Why did free beds in TI collapse in the third wave compared to the second, in proportion to the number of Covid hospitalized? Germany had more than 9,000 free beds in TI in the first wave with 2,900 hospitalized with Covid, on April 30 there were 1,920 free beds in TI with 5,015 hospitalized-Covid.
IT nurses are highly skilled and it is not easy to increase the number. In 2020, among other things, hospitals and nursing homes for the elderly recorded the exit of approximately 9,000 IT nurses. We are in a decreasing trend, it is a profession with decreasing numbers. And this shortage is compounded by a new law introduced in Germany in 2020 with the Covid pandemic, which imposed a certain number of nurses per bed in TI, with a squeeze in 2021. We started with 2.5 beds per nurse from day and 3.5 beds at night but from January 1st of this year the law requires a nurse for 2 day beds and 3 beds at night, because Covid patients need more assistance. Thus also the electronic platform that we created to record the number of free beds in TI for Covid in hospitals in Germany on a daily basis had to adapt to these new provisions: and so the free beds collapsed. And that explains what happened between the first and second wave of the coronavirus and the third.
It is also for this reason that a light “triage” has begun in Germany, (weiche Triage), as said by prof. Michael Hallek in recent days at the much-followed Anne Will evening talk show appealing to politicians for a tougher lockdown?
I avoid using this term, “triage”, because I don’t think we are in this kind of situation in Germany for Covid. The triage concerns real catastrophes, such as battlefields in war, derailed trains, where a handful of doctors must intervene on a hundred seriously injured who risk dying. But it must also be said that to manage the shortage of IT nurses, some hospitals have been forced to plan their surgical operations differently to focus equipment on the Covid emergency. Hospitals must ensure that there are enough free beds in TI to hospitalize those infected with Covid, and this can be done because the forecasts are correct.
What do you mean? Is it possible to accurately predict how many Covid patients will be in TI in the immediate future?
Certainly. First of all, we know that a Covid patient takes an average of 14 days after being infected to seek treatment in IT. Then we know that about 1% of Covid patients need IT. So when we register 20,000 new cases in one day, we know that after 10-14 days we will need 200 beds in TI. To this we add that a Covid patient is on average more in TI than other patients: an average of 20-24 days, with peaks of 50-60 days. And this also reduces the free beds. Last year, 50% of Covid patients in TI died, and 100% aged 80 and over. To refine our predictions, we have created an ad hoc mathematical model for Covid that also takes into account the variants. And under this model, to keep the pandemic under control, we need to bring down the weekly incidence of new cases per 100,000 inhabitants. The lockdown prevents contagions. And save lives.
In addition to the weekly incidence per 100,000 inhabitants, to defeat the coronavirus there is also tracking with apps and tests, the Rt value, vaccinations …
The Apps do not work in Germany because the privacy law and the protection of the processing of personal data make this tool ridiculous for tracking. Rt… the point is that the contagion stops when there is no contact. No contact, no contagion. When the number of newly infected is high and remains high while vaccinations are still low, the number of ICU patients increase. Without vaccines, not if we were going out. But until the vaccine rate is high enough, there is only one system: lockdowns and containment measures where new cases are high.