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Comment by adrianN | Hacker News Reader

Of course there is an exceptional number of ICU patients. Many hospitals in Germany already are running at capacity and can't admit any more ICU patients. And that's despite every postponable operation being postponed.

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I have posted the official chart of ICU occupation in Germany. How can you argue with that? Covid patients are only a small fraction of the occupied beds.

In general it makes sense to use existing ICU beds at capacity (or slightly below), to, you know, make use of them.

Surely you could also still adjust by delaying surgical procedures that are not urgent, if things would get worse.

You said it yourself, you want to run ICUs close to capacity, so you can't just add another 10% (or 27% like in Berlin right now) for COVID patients without calling it exceptional load. Procedures are already being delayed to free up extra capacity, and nurses are working overtime. The system is fairly close to collapse and we're lucky that the current measures stopped the growth of new infections, albeit at a very high level. We couldn't handle another doubling.

Only 20% of patients are in ICU because of Covid, so it is simply incorrect to claim that because of Covid the system is close to collapse. It is not. And if you call more than 80% use (which we don't even have) "exceptional load", it still isn't the same as "close to collapse". Have you even looked at the charts? If you count the emergency reserve, there is still capacity for 15000 more beds. A "doubling of cases" would put 4000 more people into ICU, so it wouldn't break the system at all. https://www.intensivregister.de/#/aktuelle-lage/zeitreihen

As for nurses working overtime, do you have any data for that? Quoting some individual hospital managers warning of "possible collapse" is not really evidence. They can also be politically motivated ("see, we really need more money for our ICU section"). You can also find individual hospital managers saying everything is fine.

The offical numbers say that German's hoslitals are not running at their limits. In average roughly 20% of intensive care beds are not occupied.

https://www.intensivregister.de/#/aktuelle-lage/kartenansich...

The regional differences are pretty high, and beds are in many cases not the limiting factor. It's ICU nurses.

If you can read German here is a source for Berlin: https://www.tagesspiegel.de/berlin/zu-viele-corona-patienten...

TLDR is only 85% of the beds are full, but there aren't enough nurses, so the emergency room will be closed. Several other hospitals in Berlin already stopped admitting new ICU patients.

Yes, I read German. But this is not a singular event that has never happened before. Here is a report from 2017 that sounds familiar:

https://www.welt.de/regionales/bayern/article161869919/Klini...

Yes of course, there are other occasions where this happens, but I consider in very good evidence against the claim that there is no exceptional ICU load right now.

Yes, situation is bad, but we will make it. Prof. Kluge does not sound too pessimistic. If you have time, take a look at his report about the flu season 2017/18. Pretty grim stuff, more than 40% of intensive care patients died.

https://www.researchgate.net/publication/333785335_Managemen...

As other said, it is not that unusual that individual units are full. As for staff, if things would become dire, surely more capacity could be mustered (people working overtime and so on).

And if it is really such a limiting factor, the statistics should be adjusted accordingly.

I think it is just a wildcard argument without any specific numbers. You can imagine whatever you like. How many nurses are available? How many are sick, specifically?

Also, sick nurses tend to be well again after two weeks (if they have Covid).

You never run ICUs at 100% because where would you put the people who have car crashes etc?

Optimal rate depends on the country, but about 75% is typical.

Sure, but that is exactly the case in Germany, only 80% are in use, as would be expected in normal times. Presumably they can adjust by delaying surgical procedures that are not urgent.

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