The coronavirus reached Lower Franconia about ten weeks ago. What about the clinics? Is the second wave coming? A Würzburg intensive care doctor provides answers.
The first Corona cases became known in the region in early March. Images of overburdened clinics and more and more dead came from Italy, the new virus presented enormous challenges for doctors, virologists and politicians alike. And today? “We learned a lot from a medical point of view in the corona crisis,” says Prof. Patrick Meybohm, intensive care physician and director of the Clinic for Anesthesiology at the University Hospital in Würzburg. In an interview, he explains what seriously ill Covid 19 patients need, why he does not expect a tsunami of new infections and why Lower Franconia was lucky.
Question: The corona pandemic reached Lower Franconia about ten weeks ago. How did you experience the treatment of the first patients?
Prof. Patrick Meybohm: At the beginning of March there was a mixture of excitement, excitement and a little worry in the intensive care unit, according to reports from other countries. At the same time, however, we had a certain level of self-confidence. We knew that we are well prepared in Germany with our structures and expertise in intensive care.
How many patients with Covid-19 are currently in your intensive care unit?
Meybohm: We currently have seven corona patients, a total of just under 40. At the height of the epidemic, 21 patients had to be treated at the same time by intensive care medicine.
Were you and your employees initially afraid of the virus?
Meybohm: I wouldn’t say fear. We have been specializing in seriously ill, infectious patients for years. Experience gives security. We also trained in advance – such as how protective equipment is put on and taken off properly to avoid infection.
Photo: R. Wenzl / University Hospital Würzburg
–Are Covid 19 sufferers different from other intensive care patients?
Meybohm: Not for the first few hours or days after admission. Like most other cases, there are also seriously ill patients who need a lot of care and a lot of effort, especially for our intensive care staff. It is different that corona patients tend to be younger in intensive care units and that it takes them longer to recover from pneumonia.
But does it mean that an infection can be dangerous, especially in older people?
Meybohm: There are also these cases. Since the intensive care medicine of the University Hospital in Würzburg is an expert center, the younger and middle-aged patients in particular are sent to us from the late 40s to the early 60s.
What makes treatment of Covid-19 difficult?
Meybohm: Most corona patients show only mild flu symptoms. But: the virus is quite persistent in some patients and we have them in the intensive care unit. Coronavirus usually causes concomitant damage in such patients: This not only attacks the lungs, but also often leads to problems with the kidneys or the blood coagulation system. Above all, the recovery takes longer, you need a lot of patience. We have young patients who have been in our intensive care unit for more than 40 days.
Can the body recover after such a long treatment?
Meybohm: Yes, but impairments can remain with the seriously ill. If you have been in an intensive care unit for a long time, you need a lot of time and patience to return to your old life and job with rehab, physiotherapy and training.
Photo: JONATHAN NACKSTRAND, afp
–How many of your patients have died?
Meybohm: With other clinics in Germany, we recently analyzed more than 100 cases. According to this, almost 70 percent of the corona intensive care patients survive. This is a very good result compared to other countries.
When a Covid 19 patient comes to your ward today, you now have the feeling that we have it under control?
Meybohm: We learned a lot from a medical point of view during the corona crisis. Hundreds of study results have been published in recent weeks, some data also came from Würzburg. Every day we read in our team what’s new. The new knowledge provides security. Nevertheless, in individual cases it is always a life-threatening illness. We are glad that we can offer so much in intensive care medicine in Germany – whether dialysis machines, artificial ventilation or a so-called Ecmo as an artificial lung. These are all therapies that we can afford and that save lives in individual cases.
In your view, were and are the political measures justified to protect people from infection?
Meybohm: Absolutely. The restrictions came at a time when we didn’t know how the pandemic would continue. Back then, a large number of patients came to hospitals and intensive care units in a short period of time, which was also surprising. Some clinics were almost at their limit or had to send patients to other houses because they would otherwise not have made it. This happened without hospitals being able to prepare for a long time. The measures were therefore surely justified. It is speculative whether the number of infections would have dropped again in recent weeks without the initial restrictions.
Photo: Heiko Becker
–What do you think of the easing?
Meybohm: The easing is necessary to reduce collateral damage in society and also to reduce the economic impact. I personally believe that you definitely need it. We also have other patients – such as the chronically ill with high blood pressure, weak heart or patients with a new tumor – who are now sitting at home and do not trust the doctor or the hospital. These people also have the right to fast, timely and good care. But you have to accompany the easing. It is important to take the population with you, to train them and to ensure that hygiene and safety measures are observed.
According to the Ministry of Health, 30 percent of the intensive care capacities for corona patients are to be kept free in Bavaria’s hospitals. Is that enough?
Meybohm: That’s enough. The patients do not stand at the door overnight. The development is like a wave that increases in a week or two. So long you have enough time to get your beds free again.
Do you fear a second wave of infections?
Meybohm: In my view, the number of infections will increase and with it the number of intensive care patients. But this will not be a tsunami like in March, but probably a flat wave. In addition, many hospitals have learned and have become braver and safer in caring for corona patients.
Do you think the region’s health system can withstand this second wave again?
Meybohm: Definitely: yes. Our health system in Lower Franconia was never at risk or at the limit. But we were just a little bit lucky.
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