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Intensive care unit for corona patients at Essen University Hospital: Doctors must have learned a lot from the first corona wave in spring
Photo: Fabian Strauch / dpa
Imagine arriving at Cologne Central Station.
You get off the train and the whole station is deserted.
Nowhere is a person to be seen.
You won't meet anyone in the forecourt of the station, either in the old town or on the Rhine.
The whole city seems wiped out.
This admittedly somewhat apocalyptic scenario is intended to illustrate how devastating the coronavirus has been so far.
According to the official version, more than 1.1 million people have died from or with the virus to date.
That corresponds to a little more than the Cologne population.
The actual death toll could be even higher, as the statistics from Johns Hopkins University in the United States probably do not include all cases.
The number of cases is currently rising again at a dizzying speed.
But even if the many new infections are currently worrying intensive care physicians, there is positive news.
According to some studies, fewer and fewer people with Covid-19 have died recently.
This also applies to Germany.
According to yesterday's management report from the Robert Koch Institute, 89 people died of the virus, and the value has risen continuously in recent weeks.
Although there were far fewer new infections in April, some days there were around 300 deaths.
In April as a whole, the number of deaths was ten percent above the German average.
Doctors from other parts of the world report similar things.
In a study, researchers determined the death rates in intensive care units in the UK for Covid patients for the period March to June.
In the high-intensity area, around 40 percent of the sick died at the end of March.
At the end of June, the survival rate was over 80 percent, writes John Dennis from the University of Exeter Medical School in the post published on a preprint server.
Data from almost 15,000 patients were analyzed for the study.
But why do more people survive even with serious illnesses?
The virus has not become less dangerous.
Corresponding speculations have since been rejected by many experts.
Age and gender also played no role in the British study: the researchers took factors such as the ethnicity of the patients into account in their statistical models.
Nevertheless, they come to the conclusion that the survival rate for all patients in the intensive care units has improved by around ten percent since the end of March.
A study from New York with more than 5,000 patients that appeared in the "Journal of Hospital Medicine" delivers a similar result.
The analysis of the data, which comes from three hospitals from March to August, showed: The higher survival rates are real, even if one considers differences in age, gender, ethnicity, pre-existing health problems and the severity of Covid symptoms (e.g. controlled by the oxygen content in the blood at the time of admission).
The death rate fell significantly from just under 25.6 percent in March to 7.6 percent in August.
"The data suggest that mortality from Covid 19 decreases even taking into account the patient characteristics," write the researchers led by Leora Horwitz, director of the NYU Langone Center for Healthcare Innovation & Delivery Science.
Nevertheless, the researchers limit the meaningfulness of their data.
The long-term effects of the virus were not recorded in the study.
Unfortunately, many patients suffer from the consequences long after they have suffered illness.
But there are probably a number of individual factors that play a role.
Intensive care physicians must have learned a lot from the first corona wave in spring.
How to treat the dangerous lung disease, when to give which medication - more is now known about all of this.
The main decisive factor was the capacity utilization of the intensive care units in hospitals in the summer compared to the previous peak of the pandemic in spring.
In New York, the health system was sometimes on the verge of collapse, and medical professionals were overwhelmed by the increase in patient numbers.
Doctors who had not worked in intensive care for years were called up to take care of seriously ill patients, and nursing staff and equipment were scarce.
In the meantime, however, there is also a better medical understanding of when people have to be ventilated and which complications such as blood clots and kidney failure should be observed, Horwitz told the New York Times.
Patients are now turned on their stomachs more often and are not supplied with mechanical ventilators straight away, but initially receive additional oxygen.
Since the summer months it has also been known that the drug dexamethasone helps patients on ventilators, i.e. with very severe Covid-19 courses.
The administration of this cortisone has meanwhile also been endorsed by the Federal Institute for Drugs and Medical Devices (BfArM).
In the course of the pandemic, doctors have also discovered life-threatening blood clots in some patients.
Such thromboses are counteracted by treating the patient with blood thinners.
Fewer viruses, less severe gradients
Another study, published in late September, suggests otherwise.
Researchers at Wayne State University in Detroit observed a decrease in viral load in smears from Covid-19 patients over the course of the pandemic.
Fewer viruses in the throat resulted in milder disease courses in the infected.
The researchers believe that this success can be attributed to wearing masks and following distance rules.
However, it remains to be seen what all these results are worth in times of rising infection rates.
Severe disease processes only become visible after a while.
Experts expect that the curve with the deaths will only rise after a time.
And in Germany the number of patients in intensive care units is increasing again.
According to the latest management report from the Robert Koch Institute, the number of intensive care beds occupied by Covid patients has more than doubled in the past two weeks from 655 patients to 1,696 patients on Thursday.
The data clearly shows one thing: Overloading the health system in Germany and everywhere else in the world should absolutely be prevented.
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