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Map of usage of intensive care beds in Germany

158 points by epaga 7y ago

deleted 7y ago
[deleted]
est31 7y ago
Germany is pretty well equipped with ICU beds and they've increased the capacity even further in preparation for Corona. I'm not worried about Germany really. I'm more worried about other parts of Europe like eastern europe. A Czech friend told me they have barely any respirators in the country.
- cosmodisk 7y ago
  I think western countries have it worse: https://en.m.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.m.wikipedia.org/wiki/List_of_countries_by_hospita...
  - est31 7y ago
    From that list, Germany has more ICU beds per 100k inhabitants than any other country in that list except for the US, so it confirms that at least. Italy, France, Belgium, etc all have > 11, while Poland, Slovakia, Slovenia, Russia etc. have less than 10 each. Hungary and Czech republic have really good numbers, opposite to the trend and Netherlands, Portugal, Sweden, Denmark have really low numbers, also opposite to the trend. So it's pretty mixed actually. Only gives me more countries to be worried about :(
  - pkaye 7y ago
    Some countries seem to have high bed utilization rates despite high number of beds. Is it due to more elderly population?
    - Someone 7y ago
      Part of it is cultural. For hospital beds, do you keep patients one extra night ‘just in case’, or do you send them home as soon as possible? For IC beds, do you give patients the choice between going home to die a week later and a bed in IC that will make them live a bit longer, but with a less comfort and less contact with their loved ones, or do you always go for “all life is sacred”? Some countries discus this with patients, even if the IC option has a chance of survival. That may sound unethical, but survival, for many patients, will be with much lower quality of life. They may have to move to a care home, stay on medication with severe side effects, may have to train hard for months to even be able to walk again. Patients that already have a low life expectancy may choose to stay out of IC.
- adventured 7y ago
  I agree with your concerns about Eastern Europe. I have many friends there and their respective countries are not prepared at all in terms of resources. Turkey has me the most worried at the moment. Turkey is maxing out its testing capacity every day, with cases rising by 4k like clockwork; 47k cases with very few recovered and it's accelerating. Their infrastructure can't handle the existing cases much less another 50k+ in the coming 7-10 days. And then Russia. I wish there was a clearer picture of what was going on there. For example: "Suifenhe in China’s far northeastern Heilongjiang province has seen an influx of Chinese people returning home, many infected with the virus, travelling by road from the Russian far eastern city of Vladivostok after flying there from Moscow." https://www.reuters.com/article/us-health-coronavirus-china-border/on-russian-border-china-scrambles-to-contain-coronavirus-influx-idUSKCN21S0TI https://www.reuters.com/article/us-health-coronavirus-china-...
- DoreenMichele 7y ago
  If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators) that some doctors are trying to avoid using them, if possible, because they are concerned the ventilators are actually killing people. https://news.ycombinator.com/item?id=22819580 https://news.ycombinator.com/item?id=22819580 I previously suggested that ventilators were problematic and I wasn't happy with the rush to create more of them instead of promoting less invasive treatments. I'm glad some doctors are looking for alternatives, but we really need to be a lot more aggressive about that angle.
  - est31 7y ago
    Interesting points, thank you. I previously mostly had the death rate for "ordinary" ICU admissions in mind, which were 50%. Didn't know that once you are you are connected a ventilator, you have a 80% death rate. To compare the effect of ventilators vs none, one needs good studies with randomized groups where one gets ventilators and the other doesn't. But I guess those aren't available and doing them is probably not possible due to moral issues. I wonder if there are statistics that are the next best thing, death rate of people who doctors would have wanted to connect to ventilators but there were none available. You shouldn't compare it to the death rate of people with ventilators in places where there is ventilator shortage because then obviously there is some element of choice in who gets the ventilator and who doesn't, e.g. they choose the patients with the worst symptoms, or the patients with the largest chances of survival. Most places probably have/had shortages, so the data we have are all pretty bad to judge whether ventilators help, and if yes how much.
    - DoreenMichele 7y ago
      I have a really serious lung condition. I used to use mechanical intervention to treat my condition. I have found other methods and no longer do that, in part because such interventions are hard to keep adequately sterile and are known to increase risk of antibiotic resistant infections because of that element. It's really not good to think of this problem space in terms of finding some group without ventilators at all. I get your point about the data, but the problem is that lungs are a critical system. If you have lung issues, you are a priority admit at an ER because that whole not breathing thing can kill within minutes. Inability to breathe is one of the quicker ways to die. What I was previously suggesting was non invasive airway clearance methods and management techniques like being mindful of better positions to sleep in (which is apparently at least part of what some doctors are now doing according to the article I linked above). I got hounded and attacked as "practicing medicine without a license" for talking about my first-hand experience with managing my very deadly condition using such techniques. You really can't just not treat patients experiencing lung distress and hope they live. That's a good way to kill people. But I have looked at a little info on ARDS (the process that actually kills people with Coronavirus) and how ventilators work and I'm quite horrified that the world rushed to create more ventilators rather than rushing to say "We must do everything possible to intervene effectively without ventilators. Ventilators must be an absolute last ditch effort after every other possible intervention has been exhausted." They aren't doing that. They are too quick to put people on ventilators and the fact that doctors are now coming up with non invasive alternatives tells you they haven't been sufficiently aggressive in exhausting all other treatment modalities first. I have substantial first-hand experience with staying alive in the face of having routine lung distress that could kill me. I knew from the outset that they were putting people on ventilators too quickly, that ventilators are quite dangerous in their own right and that there are, in fact, other options available. I'm quite frustrated by the whole thing. This absolutely never needed to be this ugly. I'm certainly not the only person on the planet who knew ahead of time that ventilators are problematic and that there are myriad other options available that can be tried first, especially before it gets that severe in hopes of not letting it get to that point.
- m4rtink 7y ago
  I would say the respirator situation here in Czech Republic stabilized since the - the awrial bridge is still running and medical personel shoukd be stocked now by PPE & some buffer is being built. As for normal people - everyone uses hand made cloth masks & that seems to work fine. You can even buy the cloth masks easily online now if you don't have sewing skills and don't know someone who does.
- perf1 7y ago
  I read somewhere that they have difficulties getting medication and might running out of sedatives in the next weeks to take out people who have to be ventilated. Edit: found the Article: https://www.spiegel.de/wirtschaft/corona-krise-lieferengpass-bei-narkosemedikamenten-a-00000000-0002-0001-0000-000170435637# https://www.spiegel.de/wirtschaft/corona-krise-lieferengpass...
- alkonaut 7y ago
  I wonder why they have such extreme numbers of ICU beds. Are they reporting them differently, e.g. disaster wards that are normally not operating unless there is a disaster are counted? Or do they really run with a tiny fraction of beds occupied, in the years between wars and pandemics? It seems a bit wasteful to have that low usage, instead of having the capability stored for a rainy day.
pacificmint 7y ago
Translation of the German captions: The number of hospitals that report that their ICU capacities as: Blue: Has Free Capacities (639 currently) Yellow: Some Contention (326 currently) Red: Fully Utilized (41 currently) Covid 19 patients in ICUs: 2453 (76% of which are on ventilators) ICU beds reported by hospitals: 19,663 (58% in use currently)
- DoreenMichele 7y ago
  Thank you. The translation I saw described yellow as something like "emerging bottlenecks." There seem to be a lot of them in Bavaria, where I have relatives.
  - Cass 7y ago
    My Bavarian hospital is on there as yellow. I'm currently sitting in the empty urgent care clinic and just had a chat with the nurse from the almost empty emergency room about the fact that both the COVID-19 ward and the ICU are far from capacity. Not really sure why we're yellow, to be honest.
    - deleted 7y ago
      [deleted]
    - hagemey 7y ago
      Same here. Yesterday I just had a chat with my brother-in-law who runs the emergency room in a large hospital in Lower Saxony which is depicted yellow. From what he told me yesterday they are far from exceeding their capacity even giving me some numbers.
    - neuronic 7y ago
      Whatever is reported to government agencies ends up in these graphs (Gesundheitsbehörde).
    - rasmus1610 7y ago
      There are certain hospitals that are marked red with one patient or so on ICU where I know for a fact that they have more than 1 ICU...
themark 7y ago
Why can’t we see data like this here?
- techolic 7y ago
  New Jersey has started to publish this yesterday, see 'Hospital Census' https://covid19.nj.gov/#live-updates https://covid19.nj.gov/#live-updates
a_bonobo 7y ago
This may make more sense if it's normalised by the size of each hospital? Small hospitals are immediately at limit and make a red dot for obvious reasons. For example, there's a red circle next to Bremen, Alle-Weser-Klinik Verden, they have 131 beds [1]. Verden has about 27k inhabitants. There's a large blue circle in Baden-Wuerttenberg, Klinikum am Gesundbrunnen, they have 970 beds [2]. It's in Heilbronn which has 120k inhabitants. So in a way, this is a population density map https://xkcd.com/1138/ https://xkcd.com/1138/ [1] https://de.wikipedia.org/wiki/Aller-Weser-Klinik https://de.wikipedia.org/wiki/Aller-Weser-Klinik [2] https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-kliniken-in-zahlen/ https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-k...
m0zg 7y ago
Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro area is 75 years and 21 million people live there, 1/75th of the population, or 280K people die per year in NY metro area alone. That's 7671 person per day on average. At the time of this writing 7844 people have died of corona in the entire state, total. I'd bet good money a good chunk (if not most) of these people would die of something else if it wasn't corona, so that's not a "net" increase. If you want to tell me these deaths require mass graves, I have some fine swamp land in Florida that you might want to check out.
- woodruffw 7y ago
  The New York Times put out an article just yesterday[1] that directly addresses most of your doubts. In summary: * Substantially more people have died in both NYC and NY state than is demographically expected, suggesting a significant effect from the virus. * Virus deaths are probably still under-counted, as bodies retrieved from homes aren't being tested. Patients with significant comorbidities may also be being mis- or under-counted. I live in NYC, and all of my local hospitals are at the limits of their normal capacities (many have been able to expand their capacities, thankfully). The city has been asking for volunteers to come out of retirement. To my knowledge, none of my friends or family have been able to get non-urgent treatment or tests for coronavirus symptoms; the system is completely focused on (and occupied with) treating those most at need. Edit: I also forgot to mention: I don't know exactly what you're referring to w/r/t "mass graves," but I'm guessing it has something to do with Hart's Island. The city buries its unclaimed dead there; any uptick in activity probably tracks roughly with death's among the city's general demographics. It wouldn't be surprising for them to need a few more trenches. [1]: https://www.nytimes.com/2020/04/10/nyregion/new-york-coronavirus-death-count.html https://www.nytimes.com/2020/04/10/nyregion/new-york-coronav...
  - m0zg 7y ago
    Yes, Hart Island is being sold as "mass graves". Plus this right here clown (of "come to celebrate the Chinese new year, in spite of coronavirus" fame) said the other day there'd be _temporary burials_ in city parks: https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ct... My point is, as bad as the situation on the ground is in NY, the single digit percentage uptick in the overall number of deaths would most definitely not overwhelm anything at all, and given the dis-use of the emergency hospital capacity and reduced hospital and ICU admissions over the past few days, crowding in the hospitals seems like a load balancing problem to me. And if anything, I would not be surprised if the official figures _overstate_ the death toll. Dr. Birx mentioned in the presser the other day that everyone who died _with_ C19 is counted as a C19 fatality, even if they did not die _of_ C19. Died of cancer but also have C19? You'll be counted as a C19 fatality.
chvid 7y ago
Germany (like a few other countries) is in the situation "too much lockdown, too few sick". So it has to remove those lockdowns. This creates a fun political dynamic where the authorities who just spend a month scaring the population in doors now has to explain and justify why it is ok to go out and get a little sick.
- _ph_ 7y ago
  I strongly disagree with the statement, that we have "too few sick" here in Germany. With the lockdown, we managed to just keep the health system from being completely overloaded in the most infected regions. But that already at the price of postponing non-urgent medical procedures. So yes, there are a few free beds in hospitals still, but we might still need them. What is not accounted for is, that supplies (masks...) are still scarce and more importandly, most medical personal is working at an unsustainable intensity. There is plenty of reason of desiring even less sick people. The reasons for reducing the lockdown are practical, social and economic. The lockdown is hard on many people, depending on their social and living situation. Especially in dense cities, most people don't have housing which was designed to be confined to it for many weeks. And apart from that, people want to go out, want to meet other people again. Need to do shopping for clothing, get a haircut. Also, we should try to keep the economy from collapsing. The trick will be to reduce the lockdown while keeping the minimum safety in place and without too many people acting reckless and endangering the population again.
  - luckylion 7y ago
    > I strongly disagree with the statement, that we have "too few sick" here in Germany. We want to be close to maximum capacity (but just under) though, and we're not. If "the curve" is too flat, it gets drawn out much more than necessary, and nobody should fool themselves into thinking that this can be a permanent setup. You'll need martial law if you want to confine everyone to their homes for 12+ months.
    - _ph_ 7y ago
      That is why we have to find a way out of the lockdown: because, as I wrote, you can't confine people to their home for too long. But not because we have "too few sick". If you are playing towards herd immunity: it doesn't look like we are getting there with "acceptable" infection rates. The disease is too nasty for that. So we have to reduce the lockdown in a way so that the infection rate does not increase significantly.
perlgeek 7y ago
This is very cool, though not quite complete. https://www.klinikum-fuerth.de/ https://www.klinikum-fuerth.de/ is missing from the map, which is the biggest hospital in Fürth, Bavaria. Also interesting: some hospital report some contention, but no COVID-19 cases.
polycaster 7y ago
According to the district office there are 778 cases in the district of Ortenau right now [1]. Curiously the map colors indicate shortages in several places but checking the individual clinics yield 0 cases. [1] https://www.ortenaukreis.de/Politik-Verwaltung/Verwaltung/Sicherheit-Ordnung-Gesundheit/Gesundheitsamt/Corona/778-best%C3%A4tigte-Covid-19-F%C3%A4lle-im-Ortenaukreis.php https://www.ortenaukreis.de/Politik-Verwaltung/Verwaltung/Si...
- polycaster 7y ago
  ... I am aware cases != clinic beds. But 0 clinical cases at 778 total cases is unlikely (right?).
  - yorwba 7y ago
    There's a single patient with COVID-19 in MediClin Herzzentrum Lahr/Baden. Some of the other 777 will probably end up hospitalized over the next week.
- ygra 7y ago
  Shortages may also be due to non-Covid-19 patients. It's not that hospitals suddenly stopped caring for all other ailments.
riedel 7y ago
Probably from the same data source(DIVI Intensivregister/RKI): https://diviexchange.z6.web.core.windows.net/report.html https://diviexchange.z6.web.core.windows.net/report.html
- riedel 7y ago
  It includes Fürth, so I guess it is a scraping problem. Maybe all cities with umlauts are missing :)
  - deleted 7y ago
    [deleted]
evaneykelen 7y ago
Germany has also accepted patients from Italy, France, and The Netherlands. For the latter the university hospital in Münster is coordinating the distribution of Dutch patients who require ICU care across Germany. Great to see neighboring/close by countries cooperate in this way.
- bsaul 7y ago
  Do you have more infos on that ?? I live in france and the general message we keep hearing is that every nation is dealing with the crisis alone and that the european union project may die because of that.
  - quonn 7y ago
    Alone? Like with the 500 billion euro EU emergency fund that was agreed yesterday?
    - sakisv 7y ago
      These 500bn are loans from the ESM. The part of that will go to support public healthcare will be without conditions, but the rest that will go to support the other parts of the economies will be given on conditions of austerity. This agreement comes on the heels of the rejection of what 9 Eurozone countries including France had asked initially: A Eurobond, or coronabond as it made some headlines. That would have allowed the EU as an entity to borrow money instead of individual counties, but the governments of Germany and Netherlands seems that were against it.
      - notechback 7y ago
        Actually coronabonds would not allow the EU to borrow. It would allow individual countries to borrow with the guarantee given by all countries jointly. Those against it were mainly Netherlands, Austria and Finland, but Germany was not exactly a fan either. See it this way: everyone knows Italian debt at 140% of GDP is unsustainable. Successive governments have promised again and again to do something about it, but then each finds a reason not to follow this promise. The Italian state is leaking money in all corners with many politically friendly businesses making huge gains at the cost of taxpayers. The default is mostly inevitable if there is not finally a serious attempt to address this issue. Successive Italian governments have asked for mutualised debt - while increasing the national deficit and debt further each year. It would be crazy for any other government to give Italy a blank check and say "okay take whatever loans you need, wecll guarantee it". It means you are consciously taking up the risk of default for yourself while having no way to stop overspending or fix the underlying systemic issues. This means Italian governments have even less incentive to change the horribly corrupt and broken system. That other countries say no is not a decision against the Italian citizens. It would be irresponsible towards their own citizens to take this up without some kind of real guarantee that Italy will finally fix the systemic issues, because the past 20 years of promises have been broken.
jamessb 7y ago
There is a more detailed interactive map of critical care bed capacity created by researchers at Konstantz University. Visualization: https://coronavis.dbvis.de/en/ https://coronavis.dbvis.de/en/ Press release (English): https://www.campus.uni-konstanz.de/en/science/university-of-konstanz-develops-visualization-tool-for-illustration-of-critical-care-bed-capacities-all-over-germany https://www.campus.uni-konstanz.de/en/science/university-of-...
k__ 7y ago
People from other countries are always hating "just wait, we laughed too, but then things got worse!" But I have the feeling, in Germany we are doing pretty good for ourselves. I don't think this will be over soon, but when I look at our numbers, I just can't see it getting much worse, let alone as bad as our neighbors or the US has it...
- iforgotpassword 7y ago
  We reacted late, but not as late as for example Italy. And at least where I live, many people tried to reduce social contacts. Not all obviously, but streets got emptier. But probably the most relevant thing to do was closing schools and especially kindergartens. It may just work out fine, I think it also depends on whether people get their shit together during the Easter weekend regarding family visits. Good weather also helps making things look less grim.
  - bayesian_horse 7y ago
    We acted later than Italy, in temporal terms. Maybe earlier in terms of the infection curve. At some point there wasn't anything to act on. Cases where far and few between and have been individually isolated for a time. There was no way to find community spread because there was no way to identify other cases without testing millions. And the official incidence rate is still about one in a thousand people.
- lnsru 7y ago
  Wait few days after Eastern celebration, parks in Munich are full, people around houses are celebrating in packs. Even deep in woods 30 miles away isn’t that empty as it was few days ago. 4000+ new cases alone yesterday. So another 200 intensive care beds needed. I am really worried about all this careless “we are doing well”.
  - k__ 7y ago
    The problem are the people who don't follow the rules, not the ones who say we're doing well. I think we're doing well and still don't meet friends or go out often.
tullatulla 7y ago
Looks like the peak ICU occupation in Germany has clearly passed: 11/04: 2088, 76% on ventilators 10/04(?): 2453, 76% -"- 04/04: 2680, 83% -"- 03/04: 2421, 83% -"- 02/04: 2139, 83% -"- 01/04: 1876, 82% -"- Can't find data for in between 04/04 and 10/04, since DIVI stopped publishing daily reports apparently, but must have peaked in between. https://www.intensivregister.de/#/intensivregister https://www.intensivregister.de/#/intensivregister https://www.divi.de/images/Dokumente/DIVI-IntensivRegister_Tagesreport_2020_04_04.pdf https://www.divi.de/images/Dokumente/DIVI-IntensivRegister_T...

158 points by epaga 7y ago

deleted 7y ago

[deleted]

Germany is pretty well equipped with ICU beds and they've increased the capacity even further in preparation for Corona. I'm not worried about Germany really. I'm more worried about other parts of Europe like eastern europe. A Czech friend told me they have barely any respirators in the country.

cosmodisk 7y ago
I think western countries have it worse: https://en.m.wikipedia.org/wiki/List_of_countries_by_hospital_beds https://en.m.wikipedia.org/wiki/List_of_countries_by_hospita...
- est31 7y ago
  From that list, Germany has more ICU beds per 100k inhabitants than any other country in that list except for the US, so it confirms that at least. Italy, France, Belgium, etc all have > 11, while Poland, Slovakia, Slovenia, Russia etc. have less than 10 each. Hungary and Czech republic have really good numbers, opposite to the trend and Netherlands, Portugal, Sweden, Denmark have really low numbers, also opposite to the trend. So it's pretty mixed actually. Only gives me more countries to be worried about :(
- pkaye 7y ago
  Some countries seem to have high bed utilization rates despite high number of beds. Is it due to more elderly population?
  - Someone 7y ago
    Part of it is cultural. For hospital beds, do you keep patients one extra night ‘just in case’, or do you send them home as soon as possible? For IC beds, do you give patients the choice between going home to die a week later and a bed in IC that will make them live a bit longer, but with a less comfort and less contact with their loved ones, or do you always go for “all life is sacred”? Some countries discus this with patients, even if the IC option has a chance of survival. That may sound unethical, but survival, for many patients, will be with much lower quality of life. They may have to move to a care home, stay on medication with severe side effects, may have to train hard for months to even be able to walk again. Patients that already have a low life expectancy may choose to stay out of IC.
adventured 7y ago
I agree with your concerns about Eastern Europe. I have many friends there and their respective countries are not prepared at all in terms of resources. Turkey has me the most worried at the moment. Turkey is maxing out its testing capacity every day, with cases rising by 4k like clockwork; 47k cases with very few recovered and it's accelerating. Their infrastructure can't handle the existing cases much less another 50k+ in the coming 7-10 days. And then Russia. I wish there was a clearer picture of what was going on there. For example: "Suifenhe in China’s far northeastern Heilongjiang province has seen an influx of Chinese people returning home, many infected with the virus, travelling by road from the Russian far eastern city of Vladivostok after flying there from Moscow." https://www.reuters.com/article/us-health-coronavirus-china-border/on-russian-border-china-scrambles-to-contain-coronavirus-influx-idUSKCN21S0TI https://www.reuters.com/article/us-health-coronavirus-china-...
DoreenMichele 7y ago
If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators) that some doctors are trying to avoid using them, if possible, because they are concerned the ventilators are actually killing people. https://news.ycombinator.com/item?id=22819580 https://news.ycombinator.com/item?id=22819580 I previously suggested that ventilators were problematic and I wasn't happy with the rush to create more of them instead of promoting less invasive treatments. I'm glad some doctors are looking for alternatives, but we really need to be a lot more aggressive about that angle.
- est31 7y ago
  Interesting points, thank you. I previously mostly had the death rate for "ordinary" ICU admissions in mind, which were 50%. Didn't know that once you are you are connected a ventilator, you have a 80% death rate. To compare the effect of ventilators vs none, one needs good studies with randomized groups where one gets ventilators and the other doesn't. But I guess those aren't available and doing them is probably not possible due to moral issues. I wonder if there are statistics that are the next best thing, death rate of people who doctors would have wanted to connect to ventilators but there were none available. You shouldn't compare it to the death rate of people with ventilators in places where there is ventilator shortage because then obviously there is some element of choice in who gets the ventilator and who doesn't, e.g. they choose the patients with the worst symptoms, or the patients with the largest chances of survival. Most places probably have/had shortages, so the data we have are all pretty bad to judge whether ventilators help, and if yes how much.
  - DoreenMichele 7y ago
    I have a really serious lung condition. I used to use mechanical intervention to treat my condition. I have found other methods and no longer do that, in part because such interventions are hard to keep adequately sterile and are known to increase risk of antibiotic resistant infections because of that element. It's really not good to think of this problem space in terms of finding some group without ventilators at all. I get your point about the data, but the problem is that lungs are a critical system. If you have lung issues, you are a priority admit at an ER because that whole not breathing thing can kill within minutes. Inability to breathe is one of the quicker ways to die. What I was previously suggesting was non invasive airway clearance methods and management techniques like being mindful of better positions to sleep in (which is apparently at least part of what some doctors are now doing according to the article I linked above). I got hounded and attacked as "practicing medicine without a license" for talking about my first-hand experience with managing my very deadly condition using such techniques. You really can't just not treat patients experiencing lung distress and hope they live. That's a good way to kill people. But I have looked at a little info on ARDS (the process that actually kills people with Coronavirus) and how ventilators work and I'm quite horrified that the world rushed to create more ventilators rather than rushing to say "We must do everything possible to intervene effectively without ventilators. Ventilators must be an absolute last ditch effort after every other possible intervention has been exhausted." They aren't doing that. They are too quick to put people on ventilators and the fact that doctors are now coming up with non invasive alternatives tells you they haven't been sufficiently aggressive in exhausting all other treatment modalities first. I have substantial first-hand experience with staying alive in the face of having routine lung distress that could kill me. I knew from the outset that they were putting people on ventilators too quickly, that ventilators are quite dangerous in their own right and that there are, in fact, other options available. I'm quite frustrated by the whole thing. This absolutely never needed to be this ugly. I'm certainly not the only person on the planet who knew ahead of time that ventilators are problematic and that there are myriad other options available that can be tried first, especially before it gets that severe in hopes of not letting it get to that point.
m4rtink 7y ago
I would say the respirator situation here in Czech Republic stabilized since the - the awrial bridge is still running and medical personel shoukd be stocked now by PPE & some buffer is being built. As for normal people - everyone uses hand made cloth masks & that seems to work fine. You can even buy the cloth masks easily online now if you don't have sewing skills and don't know someone who does.
perf1 7y ago
I read somewhere that they have difficulties getting medication and might running out of sedatives in the next weeks to take out people who have to be ventilated. Edit: found the Article: https://www.spiegel.de/wirtschaft/corona-krise-lieferengpass-bei-narkosemedikamenten-a-00000000-0002-0001-0000-000170435637# https://www.spiegel.de/wirtschaft/corona-krise-lieferengpass...
alkonaut 7y ago
I wonder why they have such extreme numbers of ICU beds. Are they reporting them differently, e.g. disaster wards that are normally not operating unless there is a disaster are counted? Or do they really run with a tiny fraction of beds occupied, in the years between wars and pandemics? It seems a bit wasteful to have that low usage, instead of having the capability stored for a rainy day.

pacificmint 7y ago

Translation of the German captions: The number of hospitals that report that their ICU capacities as: Blue: Has Free Capacities (639 currently) Yellow: Some Contention (326 currently) Red: Fully Utilized (41 currently) Covid 19 patients in ICUs: 2453 (76% of which are on ventilators) ICU beds reported by hospitals: 19,663 (58% in use currently)

DoreenMichele 7y ago
Thank you. The translation I saw described yellow as something like "emerging bottlenecks." There seem to be a lot of them in Bavaria, where I have relatives.
- Cass 7y ago
  My Bavarian hospital is on there as yellow. I'm currently sitting in the empty urgent care clinic and just had a chat with the nurse from the almost empty emergency room about the fact that both the COVID-19 ward and the ICU are far from capacity. Not really sure why we're yellow, to be honest.
  - deleted 7y ago
    [deleted]
  - hagemey 7y ago
    Same here. Yesterday I just had a chat with my brother-in-law who runs the emergency room in a large hospital in Lower Saxony which is depicted yellow. From what he told me yesterday they are far from exceeding their capacity even giving me some numbers.
  - neuronic 7y ago
    Whatever is reported to government agencies ends up in these graphs (Gesundheitsbehörde).
  - rasmus1610 7y ago
    There are certain hospitals that are marked red with one patient or so on ICU where I know for a fact that they have more than 1 ICU...

themark 7y ago

Why can’t we see data like this here?

techolic 7y ago
New Jersey has started to publish this yesterday, see 'Hospital Census' https://covid19.nj.gov/#live-updates https://covid19.nj.gov/#live-updates

a_bonobo 7y ago

This may make more sense if it's normalised by the size of each hospital? Small hospitals are immediately at limit and make a red dot for obvious reasons. For example, there's a red circle next to Bremen, Alle-Weser-Klinik Verden, they have 131 beds [1]. Verden has about 27k inhabitants. There's a large blue circle in Baden-Wuerttenberg, Klinikum am Gesundbrunnen, they have 970 beds [2]. It's in Heilbronn which has 120k inhabitants. So in a way, this is a population density map https://xkcd.com/1138/ https://xkcd.com/1138/ [1] https://de.wikipedia.org/wiki/Aller-Weser-Klinik https://de.wikipedia.org/wiki/Aller-Weser-Klinik [2] https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-kliniken-in-zahlen/ https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-k...

m0zg 7y ago

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro area is 75 years and 21 million people live there, 1/75th of the population, or 280K people die per year in NY metro area alone. That's 7671 person per day on average. At the time of this writing 7844 people have died of corona in the entire state, total. I'd bet good money a good chunk (if not most) of these people would die of something else if it wasn't corona, so that's not a "net" increase. If you want to tell me these deaths require mass graves, I have some fine swamp land in Florida that you might want to check out.

woodruffw 7y ago
The New York Times put out an article just yesterday[1] that directly addresses most of your doubts. In summary: * Substantially more people have died in both NYC and NY state than is demographically expected, suggesting a significant effect from the virus. * Virus deaths are probably still under-counted, as bodies retrieved from homes aren't being tested. Patients with significant comorbidities may also be being mis- or under-counted. I live in NYC, and all of my local hospitals are at the limits of their normal capacities (many have been able to expand their capacities, thankfully). The city has been asking for volunteers to come out of retirement. To my knowledge, none of my friends or family have been able to get non-urgent treatment or tests for coronavirus symptoms; the system is completely focused on (and occupied with) treating those most at need. Edit: I also forgot to mention: I don't know exactly what you're referring to w/r/t "mass graves," but I'm guessing it has something to do with Hart's Island. The city buries its unclaimed dead there; any uptick in activity probably tracks roughly with death's among the city's general demographics. It wouldn't be surprising for them to need a few more trenches. [1]: https://www.nytimes.com/2020/04/10/nyregion/new-york-coronavirus-death-count.html https://www.nytimes.com/2020/04/10/nyregion/new-york-coronav...
- m0zg 7y ago
  Yes, Hart Island is being sold as "mass graves". Plus this right here clown (of "come to celebrate the Chinese new year, in spite of coronavirus" fame) said the other day there'd be _temporary burials_ in city parks: https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ct... My point is, as bad as the situation on the ground is in NY, the single digit percentage uptick in the overall number of deaths would most definitely not overwhelm anything at all, and given the dis-use of the emergency hospital capacity and reduced hospital and ICU admissions over the past few days, crowding in the hospitals seems like a load balancing problem to me. And if anything, I would not be surprised if the official figures _overstate_ the death toll. Dr. Birx mentioned in the presser the other day that everyone who died _with_ C19 is counted as a C19 fatality, even if they did not die _of_ C19. Died of cancer but also have C19? You'll be counted as a C19 fatality.

chvid 7y ago

Germany (like a few other countries) is in the situation "too much lockdown, too few sick". So it has to remove those lockdowns. This creates a fun political dynamic where the authorities who just spend a month scaring the population in doors now has to explain and justify why it is ok to go out and get a little sick.

_ph_ 7y ago
I strongly disagree with the statement, that we have "too few sick" here in Germany. With the lockdown, we managed to just keep the health system from being completely overloaded in the most infected regions. But that already at the price of postponing non-urgent medical procedures. So yes, there are a few free beds in hospitals still, but we might still need them. What is not accounted for is, that supplies (masks...) are still scarce and more importandly, most medical personal is working at an unsustainable intensity. There is plenty of reason of desiring even less sick people. The reasons for reducing the lockdown are practical, social and economic. The lockdown is hard on many people, depending on their social and living situation. Especially in dense cities, most people don't have housing which was designed to be confined to it for many weeks. And apart from that, people want to go out, want to meet other people again. Need to do shopping for clothing, get a haircut. Also, we should try to keep the economy from collapsing. The trick will be to reduce the lockdown while keeping the minimum safety in place and without too many people acting reckless and endangering the population again.
- luckylion 7y ago
  > I strongly disagree with the statement, that we have "too few sick" here in Germany. We want to be close to maximum capacity (but just under) though, and we're not. If "the curve" is too flat, it gets drawn out much more than necessary, and nobody should fool themselves into thinking that this can be a permanent setup. You'll need martial law if you want to confine everyone to their homes for 12+ months.
  - _ph_ 7y ago
    That is why we have to find a way out of the lockdown: because, as I wrote, you can't confine people to their home for too long. But not because we have "too few sick". If you are playing towards herd immunity: it doesn't look like we are getting there with "acceptable" infection rates. The disease is too nasty for that. So we have to reduce the lockdown in a way so that the infection rate does not increase significantly.

perlgeek 7y ago

This is very cool, though not quite complete. https://www.klinikum-fuerth.de/ https://www.klinikum-fuerth.de/ is missing from the map, which is the biggest hospital in Fürth, Bavaria. Also interesting: some hospital report some contention, but no COVID-19 cases.

polycaster 7y ago

According to the district office there are 778 cases in the district of Ortenau right now [1]. Curiously the map colors indicate shortages in several places but checking the individual clinics yield 0 cases. [1] https://www.ortenaukreis.de/Politik-Verwaltung/Verwaltung/Sicherheit-Ordnung-Gesundheit/Gesundheitsamt/Corona/778-best%C3%A4tigte-Covid-19-F%C3%A4lle-im-Ortenaukreis.php https://www.ortenaukreis.de/Politik-Verwaltung/Verwaltung/Si...

polycaster 7y ago
... I am aware cases != clinic beds. But 0 clinical cases at 778 total cases is unlikely (right?).
- yorwba 7y ago
  There's a single patient with COVID-19 in MediClin Herzzentrum Lahr/Baden. Some of the other 777 will probably end up hospitalized over the next week.
ygra 7y ago
Shortages may also be due to non-Covid-19 patients. It's not that hospitals suddenly stopped caring for all other ailments.

riedel 7y ago

Probably from the same data source(DIVI Intensivregister/RKI): https://diviexchange.z6.web.core.windows.net/report.html https://diviexchange.z6.web.core.windows.net/report.html

riedel 7y ago
It includes Fürth, so I guess it is a scraping problem. Maybe all cities with umlauts are missing :)
- deleted 7y ago
  [deleted]

evaneykelen 7y ago

Germany has also accepted patients from Italy, France, and The Netherlands. For the latter the university hospital in Münster is coordinating the distribution of Dutch patients who require ICU care across Germany. Great to see neighboring/close by countries cooperate in this way.

bsaul 7y ago
Do you have more infos on that ?? I live in france and the general message we keep hearing is that every nation is dealing with the crisis alone and that the european union project may die because of that.
- quonn 7y ago
  Alone? Like with the 500 billion euro EU emergency fund that was agreed yesterday?
  - sakisv 7y ago
    These 500bn are loans from the ESM. The part of that will go to support public healthcare will be without conditions, but the rest that will go to support the other parts of the economies will be given on conditions of austerity. This agreement comes on the heels of the rejection of what 9 Eurozone countries including France had asked initially: A Eurobond, or coronabond as it made some headlines. That would have allowed the EU as an entity to borrow money instead of individual counties, but the governments of Germany and Netherlands seems that were against it.
    - notechback 7y ago
      Actually coronabonds would not allow the EU to borrow. It would allow individual countries to borrow with the guarantee given by all countries jointly. Those against it were mainly Netherlands, Austria and Finland, but Germany was not exactly a fan either. See it this way: everyone knows Italian debt at 140% of GDP is unsustainable. Successive governments have promised again and again to do something about it, but then each finds a reason not to follow this promise. The Italian state is leaking money in all corners with many politically friendly businesses making huge gains at the cost of taxpayers. The default is mostly inevitable if there is not finally a serious attempt to address this issue. Successive Italian governments have asked for mutualised debt - while increasing the national deficit and debt further each year. It would be crazy for any other government to give Italy a blank check and say "okay take whatever loans you need, wecll guarantee it". It means you are consciously taking up the risk of default for yourself while having no way to stop overspending or fix the underlying systemic issues. This means Italian governments have even less incentive to change the horribly corrupt and broken system. That other countries say no is not a decision against the Italian citizens. It would be irresponsible towards their own citizens to take this up without some kind of real guarantee that Italy will finally fix the systemic issues, because the past 20 years of promises have been broken.

jamessb 7y ago

There is a more detailed interactive map of critical care bed capacity created by researchers at Konstantz University. Visualization: https://coronavis.dbvis.de/en/ https://coronavis.dbvis.de/en/ Press release (English): https://www.campus.uni-konstanz.de/en/science/university-of-konstanz-develops-visualization-tool-for-illustration-of-critical-care-bed-capacities-all-over-germany https://www.campus.uni-konstanz.de/en/science/university-of-...

k__ 7y ago

People from other countries are always hating "just wait, we laughed too, but then things got worse!" But I have the feeling, in Germany we are doing pretty good for ourselves. I don't think this will be over soon, but when I look at our numbers, I just can't see it getting much worse, let alone as bad as our neighbors or the US has it...

iforgotpassword 7y ago
We reacted late, but not as late as for example Italy. And at least where I live, many people tried to reduce social contacts. Not all obviously, but streets got emptier. But probably the most relevant thing to do was closing schools and especially kindergartens. It may just work out fine, I think it also depends on whether people get their shit together during the Easter weekend regarding family visits. Good weather also helps making things look less grim.
- bayesian_horse 7y ago
  We acted later than Italy, in temporal terms. Maybe earlier in terms of the infection curve. At some point there wasn't anything to act on. Cases where far and few between and have been individually isolated for a time. There was no way to find community spread because there was no way to identify other cases without testing millions. And the official incidence rate is still about one in a thousand people.
lnsru 7y ago
Wait few days after Eastern celebration, parks in Munich are full, people around houses are celebrating in packs. Even deep in woods 30 miles away isn’t that empty as it was few days ago. 4000+ new cases alone yesterday. So another 200 intensive care beds needed. I am really worried about all this careless “we are doing well”.
- k__ 7y ago
  The problem are the people who don't follow the rules, not the ones who say we're doing well. I think we're doing well and still don't meet friends or go out often.

tullatulla 7y ago

Looks like the peak ICU occupation in Germany has clearly passed: 11/04: 2088, 76% on ventilators 10/04(?): 2453, 76% -"- 04/04: 2680, 83% -"- 03/04: 2421, 83% -"- 02/04: 2139, 83% -"- 01/04: 1876, 82% -"- Can't find data for in between 04/04 and 10/04, since DIVI stopped publishing daily reports apparently, but must have peaked in between. https://www.intensivregister.de/#/intensivregister https://www.intensivregister.de/#/intensivregister https://www.divi.de/images/Dokumente/DIVI-IntensivRegister_Tagesreport_2020_04_04.pdf https://www.divi.de/images/Dokumente/DIVI-IntensivRegister_T...