The traffic light is red. Even in the Freising Clinic, unvaccinated corona patients keep doctors and nurses in suspense - with drastic consequences for many.
The hospital traffic light turned red in Bavaria on Monday.
The FT has worked with the Corona officer of the Freising Clinic, Dr.
Christian Fiedler, spoke about the consequences of this development.
For example, that people who urgently need an operation are often currently unable to be treated.
Dr. Fiedler, the hospital traffic light system was introduced a little over two months ago. Would you have thought that the traffic light would turn red so quickly?
I'm not surprised that the traffic light switched to red in November because the vaccination rate in Germany is still too low.
This is now also evident: there are currently only unvaccinated patients in the intensive care unit.
However, there was an extremely massive increase in the past week that was not to be expected now.
Have you only had unvaccinated corona patients in intensive care so far?
Almost only.
Vaccinated corona patients are actually only in intensive care with us if they are there because of another ailment and also have corona, or if their immune system is extremely weakened in cases of transplant or chemotherapy patients.
Are all of your intensive care beds occupied?
Yes.
If we were now asked whether we could still take in a corona patient, we would have to answer that all intensive care beds that we can care for are full.
Corona patients are in the intensive care unit significantly longer than other patients.
Dr.
Christian Fiedler
What if a patient just walks into the emergency room with severe symptoms?
Then we will certainly not send him home.
But then we have an overcrowding with the corresponding burden on the staff.
What consequences does the red light have for the hospital?
We do not impose a ban on visits like other clinics, but from now on, 2G and FFP2 masks are mandatory for visitors in the hospital.
The full occupancy of the intensive care unit also has consequences for other sick people. You will probably have to postpone so-called predictable operations again, right?
Unfortunately, we've had to do that again for weeks.
This is a daily balancing act.
Because if I admit a patient and want to operate, he of course needs a bed afterwards.
If I don't have a bed, I simply can't operate on it.
And it gets really complicated when the patient might need an intensive care bed.
Because ventilation is not only necessary in severe corona cases, there are also repeated operations that require re-ventilation of the patient.
In which operations, for example?
For operations in the abdomen or on the lungs.
(By the way: Everything from the region is now also available in our regular Freising newsletter.)
How should you imagine if you postpone operations - do you then call the affected patients and tell them off?
That would be the most pleasant option.
In these cases, however, it is usually the case that the patients are already in the hospital because the operation is planned at 9 o'clock, then wait all day soberly until someone tells them in the evening: "It won't work.
Let's try it again the day after tomorrow. ”That also depends on the severity of the suffering.
In critical cases, of course, we also act when we actually have no capacity.
But everything that can be moved somehow fails.
Only: at some point, the cases in which I can still say today that I can still perform the operation in a few weeks' time will also become acute.
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"Vaccination rate too low": Dr.
Christian Fiedler is Corona officer at the Freising Clinic.
© Freising Clinic
There have already been reports that cancer operations had to be postponed because an unvaccinated corona patient needed the intensive care bed.
These are extreme cases.
You don't have to blame everything on Corona and unvaccinated people.
In principle, the house is not only full because of corona patients, but it is full overall.
Overcrowding has also existed in the past.
But Corona comes on top - and demands staff and other capacities.
And corona patients are also in the intensive care unit significantly longer than other patients.
It is customary to come down from intensive after about a week at the latest.
Corona patients are sometimes in intensive care for eight weeks.
For the five patients we are currently ventilating, discharge from the intensive care unit is also not in sight.
There are currently a total of 17 corona patients in the clinic. Who actually decides whether an infected person has to go to hospital?
The patient decides for himself. He comes to the emergency room because he feels sick or cannot breathe easily.
Ultimately, you have to be very restrictive in the current situation and you can really only accept those who absolutely need a hospital.
We currently have to send about a third of the corona patients home.
A few weeks ago we could be even more generous.
There were still so many beds free in the isolation ward that an elderly lady was admitted if she suffered from Corona - even if the clinical stay was perhaps not absolutely necessary.
Now you have to think carefully about each one: do we have to keep them here?
A bad feeling for both sides.
It doesn't feel comfortable to send someone home again.
In terms of responsibility, it would be much easier and better to take someone in, watch them for a few days and then hopefully send them home.
We currently have no vaccinated people in the hospital because of Corona.
Dr.
Christian Fiedler
So how do you currently decide who needs to be admitted?
That depends on what the X-ray looks like and the oxygen saturation.
In other words, the twelve patients who are currently in the isolation ward are really sick?
Those who come because of Corona are doing badly.
Indeed, the unvaccinated are also.
Are they worse off than those who have been vaccinated?
We currently have no vaccinated in the hospital because of corona.
But there are always vaccinated people who come to the isolation ward.
These are multimorbid, mostly elderly people.
In other words, patients who come because of another ailment and for whom the obligatory corona test as part of the admission has a positive result.
They have no corona symptoms, but still have to go to the isolation ward due to the risk of infection and therefore appear in the statistics.
And then there are cases in the elderly where the corona protection has waned because the vaccination was six months or more ago.
And how are they?
They have symptoms, but not so severe that one should fear for their lives.
That was very different in the first two waves.
A corona infection in an 80-year-old often amounted to a death sentence.
This also shows that there is a clear difference between those who have been vaccinated and those who have not been vaccinated.
It takes months before those affected are back at almost 100 percent of their capabilities.
Dr.
Christian Fiedler
How are the five corona patients who are in the intensive care unit?
They all have to be ventilated. Some of them have been there for four or five weeks - with no end in sight. The interesting thing is: Often these patients have already survived the first virus surge in the isolation ward. The reason that they still have to be ventilated is due to an overreaction of the immune system. That means: The virus spreads in the body, attacks the lungs, is then repelled, but the body reacts excessively. With affected patients, you have to do the opposite of what you would actually assume: You have to weaken the immune system because the body itself damages the liver, kidneys and lungs. What you also have to say: Mechanical artificial ventilation is an immense physical strain that also damages the organs.
Anyone who spends several weeks in intensive care under such stress must still be completely exhausted afterwards. He can't just go home, can he?
There's no way it's going home.
The patients remain in the normal ward for weeks after they have been discharged from intensive care.
This is usually followed by a few months of rehab, and at home it also takes months before those affected are almost 100 percent efficient again.
An infection should therefore be avoided as far as possible.
I don't want to have a serious corona disease.
The defense against the vaccination is waning and is now hitting the fourth wave.
Dr.
Christian Fiedler
How many patients can you ventilate?
We have twelve ventilation stations in operation.
But we would have more beds available - if we had the staff.
In the meantime, we were only able to operate ten beds due to frequent sick leave among the staff.
They have reported that the vaccination wears off in the elderly. Do you fear more vaccination breakthroughs in the coming weeks?
Caution!
A vaccination breakthrough occurs when someone has just been vaccinated and should actually have defenses, but no antibodies are formed.
We recently had a case like this in the clinic.
As a rule, however, we are dealing with patients who have lost their vaccination protection.
That is why there are now more positive cases again in old people's homes.
The defense against the vaccination is waning and is now hitting the fourth wave.
That means: You should have started the third vaccinations earlier.
In retrospect: yes.
But there are also two good pieces of news.
Firstly, no newly infected nursing home residents had to go to hospital because the protection is apparently still large enough.
And secondly, the third vaccination in the Freising district has already been carried out in all retirement homes.
This is not the case in every district.
But it's true: You really have to step on the gas with the booster vaccination.
Because many who were initially vaccinated are now at risk.
