A few days ago, those responsible in the Bayreuth district hospital pulled the emergency brake and imposed a three-day admission freeze in the clinic for psychiatry, psychotherapy and psychosomatic medicine. 81 employees from the nursing and educational service were on sick leave – too many to keep up the admission of new patients. For the first time in the corona pandemic, the operators were forced to take such a drastic step. Even emergencies, such as people who are acutely suicidal, should have been sent to other houses in the meantime – the clinic does not know how many were actually affected. In the meantime, the situation has stabilized, and since last Monday it has been possible to take care of new cases again, says a spokesman for the health facilities in the Upper Franconia district. “But we continue to monitor the situation with great concern.”
The concerns are great, not only in Bayreuth. Almost all Bavarian hospitals are under pressure in this corona summer wave. Above all, staff shortages are causing problems for the facilities, the Bavarian Hospital Society (BKG) estimates that up to 15 percent of employees in Bavaria are unable to work – due to illness or quarantine. A few months ago it was the intensive care units that caused the most stress in the clinics, but now it is often the emergency rooms.
The RoMed-Klinikum in Rosenheim, Upper Bavaria, for example, has repeatedly had to log out of its emergency room – the largest and most important in south-eastern Upper Bavaria. Because two to three times as many employees are sick as usual at the moment, the clinic has not been able to take in any new emergency patients for almost a third of the time in the past few months, says RoMed Managing Director Jens Deerberg-Wittram. This is extremely unusual for a house of this size and importance. At normal times, i.e. before Corona, the Rosenheim emergency room was available around the clock, according to Deerberg-Wittram, and the cancellation rate was just 0.65 percent.
“The ambulance will come safely”
The problem affects houses throughout Bavaria and has long since reached the emergency services. “The ambulance will come safely. We bring the patients into the ambulance, but it’s currently difficult for us to get them out of the car again,” says the medical director for the ambulance service in the Rosenheim area, Michael Städtler. The ambulances often have to travel long distances to distant clinics with correspondingly stable patients and are therefore available later for the next assignment – and that with the general increase in the number of emergencies in the region.
According to RoMed boss Deerberg-Wittram, the fact that more patients end up in the emergency rooms also has to do with the fact that many general practitioners are ill themselves or are left without practice staff – patients are then sent to the clinic. Deerberg-Wittram explains that the staff shortage due to Corona is so great that a PCR test has to be carried out in the clinics at least twice a week, while in other areas infections are no longer detected due to a lack of tests. That is why he considers the officially reported corona incidence – most recently the value for all of Bavaria was almost 800 – to be far too low.
“We didn’t expect to run into such supply bottlenecks in the summer,” says Roland Engehausen, Managing Director of the Bavarian Hospital Society (BKG). The “summer slump” of the past two Corona years did not materialize this time. Not only is the incidence far higher than in the previous year, the number of weekly hospital admissions related to Covid also rose sharply in July, to 1400 most recently.
In order to take the pressure off the heavily loaded emergency rooms, Engehausen is now appealing to all patients to only go to the hospital in real emergencies. For “trivial treatments” one should visit the on-call services of the established doctors. But especially during the holiday season, the staffing situation is also tense among general practitioners.
The staff not only falls ill with Corona, but also with chronic diseases
Holidays, which the employees in the hospital system desperately need, says Robert Hinke, Head of Health at Verdi Bayern. But again, nurses would have to postpone holidays to compensate for the shortage. “Many simply can’t take it anymore,” emphasizes the trade unionist. He describes the example of a rescue service driver who has been on duty for weeks up to 15 hours a day and is now absent for months due to a mental illness. More and more medical staff would become chronically ill, says Hinke. “We are dealing with a parallel world. While people live outside as if the virus no longer exists, the situation in the clinics is getting worse and worse.”
What could help the clinics at the moment, clinic boss Deerberg-Wittrams and BKG managing director Engehausen agree, would be central hospital coordination like at the time when the pandemic was officially considered a disaster. Then private clinics would also have to participate in emergency and Covid care. Can another corona emergency be averted in autumn and winter? “The staff expects everything,” says Verdi’s Hinke. That doesn’t sound confident.