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RS virus in Germany: Pediatric clinics at their limits

2022-12-11 13:15:56Kosova&Bota SHKRUAR NGA REDAKSIA VOX

RS virus in Germany: Pediatric clinics at their limits

A respiratory virus affecting children is circulating in Germany. Hospitals are in a state of emergency, the situation is dramatic. But the clinics themselves are also to blame for the difficult situation.

A resuscitated baby is admitted to the overcrowded pediatrics. To accept this child, a three-year-old must continue to wait for the third light in a row to undergo a necessary heart surgery. The admitted child traveled 150 kilometers from Hanover to Magdeburg during the night to find a free bed, because the 21 nearest clinics are full and have no more free beds. There are hundreds of children who are waiting in the emergency room and are still sent back home. Or they are treated in the usual wards, although they should be treated in the intensive care unit.

"Children die because we are no longer able to take care of them," warns Michael Sasse, chief physician in the pediatric intensive care unit at the Hanover Medical School, when speaking of the catastrophic situation in German children's clinics.

These words are heavy. When you talk to Mehrak Yosef, you learn more about reality. The pediatrician at Berlin's Charité hospital says: "Currently in all emergency centers for children the service is 24 hours. Capacity is exhausted, we can no longer provide care. We must see to it that no child dies during this time."

The RS virus is especially dangerous for young children

This December period is the strongest period for viruses in Germany. According to the Robert Koch Institute, nearly one in ten people currently suffer from a respiratory disease. The figure has reached almost 9 million people. Viruses spread very rapidly, especially among school children between the ages of 5 and 14. Very dangerous for children and especially for babies is the so-called RS virus, the syncytial virus of the respiratory organs. It sickens the airways and causes severe shocks that even require artificial respiration.

The spread of the virus with great fury in Germany is related to the Corona pandemic. Due to mask wearing and isolation from Corona, small children have rarely been infected with the RS virus, so they get it now. This has major consequences for the German health system, which is already suffering from an overload of chronic diseases. Yoosefi, who wears a mask to avoid getting sick himself, says: "We can't put some of these children to bed, because we don't have beds. Some children cannot be given breathing support because we do not have cheap equipment to check oxygen saturation. These are children who may become ill from respiratory arrest. Children are discharged from the hospital prematurely and sent from the intensive care wards to the normal ones earlier than necessary."

There are no more free beds in the clinics

A survey conducted by DIVI, the German Interdisciplinary Association for Intensive and Emergency Medicine, revealed that one in two clinics is forced to refuse additional children to the intensive care unit. Of the 110 children's clinics, 43 of them no longer had any free beds in the intensive care wards.

In addition, even if there are enough intensive care beds, 40 percent of them cannot be used due to lack of staff. "We are all exhausted," says the Charité hospital children's doctor, "there are shortages in all corners, including staff shortages, to cope with the many arrivals."

The problem is not that German children's clinics have not made predictions about what awaits them this winter. Since January Mehrak Yoosefi, together with the initiative of pediatric clinics in Berlin, a group of doctors and physicians of the capital turned to politics. But he got no answer. A second letter of appeal to Berlin's health senator Ulrike Gote (Greens) and Social Democrat Health Minister Karl Lauterbach followed in September. "We predicted this virus wave. And now the shock is great, because the situation is much worse than thought."

 

Medical treatment of children requires more time and a different approach than treating adult patients


300 million euros for pediatrics in the next two years

Late, very late for this winter came the reactions from politics. The German parliament approved a legal package for hospitals, which will give more money to the empty coffers of children's clinics. 300 million euros more will be given in 2023 and 2024. As well as 120 million euros for providing obstetric places. But Yoosefi is deeply angered by Health Minister Karl Lauterbach's proposals to deal with the current crisis by sending staff from other wards to children's hospitals.

"On paper it is easy to say that mail can be sent from one place to another. And where can these people be found to receive them? Other pavilions don't have excess staff, which they can spread left or right. In addition, children's health is a specialty in itself. Personnel who usually work with adults feel partly insecure about working in pediatrics."

Disadvantages of general nursing education

Nursing education would become more modern and interesting with the changes made as of January 1, 2020, the federal Ministry for Family Affairs proudly announced at the time. But three years later, children's clinics are painfully aware that the so-called general education of nurses, where employees of all ages and all sectors of health care are allowed to work, has not only advantages.

Professor Jörg Dötsch, director of the pediatric clinic of the University of Cologne and president of the German Association for Pediatric and Adolescent Medicine, sees a high-risk gap in nursing: "A few years ago the decision was made to adapt the education of nurses to European customs. Hoping that some of these people might specialize in caring for sick children. The problem is that the share of those who have specialized in this field is very small. Perhaps more critical is work, because in some German states the opportunities for this specialization are not offered at all."

In addition, just like in adult nursing, pediatric clinic nurses quit their jobs during and after the Corona pandemic. Previously, people worked 30 or 40 years in nursing, today they leave this profession after eight, nine years, notes Dötsch. These are the people who are often missing to deliver optimal care to children and young people. "We have shortages of qualified personnel and therefore we cannot use all the beds now."

Payment for the number of fatal patients, especially for children's clinics 

Shqetësim krijon po ashtu pagesa e infermierëve për numër të sëmurësh, sidomos për spitalet e fëmijëve. Që nga viti 2004, shërbimi në spitale paguhet sipas diagnozës së të sëmurit, jo sipas personelit që i shërben të sëmurit dhe kohës që harxhon me të. Ndërkohë që për një injeksion tek një i rritur duhet një minutë, për të marrë analizat e gjakut, tek një fëmijë dhe për të sqaruar prindërit e tij duhet gjysmë ore. “Për fëmijët dhe të rinjtë duhet më shumë energji dhe kohë, sepse ata dhe prindërit e tyre kanë nevoja të tjera kujdesi,” thotë drejtori i klinikës së fëmijëve, Dötsch.

However, the Minister of Health Karl Lauterbach has announced that in the future, treatment decisions in clinics will not be made by economic obligations, but by medical needs, and that the system of payment according to the number of patients treated will soon be ended. , as if we are dealing with stores that sell "cheap and wholesale" food. Mehrak Yoosefi, a pediatrician in Berlin, can't wait for this to happen: "Pediatrics needs to get out of the system of payment according to the number of patients and needs to find another way of financing."


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