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HEALTH

Telemedicine takes off in Germany during pandemic

When doctor Andreas Bootsveld has to make life-or-death decisions about Covid-19 patients, he is not alone — as well as consulting his colleagues, he can draw on the advice of a team of specialists.

Telemedicine takes off in Germany during pandemic
Doctors at the University hospital in Aachen use telemedicine for the treatment via internet of Covid-19 patients. Photo: AFP

These experts are not with him in the intensive care unit, but at a bigger hospital 20 kilometres (12 miles) away, linked up via videoconference as part of a project to connect medics in the state of North Rhine-Westphalia.

The project dubbed the Virtual Hospital has been running since March and aims to help smaller hospitals take in and care for Covid-19 patients, preventing major hospitals from becoming overwhelmed.

So-called telemedicine has become increasingly popular during the pandemic and could also be used in the future to help improve access to specialist care in areas outside of big cities.

“Patients suffering from respiratory failure are normally cases for large, multi-disciplinary and very well-equipped hospitals,” said Gernot Marx, director of the intensive care unit at Aachen University Hospital, one of the centres of expertise for the project.

“Local and regional hospitals would not normally do that,” he told AFP.

Thanks to the virtual consultations, “we can do things that would have absolutely required a transfer before,” said Bootsveld. 

Doctor Judith Ibba, Clinic Director of Intesiv Medicine at the University hospital in Aachen Gernot Marx, and Joachim Koeck use telemedicine for the treatment of Covid-19 patients in Aachen. Photo: AFP

The doctor oversees 14 intensive care beds in the small hospital in the town of Stolberg — a fifth of the number overseen by Marx.

Telemedicine has made it possible to “safeguard intensive care capacity” during the pandemic, said project manager Sandra Dohmen. 

“So far, 90 percent of our patients have been able to stay in hospitals close to where they live,” she said.

READ ALSO: German Health Minister calls for cautious shutdown exist amid Covid-19 mutation concerns

Virtual advice network

North Rhine-Westphalia had already been connecting 17 local hospitals with the region's two big university hospitals through a virtual advice network since 2012.

But “the coronavirus in March was an opportunity to extend the offer” to all hospitals in the region, Dohmen said.

“There was a great fear that the situation in Germany would be comparable to that in Italy,” Marx said. 

Participants in the scheme have so far carried out more than 1,800 videoconferences, helping to treat 300 patients.

A similar EU-backed scheme called ICU4Covid is planned to help doctors monitor some 30,000 patients a year across several countries.

In Stolberg, virtual consultations are carried out with the help of a trolley, equipped with a computer and a camera, that can be wheeled from bed to bed.

Senior consultant Andreas Bootsveld (R) speaks with intensive care physician at the University hospital in Aachen Judith Ibba about a COVID-19 case while using telemedicine at the Bethlehem Hospital in Stolberg. Photo: AFP

But in the interests of speed in the pandemic, doctors can now also request a meeting at the click of a button with just a laptop and a webcam.

Among those joining the virtual meetings has been a pharmacist specialising in intensive care — one of only about 50 such specialists in Germany.

READ ALSO: Can Germany get on board with a 'no Covid' strategy?

'Added value'

“Faced with Covid-19 and the many unknowns, the Virtual Hospital makes it possible to create a network for sharing expertise to help patients on site,” said Dohmen, who sees it as “great added value”.

This virtual link has also helped reassure relatives who may have been worried about their loved ones not being treated in a university hospital.

And it can be reassuring for the staff, too, “when they confirm that we have thought of everything” –although “it has to remain a consultation, it must not become remote treatment”, Bootsfeld said.

“It clearly doesn't mean that we were doing a bad job before,” but “we have access to specialist knowledge that we would not normally have in a local hospital,” said the doctor.

Senior consultant Andreas Bootsveld and colleagues attend a video conference with the University hospital in Aachen about a COVID-19 case while using telemedicine at the Bethlehem Hospital in Stolberg. Photo: AFP

But some things have not changed in a country famously lagging behind in the digital revolution: participants of a meeting still have to take notes by hand, and lists of medicines are sent by fax.

The next step for the project will be to devise ways of transferring health data such as vital signs automatically during the calls.

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HEALTH

Could there be a new wave of Covid-19 in Germany this autumn?

It’s back again: amid sinking temperatures, the incidence of Covid-19 has been slowly rising in Germany. But is this enough to merit worrying about the virus?

Could there be a new wave of Covid-19 in Germany this autumn?

More people donning face masks in supermarkets, friends cancelling plans last minute due to getting sick with Covid-19. We might have seen some of those familiar reminders recently that the coronavirus is still around, but could there really be a resurgence of the virus like we experienced during the pandemic years?

According to virologists, the answer seems to be ‘maybe’: since July, the number of people newly infected with Covid-19 has been slowly rising from a very low level.

According to the Robert Koch Institute (RKI), nine people per 100,000 inhabitants became newly infected in Germany last week. A year ago, there were only around 270 reported cases.

Various Corona variants are currently on the loose in the country. According to the RKI,  the EG.5 (also called Eris) and XBB.1.16 lines were each detected in the week ending September 3rd with a share of just under 23 percent. 

The highly mutated variant BA.2.86 (Pirola), which is currently under observation by the World Health Organisation (WHO), also arrived in the country this week, according to RKI. 

High number of unreported case

The RKI epidemiologists also warned about a high number of unreported cases since hardly any testing is done. They pointed out that almost half of all registered sewage treatment plants report an increasing viral load in wastewater tests.

The number of hospital admissions has also increased slightly, but are still a far cry from the occupation rate amid the pandemic. Last week it was two per 100,000 inhabitants. In the intensive care units, only 1.2 percent of all beds are occupied by Covid-19 patients.

Still, a good three-quarters (76.4 percent) of people in Germany have been vaccinated at least twice and thus have basic immunity, reported RKI. 

Since Monday, doctors’ offices have been vaccinating with the adapted vaccine from Biontech/Pfizer, available to anyone over 12 years old, with a vaccine for small children set to be released the following week and one for those between 5 and 11 to come out October 2nd.

But Health Minister Karl Lauterbach has so far only recommended that people over 60 and those with pre-existing conditions get vaccinated.

READ ALSO: EXPLAINED: Who should get a Covid jab this autumn in Germany?

“The pandemic is over, the virus remains,” he said. “We cannot predict the course of coming waves of corona, but it is clear that older people and people with pre-existing conditions remain at higher risk of becoming severely ill from Covid-19”

The RKI also recommended that people with a cold voluntarily wear a mask. Anyone exhibiting cough, cold, sore throat or other symptoms of a respiratory illness should voluntarily stay at home for three to five days and take regular corona self-tests. 

However, further measures such as contact restrictions are not necessary, he said.

One of many diseases

As of this autumn, Covid-19 could be one of many respiratory diseases. As with influenza, there are no longer absolute infection figures for coronavirus.

Saarbrücken pharmacist Thorsten Lehr told German broadcaster ZDF that self-protection through vaccinations, wearing a mask and getting tested when symptoms appear are prerequisites for surviving the Covid autumn well. 

Only a new, more aggressive mutation could completely turn the game around, he added.

On April 7th of this year, Germany removed the last of its over two-year long coronavirus restrictions, including mask-wearing in some public places.

READ ALSO: German doctors recommend Covid-19 self-tests amid new variant

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