More severe cases of Covid-19 Bonn hospital faces shortage of intensive care beds over Easter

Bonn · Intensive care units in the city could reach their capacity in a very short time. One hospital in Bonn has already issued a clear warning. Doctors are increasingly dealing with the variant that was first found in the UK. They are observing more severe progression of the disease in 40- to 60-year-olds.

 Randolf Forkert is head of the intensive care unit at Johanniter Hospital: "We are now increasingly dealing with the UK variant of the coronavirus, where we are seeing more severe progressions in the disease."

Randolf Forkert is head of the intensive care unit at Johanniter Hospital: "We are now increasingly dealing with the UK variant of the coronavirus, where we are seeing more severe progressions in the disease."

Foto: Benjamin Westhoff

Just ahead of the Easter holidays, the intensive care units of Bonn's hospitals are already feeling the strain. Chief physician of the Johanniter Hospital, Yon-Dschun Ko, said that they will "probably reach their capacity limits over Easter". A statement from the Gemeinschaftskrankenhaus Bonn (Community Hospital Bonn) with hospitals Sankt Petrus and Sankt Elisabeth read: "If the current trend of case numbers and especially of severe progressions (of the virus) continues, it is quite likely that the available intensive care places will shrink.”

Medical Director Wolfgang Holzgreve of Bonn University Hospital (UKB) explained, "A further, but unfortunately anticipated increase in mainly young sufferers could significantly exacerbate the situation, especially because of the possibility that this group of patients will require more time in intensive care." But local hospitals are prepared to expand the number of intensive care beds if the situation worsens. Says Holzgreve, "At UKB, we have taken precautions and can manage additional intensive care unit beds at any time as part of our contingency plan.”

Capacity reports registered with the state of North Rhine-Westphalia show that there are 231 intensive care beds with ventilator options in Bonn, and only 15 of those were still available as of Friday. According to city spokeswoman Monika Hörig, there are also 158 intensive care and other beds without ventilation options, and only twelve of those remained available. According to the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the percentage of vacant beds on Friday was 6.49 percent. Covid-19 patients accounted for about 18 percent of those being treated. Of 42 coronavirus patients in Bonn intensive care units, 32 required ventilators. The variant first found in the UK accounted for around 60 percent of the new infections, according to the city.

Randolf Forket, head of an intensive care unit at the Johanniter Hospital, gave an update on the condition of a 35-year-old patient, “He made it, and he's doing very well again. We're now dealing more and more with the UK variant of coronavirus, where we're seeing more severe progression of the disease." The symptoms remained the same as with the first variant, respiratory distress, fever, cough, diarrhea and disturbances in taste and smell.

The UKB also has to deal "almost exclusively" (Holzgreve) with the B 1.1.7 variant. As at the Helios Clinic, the medical director shares the opinion of the Robert Koch Institute that it will probably be associated with an increased mortality rate in all age groups. In his view, however, it has not been clearly proven that the more severe progressions of the disease are only because of the mutant that first appeared in the United Kingdom in late 2020. "Since this is now the predominant type," a direct comparison is not possible, he said.

With the increase in new infections and the accompanying increase in Covid-19 patients requiring intensive care, Helios Hospital has been treating "more younger patients with lower mortality rates to date" since the beginning of the year. All hospitals report a trend toward younger patients. More people between 40 and 60 now need ventilation.

In contrast, the number of elderly Covid-19 patients has a downward trend. Among the first 15 Covid-19 patients at UKB last year, for example, four were over 80 years old; among the last 15 patients, the oldest was 77. As reported, the Bonn hospital physicians attribute this trend to the progress made with vaccinations, which began with the 80+ age group. Also, despite rising incidence rates, significantly fewer people overall have died with the coronavirus in Bonn in recent weeks than in the previous period.

The university hospital, which unlike the other hospitals in Bonn also treats children and adolescents, has recently observed more infections among these younger patients, "but they are rarely more severe than before," Holzgreve said. The number of Covid-19 infections here is still lower than in December, he said. "It's possible that the number of cases will rise until the end of the Easter vacations and then fall again for the time being…” Regarding the so-called Pims syndrome (Pediatric Inflammatory Multisystem Syndrome) in children, the UKB cannot yet make any reliable statements, as it only occurs after some time. Little is known about long-term problems after cases of Covid-19 in children.

Inflammatory syndrome in children

If physicians have initially observed unremarkable courses of Covid-19 disease in children and adolescents, dangerous after-effects have occurred in some rare cases. Doctors use the term Pims inflammatory syndrome to describe an overreaction of the child's immune system two to four weeks after overcoming an infection, which can lead to inflammation of the organs. Possible symptoms include high fever, abdominal pain, skin rashes and conjunctivitis. According to the German Society for Pediatric Infectious Diseases, 255 children and adolescents have been affected so far in Germany. Despite sometimes severe courses of the disease, no child has died from it so far, he said. "Pims numbers are also expected to rise as overall pediatric case numbers increase," Holzgreve said.

(Orig. text: Philipp Königs, Translation: Carol Kloeppel)

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