Doctor Çelik, you are senior physician in the isolation ward for Covid-19 patients at the Darmstadt Clinic; we talk regularly regarding the state of affairs. How is the situation right now?
We have currently closed two and a half normal wards and one intensive care ward for corona patients. The original Corona ward is now the Covid focus ward, with the patients there the focus is on the Covid symptoms. The second ward is interdisciplinary, there are patients with Covid, but that is not the main reason for hospital admission. That’s not to say they’re all asymptomatic to Covid, or that Covid wasn’t a factor that brought them to the hospital. But the primary reason for admission and focus of medical treatment is different. Almost all of these patients are vaccinated or boosted, which is why the main medical responsibility lies with a specialty other than internal medicine. And half a station is then provided for suspected cases. All in all, we are once more in a very high range of bed capacities blocked for Covid.
Are there still corona-positive patients on other wards?
There are isolated exceptions in the house where corona-positive patients are isolated on other wards, for example mothers with newborn babies. But if the mothers develop more severe Covid symptoms, they come to us too.
In the 2020 winter wave you had three fully occupied stations; you were clearly more concerned then.
The disease burden cannot be compared at all to what it was then. You can see that from the oxygen consumption per station, which was much higher. We already saw a divergence in the number of infections and the burden of disease in the delta wave. This effect has continued to increase. The main reason for this is the increasing immunization in society by those who have been vaccinated and those who have been boosted, among whom the omicron variant can also spread, but above all it leads to very mild diseases. We have more lighter cases than in previous waves. The condition can still be uncomfortable, even though it is medically considered mild.
Is an omicron infection also milder in unvaccinated patients?
We continue to see the most severe courses in these patients on our ward and in the intensive care unit – but in comparison, there are not as often severe courses as in the previous waves. In the past few weeks, we have had to transfer unvaccinated patients to the intensive care unit less often than was the case with the other variants. This suggests that there is also a positive effect.
Experience shows that the incidence also goes down steeply following the very steep climbs, says Cihan Çelik, senior physician for pneumology at the Darmstadt Clinic.
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Image: Lucas Bäuml
The corona measures are now to be relaxed while you have almost three wards full of corona patients. How does that make you feel?
It has to be said very clearly: there are many patients in these three wards who would have come to the hospital even without Covid. But Covid worsens the condition of many patients once more. And it complicates things in terms of transfers and layoffs home. Many live in nursing homes, positive patients cannot simply be discharged there, so they stay longer in the hospital, and that exacerbates the capacity bottlenecks. We differentiate very precisely in our assessment of the situation and do not simply count the beds with corona patients and draw conclusions regarding what an opening would mean now.
Rather?
We assume the burden of disease from Covid. And in this phase of the pandemic we are moving in a direction in which openings will soon also be appropriate. The disease burden should be the decisive yardstick, as recommended by the government’s expert council. However, one uncertainty remains: the peak of the omicron wave seems to have been passed, but we do not know exactly whether this also applies to the risk group of the over 60 year olds and especially to the unvaccinated. If the peak of incidence in this group occurs later, more patients with severe courses might come to the hospital. That’s why we’re planning our personnel in such a way that we’re well prepared for at least the next four weeks.
And how long will surgeries be postponed?