Munich clinic boss warns after two years of Corona: "People are not unlimited resilient"

Created: 01/24/2022, 14:03

By: Andreas Beez

The long-standing corona pandemic is pushing the staff to their breaking point.

© Sebastian Gollnow/dpa

Almost exactly two years ago - on January 27, 2020 to be precise - Germany's first corona patient stood at the door of the Schwabing hospital.

In the meantime, the specialists at the city hospitals have treated around 3,700 patients with Covid-19, including the most severe cases.

They shouldered what felt like one feat after the other, in extreme cases more than 100 employees fought together to save the life of a single Corona* patient.

Munich Clinic boss Dr.

Axel Fischer in an interview with our newspaper:

Your employees have been working in crisis mode for two years.

How else can you motivate nurses and doctors?

dr

Axel Fischer:

I've been asking myself this question for a year now - and I admit: It's getting more and more difficult, also because of the mistakes in the vaccination campaign.

Colleagues are simply frustrated because the fourth wave could have been prevented to this extent if more people had been vaccinated.

We have not managed to convince a larger proportion of the population of this.

Perhaps a further drifting apart of society can be prevented with a mediation proposal.

What might this proposal look like?

On the one hand, I think it makes sense for large parts of the population to be vaccinated.

However, only until the pandemic* becomes endemic and there is no longer a risk of our healthcare system being overloaded.

By the time we get to that point, we need most of the population, not just individual groups such as nursing home and hospital workers.

Otherwise we won't get the pandemic under control.

Compulsory vaccination for everyone would be more effective than compulsory vaccination for a facility or job – but only for a limited period of time.

“Some still hesitate to get vaccinated because of previous illnesses”

If vaccinations become mandatory, how many unteachable employees will you have to lay off?

Fortunately none at all, the health department would have to issue a possible ban on employment.

I'm glad that we as employers didn't have to make this decision for the time being.

Clinic boss Axel Fischer fears staff shortages.

© Goetzfried

How high do you estimate the proportion of stubborn vaccination refusers among your employees, in some clinics there is talk of up to 20 percent?

I believe that the number of people who refuse to vaccinate is well below ten percent.

Some still hesitate to get vaccinated because of previous illnesses.

In the end, maybe two or three percent will remain.

If these employees cannot be persuaded to vaccinate even with the best arguments, then unfortunately we will have to part ways.

It's the same in all clinics.

However, it is imperative that we design our hospital landscape in such a way that we can solve such personnel problems.

But the need is already great...

That's correct.

We currently have around 200 vacancies, and we are bridging around 100 with external employees from temporary employment agencies.

A total of ten percent of our employees planned in the position plan are missing in nursing.

The percentage doesn't sound that high.

However, the problem also lies in the fact that there is a lack of employees in critical specialist areas, such as intensive care, child care or neonatology.

"More effective than a job-related vaccination requirement would be a vaccination requirement for everyone - but only for a limited period of time."

Munich clinic boss Dr.

Axel Fischer

Have other employees thrown in the towel because of Corona?

We see no mass exodus.

But I do believe that Corona has caused the camel to overflow for some employees.

It is noticeable that more and more employees are reducing their working hours due to the enormous physical and psychological stress.

It is difficult to make up for the missing hours by hiring new workers, because the job market in nursing is empty.

Little by little, the workforce is getting a little smaller.

It is imperative that we stop this negative trend.

Especially since Omikron is driving up sick leave at the same time.

“We already had a dramatic wave of infections at the beginning of the year”

How hard does the variant hit the clinics?

At the beginning of the year we already had a dramatic wave of infections, more than 200 employees were in quarantine because of family contacts or were ill.

I hope and do not believe, however, that the failures will continue to this extent or even increase.

My biggest concern are areas with comparatively few staff, but which are very important for the hospital infrastructure.

If, for example, more employees in certain laboratories, in sterile supply or in logistics departments are absent, we have a huge problem.

What will they do then?

Of course, we have corresponding crisis plans in the drawer and updated them again last time around Christmas.

But if too many employees are absent, even the best organization will no longer help - even if you use external employees.

Then we need help, for example from employees from less busy clinics.

In South Africa, Omicron infected people are allowed to work.

Would that also be conceivable in Munich?

We didn't let infected people work in any wave.

As things stand at present, that would be irresponsible.

It is different to shorten the quarantine times after contact.

Maybe for five days - like in Israel.

During the first corona wave, however, this emergency solution was already in place with an exemption from the health authorities.

Maybe, but I don't think we're going to get into such an emergency situation that we'd have to take this step.

After all, the utilization of the intensive care units is currently limited - apparently due to the many comparatively mild courses in the Omicron variant.

“We are right in the middle of the omicron wave”

Is the worst behind us?

No, not yet.

We are right in the middle of the omicron wave.

We notice that the number of hospital admissions to the normal wards is increasing again.

The rate of severe cases will be lower than Delta, but given the mass of infections, the situation can still become difficult again.

On the other hand, Omikron could also be a kind of motivational boost for all of us, because the courses of those who have been boosted are usually milder than those of Delta.

For once we have to hold out for a few more weeks until we hopefully get over the worst in the spring.

But there could be new variants.

Don't you see the danger that next autumn we will face problems similar to those we are currently facing?

You asked me that question a year ago.

At that time I said that we will continue to have corona patients in the autumn - but not as many.

I believe in that this time too, I remain an optimist.

Fight for life and death: the Covid intensive care unit in the Munich clinic.

© Peter Kneffel/dpa

Where do you draw this optimism from?

I trust the assessment of leading scientists that we will soon emerge from the pandemic into an endemic.

To put it more simply: When Omikron is through, hopefully the worst should be over.

For the clinic staff, however, this is when the real work begins.

Many doctors and nurses are already walking on the gums

How long will it take for everyday hospital life to return to normal?

After the first two corona waves in 2020, we found that it was difficult to immediately switch to normal clinic mode.

It's usually the same employees who are under a lot of strain.

For example, the colleagues in the intensive care unit.

They are also needed again to carry out major operations - especially those that had to be postponed because of Corona.

But many doctors and nurses are already walking on the gums.

I know!

People are only resilient up to a certain point.

We have to be very careful now.

We will not be able to speak of a normal year in the Munich Clinic in 2022.

It will take at least two or three years for the situation to normalize again and for everything to re-establish itself.

We now have to clean up the shards that have been caused by Corona.

What lessons do you draw from two years of the corona pandemic?

Completely different. On the one hand, the pandemic has shown how important the large hospitals with maximum care are, which have all specialist departments under one roof. The most important finding is that you have to join forces. As a healthcare system, we have proven that we can handle a pandemic. If you are honest, you also have to realize that the pandemic has confirmed that many hospitals do not automatically mean a lot of quality and that in the end the burden is less on the shoulders. Socially, I think that we were all supported and motivated by cohesion during the crisis. You could feel that. Conversely, it is all the more frustrating when a society drifts apart, as with vaccination. That can be demotivating. As a human I ask myself the question:How long can you endure such a permanent crisis?

Are you surprised that you haven't gotten any corona so far?

Yes, because the impacts in my circle of friends and acquaintances are getting closer and closer.

I sometimes feel like I'm in the middle of a hail of bullets and I'm always trying to dodge.

But I'm realistic enough to know that it will probably get me too.

I hope then that I get off lightly with my booster.

Nevertheless, I would of course be happy if I stayed healthy and try to behave as best I can.

I don't want to have the experience of a corona infection - especially because of the possible long-Covid consequences.

No doctor can yet say what it meant in the long term if you had Corona.