With the Omicron variant, the number of corona infections has reached hitherto unknown heights. The Robert Koch Institute (RKI) reports a new record high almost every day, also for the Ebersberg district. In relation to this, the number of corona patients in the clinics is quite manageable: on Wednesday morning the clinic reported 25 patients being treated with a corona infection – two of them in the intensive care unit. But is the situation in the clinic really as relaxed as it might seem at first glance? The SZ asked and spoke to Viktoria Bogner-Flatz, chief physician of the central emergency room (ZNA), and Daniel Plecity, head of the corona ward and senior physician of the Medical Clinic I department in the internal medicine department.
None of the two reports the all-clear. But first the good news: The admission of corona patients to the normal ward or the corona ward that has existed since the pandemic is slowly increasing again, after the number had recently fallen. But the previous highs of up to 40 Covid patients are a long way off. And the breakthroughs to the intensive care unit are still limited. “It was completely different at Delta,” says Bogner-Flatz. This is also confirmed by Daniel Plecity from the Corona station. During Delta times, he saw two to three times a week that the state of health of his patients was declining rapidly within a short period of time and that they had to be transferred to the intensive care unit – currently he has only had one such case in the past few weeks.
Delta also initially had little effect on the intensive care unit
But what is not, can still be – and that’s the bad news. “It is quite conceivable that we will have to treat more patients in the intensive care unit again in the future,” says Bogner-Flatz. Because at Delta it was also the case at the beginning that the normal wards were full at first and the situation only arrived in the intensive care wards after a while. “Time will show.” The 40-year-old suspects that this will probably not happen, since the increasing vaccination rate protects more and more people from a serious course of the disease. “But the pandemic has really tricked us a few times in terms of predictions.”
Daniel Plecity has been in charge of the Covid ward at the Ebersberg district clinic for two years now.
(Photo: District Clinic Ebersberg)
Daniel Plecity therefore prefers to be more pessimistic in his calculations and, when in doubt, allows himself to be pleasantly surprised than the other way around, as he says. He could imagine that the current number of Covid patients will double from 19. Then it would be as many as at the peaks of the delta wave in early December last year.
But even if this does not happen, there is no sign of the situation easing – because the patients are still in the Corona ward for an average of three to five days, and sometimes seven days in severe cases, says Plecity. And in the intensive care unit you have to reckon with a stay of around 20 days. A lot of time in which the corresponding supply capacities are tied up. In addition, the discharge of patients from nursing homes is often difficult if the corona test is still positive – although the state of health would no longer require inpatient treatment. “Logistics is often a problem, causing inpatient stays to be delayed.” Also something that ties up resources.
More and more clinic staff are absent due to an infection or a Covid contact
There is also a shift in the problem situation. Because the extremely high general infection situation creates two new challenges. On the one hand: Staff shortages due to Covid-positive employees or those who have to go into quarantine as contact persons are increasing. So far, the failures have been manageable to some extent, says clinic spokeswoman Katharina Ober, but only because of the outstanding loyalty of the employees who stand in for each other. “Nevertheless, it is a feat of strength and an enormous burden for the college.” If at some point it is no longer possible to compensate for the shortfalls, this would result in a reduction in the number of beds and thus the number of patients who can be admitted and treated in the clinic. However, such a scenario is still a long way off, as Ober emphasizes. “But no one can say with certainty what will happen next.”
Viktoria Bogner-Flatz has been in charge of the central emergency room at the Ebersberg district clinic since the beginning of the year.
(Photo: district clinic/oh)
And the other problem: “Patients no longer come only because of Corona, but more and more often with Corona,” says Bogner-Flatz. So: The reason for the admission to the hospital is the probably broken arm after a bike fall – and in the clinic a corona infection is then found as an additional finding. All patients are tested for the virus upon arrival at the clinic. Bogner-Flatz calls such cases silent or silent infection, because those affected often have no symptoms at all due to their vaccination. “For us, this means that we have patients in all departments who are required to be isolated,” Bogner-Flatz continued. The care of corona patients and thus the great effort that isolation requires is no longer limited to the Covid and intensive care units.
This not only poses a logistical challenge, but also a medical one, as Plecity explains. Because if a patient comes to the clinic because of an acute illness such as a stomach bleed, for example, and then a corona infection is found there, questions have to be answered: How serious is his infection? What is the risk that he will develop a severe course? And how bad is his actual illness? Ultimately, it is a question that Plecity formulates as follows: “Can we devote ourselves entirely to the admission diagnosis – or will the corona infection soon be the patient’s much bigger problem?”
Despite a certain routine, it is still bad when a Covid patient receives a bad prognosis
And how are the clinic staff doing with all these new difficulties? After two years, in which all employees in clinics have been asked to be extremely flexible and work hard, a certain routine has set in, says Bogner-Flatz. “But if a patient ends up in the emergency room unvaccinated and seriously ill and his prognosis is catastrophic, then that’s still bad for us – every single time,” the emergency doctor continues. “And all the more so because in most cases the situation could have been avoided with a vaccination.”
In addition, Corona is not only present at work, but also in private life – just like with everyone else. Especially when you have small children at home, the pandemic is already exhausting, says Bogner-Flatz. “And then we go to work and there, too, we get the topic knocked around our ears non-stop.”