situation at the University Hospital in Essen?

Jochen Werner: Overall, the Essen University Medical Center has 1,770 beds. Today 156 intensive care beds were operational, of which 145 were occupied. This corresponds to a utilization of 93 percent. In addition, there is a reserve of over 50 beds that could be mobilized within a few days. So the situation at the Essen University Medical Center is tense, but under control.

BI: How busy are intensive care physicians and nurses?

Werner: So far, doctors and nurses have been working with the usual staff in intensive care units. These were also selectively strengthened with staff, which was created by reducing operational capacity. However, the workload is higher due to the current circumstances - isolated patients, protective clothing, high number of extracorporeal procedures to support the lungs - than under the conditions without Covid-19 patients.

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I think we can understand our situation – and what might lie in our future – by looking at other crises. My research focuses on the fundamentals of the modern economy: global supply chains, wages, and productivity. I look at the way that economic dynamics contribute to challenges like climate change

Fortunately, the total number of Covid-19 patients at the Essen University Medical Center has decreased somewhat in the last few days. As of today, we are treating 116 corona cases, the peak was 137 patients on November 19. However, the proportion of patients requiring intensive care is still high. This is currently 40 people. The peak was 45 patients on November 26th. The pooling of resources naturally also has an impact on the treatment of patients with other diseases. Here, too, we see an increasing burden on the staff.

BI: Could there be a bottleneck in the university hospital?

Werner: Akut, there are eleven free intensive care beds available today, for which material and staff would be available immediately. Further beds could be made available with different lead times - a few hours to a few days. At the University Medical Center Essen, we work with a flexible system that controls bed and treatment capacities according to the number of Covid-19 patients. From today's perspective, the mere number of beds is not a critical scarce resource - it is rather the lack of appropriately trained medical staff.

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BI: How many beds could be made available in an extreme case?

Werner: In extreme cases, around 50 additional beds are available, and in an emergency there would be monitoring and ventilation options in the recovery rooms.

BI: In your opinion, is the current “lockdown light” sufficient to survive the Christmas holidays?

Werner: At the moment we see a stable situation. Nevertheless, from a medical point of view, we have to further reduce the number of new infections, because no clinic can work at its limit in the long term. Stress quickly turned into overload. Contributing to this is that the number of deaths in connection with Covid-19, especially older patients, is increasing alarmingly.

It is the severely corona patients who put the hospitals under increasing pressure and endanger the no less important treatments for patients with other types of disease as a side effect. Under no circumstances should this situation go out of the public eye. The possible easing for Christmas announced by politicians will be reconsidered depending on the new infection rate in mid-December. I think a relaxation for New Year's Eve celebrations is wrong.

  Klinikchef zur Lage auf der Intensivstation — und warum er Corona-Lockerungen an Silvester für falsch hält © Provided by Business Insider Germany UK-BI-Prof. Werner 10-2020 © Universitätsmedizin Essen UK-BI-Prof. Werner 10-2020

Christmas in the ICU: Decorations, lights and many tears .
OPELIKA, Ala. (AP) — A Christmas tree stands outside the intensive care room where a man stricken by COVID-19 lies unconscious, a machine breathing for him. A few feet away, a plastic snowman adorns the door of another patient whose face is barely visible behind ventilator tubes. The decorations are "a way to let family members know that we’re trying, and we love these patients and we want them to feel like it’s Christmas as much as we can,” nurse Carla Fallin said, standing just outside one of the rooms at East Alabama Medical Center.

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This is interesting!